text:
Factors associated with dietary patterns in adolescents: A school-based study in Cuiabá, Mato Grosso
- Neil Dorsey
- 2 years ago
- Views:
1 Factors associated with dietary patterns in adolescents: A school-based study in Cuiabá, Mato Grosso Fatores associados a padrões alimentares em adolescentes: um estudo de base escolar em Cuiabá, Mato Grosso Paulo Rogério Melo Rodrigues I Rosangela Alves Pereira II Diana Barbosa Cunha III Rosely Sichieri III Márcia Gonçalves Ferreira I Ana Amélia Freitas Vilela I Regina Maria Veras Gonçalves-Silva I I Faculdade de Nutrição da Universidade Federal de Mato Grosso, MT. II Instituto de Nutrição Josué de Castro da Universidade Federal do Rio de Janeiro, RJ. III Instituto de Medicina Social da Universidade do Estado do Rio de Janeiro, RJ. Abstract Objective: To identify dietary patterns among adolescents and to assess their association with socioeconomic and lifestyle characteristics and nutritional status. Methods: A probabilistic clustered two-stage sample of students between 14 and 19 years old from public and private high schools from Cuiabá, Mato Grosso, Brazil, was investigated (n = 1.139). A selfadministered food frequency questionnaire was used to obtain information on food intake. Nutritional status was classified according to the Body Mass Index (BMI = weight/height 2 ) z-score. Socioeconomic status was inferred by the education level of head of household and by the presence of electrical appliances in the household. Dietary patterns were identified by applying exploratory factor analysis (extraction method: principal component analysis) and their relationship with socioeconomic conditions, lifestyle variables, and nutritional status was estimated by mutually adjusted multilinear regression models. Results: Western, traditional and mixed dietary patterns were identified. Studying in the morning hours and reporting the intake of alcoholic beverages were associated with greater adherence to the Western pattern. Male low-income students from public schools who have a BMI in the normal range preferred the traditional pattern. The mixed pattern was adopted by boys from public schools reporting physical activity. Conclusion: Several factors were associated with dietary patterns of adolescents and the Brazilian traditional diet was associated with normal weight. Keywords: Dietary patterns. Factor analysis. Socioeconomic condition. Lifestyle. Nutritional status. Adolescents. Correspondência: Regina Maria Veras Gonçalves da Silva. Rua 27, nº 207 Bairro Boa Esperança, CEP Cuiabá, MT
2 Resumo Objetivo: Identificar padrões alimentares de adolescentes e sua associação com características socioeconômicas, estilo de vida e estado nutricional. Métodos: Investigou-se amostra probabilística de estudantes entre 14 a 19 anos de idade do ensino médio público e privado de Cuiabá/Mato Grosso (n = 1.139). Os dados foram coletados em sala de aula utilizando-se questionário autoaplicado. Para a obtenção de dados de consumo alimentar, aplicou-se questionário de frequência alimentar semiquantitativo. O estado nutricional foi classificado pelo escore z do Índice de Massa Corporal (IMC = peso/estatura 2 ). Para a classificação socioeconômica considerou-se a escolaridade do chefe da família e a presença de bens e equipamentos no domicílio. Os padrões alimentares foram identificados por meio da análise fatorial exploratória (método de extração: análise de componentes principais) e sua associação com as características socioeconômicas, estilo de vida e estado nutricional foi estimada por modelos de regressão linear múltipla mutuamente ajustados para os outros padrões. Resultados: Foram identificados três padrões alimentares: ocidental, tradicional e misto. Estudar no turno vespertino e consumir bebidas alcoólicas foram associados (p < 0,05) a maior aderência ao padrão ocidental. Meninos de escolas públicas, com menor poder aquisitivo e IMC na faixa de normalidade aderiam ao padrão tradicional. O padrão misto foi adotado pelos meninos, estudantes de escolas públicas e que relataram prática de atividade física. Conclusão: Em adolescentes, vários fatores se associam aos padrões alimentares, mas destacamos que o consumo dos alimentos tradicionais da dieta brasileira associou-se ao IMC na faixa de normalidade. Palavras-chaves: Padrões alimentares. Análise fatorial. Nível socioeconômico. Estilo de vida. Estado nutricional. Adolescentes. Introduction The traditional approach to food intake assessment for investigating the isolated effect of nutrients or foods prevents a good understanding of the relationship between dietary intake and health outcomes. 1 People usually do not eat isolated foods or nutrients 2 but combinations of several foods, nutrients and other components that can interact with each other, 3 making human diet a complex and dynamic exposure factor. 4 Dietary patterns has been a focus of studies that aimed to explore the complex relationship between diet and health outcomes. 5,6 This alternative approach helps overcome the limitations in the analysis of diet-disease 3 as it seeks to examine food intake globally. 6-8 Cutler et al. 9 have suggested that dietary pattern analysis can provide results that are more relevant to public health actions, especially in the formulation of dietary recommendations and guidelines. Dietary patterns among adolescents have been assessed in several countries. 4-6,8,9,16-18 In Brazil dietary patterns have been identified in adults but there are few studies approaching adolescents dietary patterns. The current study aimed to identify dietary patterns among adolescents of Cuiabá, Mato Grosso, Brazil and to assess their association with socioeconomic and lifestyle characteristics and nutritional status. Methods A cross-sectional school-based study was conducted with both female and male adolescents between 14 to 19 years old attending public and private high schools in the urban area of the city of Cuiabá, state of Mato Grosso, in the Central-Western region of Brazil, in According to the 2006 students census, to 19 years-old adolescents were enrolled in the city s schools: in state public schools, in federal public schools, and in private schools. 663
3 To estimate the sample size, we used a 95% confidence level, sampling error of 3% and an expected eating disorders prevalence of 0.50, totaling adolescents. There was an addition of 20% to the sample size given the likelihood of losses and/or refusals, totaling adolescents. A two-stage cluster sampling design was applied. In the first stage every one of the 62 high schools of Cuiabá was considered a cluster to guarantee the representativeness of each type of school. Based on the total number of adolescents attending each school, 10 schools were selected: seven state public schools, one federal public school and two private schools. In the second stage, the classes were randomly drawn up until to complete a minimum of 128 students per school. Pregnant or breast-feeding adolescents and those with any physical or mental condition that could prevent them from completing data collection were not eligible for the study. An informed consent form was signed by all adolescents over 18 or parents / legal guardians of those under 18. Permission for data collection was also obtained from all school principals. The study was approved by the Research Ethics Committee from Júlio Muller University Hospital, Federal University of Mato Grosso (protocol no. 459/ CEP-HUJM/07). The study was conducted by a trained team of nutritionists. The students in the classroom were given a self-administered questionnaire comprising standard questions about demographic, socioeconomic and lifestyle characteristics and a semi-quantitative Food Frequency Questionnaire (FFQ). The questionnaire was previously tested in a similar group of adolescents from a school not included in this study in order to evaluate whether the questions were easily understood, correct possible mistakes and standardize the instrument for data collection. To reduce the non-response rate, all schools were visited at least three times in an attempt to meet students who have been absent in previous visits. Self-reported weight and height in adolescents have been validated by Brener et al. 19 and Farias-Júnior 20 for epidemiological studies. Brener et al. 19 found correlations coefficients of 0.90 and 0.93 between selfreported and measured weight and height, respectively, and an intraclass correlation coefficients over 0.90 for female and male adolescents (between 15 to 18 years old). 20 Body Mass Index (BMI = kg/m 2 ) was estimated to classify the nutritional status of adolescents according to the World Health Organization (WHO) recommendations. 21 Adolescents with BMI/age +1 z-score were classified as normal weight; those with BMI/age > +1 z-score were classified as excess body weight including overweight and obesity. Information on type, frequency and duration of physical activity practiced in a typical week was gathered. The time (in minutes) of each physical activity was multiplied by the weekly frequency and total activity time was then assessed by adding up time spent on each activity. Adolescents were classified according to the level of physical activity as proposed by Currie et al. 22 in: (a) sedentary (lack of physical activity); (b) insufficiently active (up to 299 minutes of physical activity per week); and (c) active ( 300 minutes of physical activity per week). Information on alcoholic beverages intake (beer, wine and/or spirits) was obtained from the FFQ for the six months preceding the study. Adolescents were classified as alcoholic beverage reporters (regardless of the amount, frequency and type) and nonreporters. Smoking was assessed according to WHO criteria, 23 and smokers were those who reported having smoked at least one day in the last 30 days. The families socioeconomic level was categorized according to the Brazilian Marketing Research Association (Associação Brasileira de Empresas de Pesquisa, ABEP) criteria. 24 These criteria include the number of home appliances, cars and paid maids, and head of household education level. The families were categorized, according to their 664
4 scores, from grade A (highest) to E (lowest). Food consumption was assessed using a modified version of the FFQ that was developed and validated for adults in Cuiabá. 25 The modifications were based on a FFQ developed and validated for adolescents in the city of Rio de Janeiro 26 to include food items commonly consumed by adolescents. The original FFQ consisted of 81 food items, eight were excluded and three were included (cereal-based foods and breakfast cereals, omelet, and wine). The final FFQ used in this study included 76 food items. The FFQ provides eight response options (from more than 3 times a day to never or almost never) for reporting frequency of consumption and up to three choices of servings for 72 food items. The options of frequency consumption were defined based on a FFQ developed for adults 27 and adolescents, 26 both in Rio de Janeiro. Only the frequency of consumption was recorded for garlic, onions, peppers and guarana powder. Identification of dietary patterns Food items listed in the FFQ were grouped into 22 food groups (Table 1) according to their nutritional characteristics and frequency of consumption. The four items for which the amount consumed was not reported were not included in this analysis. Some food items were analyzed separately because they were either representative of some dietary patterns (e.g., milk and coffee) or were regional traditional foods (rice, beans, bread, fish and fried banana). Dietary patterns were identified based on the frequency of consumption of each of the 22 food groups using exploratory factor analysis. First, the Bartlett Test of Sphericity (BTS) and the Kaiser-Meyer-Olkin Measure of Sampling Adequacy (KMO) were used to assess data adequacy for factor analysis. The factor analysis model was appropriate as KMO was greater than 0.6 and the BTS showed a p< A correlation matrix was then constructed. For extraction of factors a principal component analysis with orthogonal (Varimax method) rotation (orthogonal transformation of factors) was used for creating independence between factors and thus enhancement of data interpretability. 2 The Cattell s scree plot was used to determine the number of factors to be extracted. It is derived by plotting the eigenvalues against the number of factors in their order of extraction. Any values to the left of the inflection point were retained. 28 The first model was test without setting the number of factors (patterns); the number of retainable factors was determined by the Cattel s Scree Plot method. Then, a second a second model was tested setting the number of patterns to be retained according to that indicated in the plot. Food groups with factor loadings greater than 0.30 and communality over 0.20 were retained in the patterns identified. The internal consistency of extracted factors was assessed using Cronbach alpha index, and values above 0.60 were considered acceptable. 29 Dietary patterns were named based on interpretability and characteristics of the items retained in each pattern. Data analysis Continuous variables were tested using the Kolgomorov-Smirnov to assess symmetry of distributions. In the univariate analysis, the chi-square test was used assess the association between independent variables and dietary patterns. The factor scores of each pattern were categorized into quartiles, and the intermediate quartiles were combined to facilitate the interpretation of associations. Multivariate linear regression models were used to assess the association between socioeconomic and lifestyle characteristics and nutritional status and dietary patterns. Each model was mutually adjusted for other patterns. The dependent variables were factor scores (continuous variables) of food patterns and the independent variables included variables with p<0.20 in the univariate analysis. 665
5 Table 1 Food groups from the Food Frequency Questionnaire (FFQ) used in factor analysis. with respective medians and interquartile range of servings consumed (g or ml) by adolescents (n=1.139) from Cuiabá. Mato Grosso Tabela 1 Agrupamentos dos alimentos do Questionário de Frequência Alimentar (QFA) utilizados na análise fatorial. com respectivas medianas e intervalos interquartílicos das porções diárias consumidas (g ou ml) por adolescentes (n = 1.139) de Cuiabá. Mato Grosso Rice Foods Daily portion median (Interquartile range) (in grams) Beans Rice ( ) Breads Beans ( ) Cakes, cookies, crackers French roll, loaf of bread ( ) Processed foods Plain cake, cake with filling and topping, with preserved fruits, cookies, crackers, filled cookies, salty crackers 97.8 ( ) Pasta Breakfast cereals and canned vegetables 4.1 ( ) Tubers and roots Pasta 25.2 ( ) Milk Baked, mashed potato, sweet potato, yam, manioc, manioc flour, farofa [toasted cassava flour], manioc mush 37.2 ( ) Dairy products Milk ( ) Beef Cheese, yogurt, curd 45.0 ( ) Other meats Beef 73.1 ( ) Fish Chicken, pork and sausages 69.9 ( ) Deli meats Fresh fish 11.2 ( ) Eggs Cold cuts (bologna, ham, fatty ham, salami, frankfurter) and smoked meats (bacon, pork loin, beef jerky) 12.0 ( ) Fruits Eggs and omelet 14.0 ( ) Green vegetables and legumes Coffee Orange, tangerine, banana, papaya, apple, watermelon, pineapple and mango Lettuce, cabbage, kale arugula, watercress, cauliflower, broccoli, tomato, cucumber, chayote, gherkin, eggplant, squash, zucchini, carrots, beets, okra ( ) ( ) Sugar-sweetened beverages Coffee 7.0 ( ) Fast-food Fried banana Soft drinks, fruit juices or pulp, guaraná soft drink syrup, tea, mate tea Pizza, hot dogs, hamburgers, French fries, chips, cheese rolls, appetizers (fried turnover, kibbeh, fried pastry, chicken croquette, sfiha), salty snacks, mayonnaise, popcorn ( ) ( ) Sweets Fried banana 4.2 ( ) Butter and margarine (g) Condensed or flavored milk, candy, jelly, chocolate bar, chocolate powder, ice cream, popsicles, sugar ( ) Manteiga e margarina Butter and margarine 2.5 ( ) Results Of all adolescents eligible to participate in the study (n=1.344), a total of (96.4%) were examined. Eighty-seven students with missing information on demographic characteristics, date of birth or socioeconomic classification as well as 70 who reported an implausible energy intake (above or below 2 standard deviations [SD] 666
6 of the mean energy intake) were not included in the analysis. Thus, the final sample comprised adolescents (84.7% of all eligible). Table 2 shows the characteristics of the sample studied. Nearly 78% were public school students, 46% belonged to lower social classes (C and D), the mother was head of household in 34%, and 17% were overweight. The KMO (0.86) and BTS tests (p<0.01) showed that the data was adequate for factor analysis. The Cattell s scree plot indicated the retention of three factors (patterns). The three identified patterns were named as Western, traditional, and mixed ; together they explained 35.3% of the dietary intake variance (Table 3). The Western pattern explained 21.5% of the model variance and was characterized by high intakes of cakes and cookies, processed foods, dairy products, deli meats, sugar-sweetened beverages, fast foods, fried banana and sweets; the traditional pattern explained 7.8% of the model variance and was characterized by high intakes of rice, beans, bread, milk, beef, coffee, butter and margarine; finally, the mixed pattern was characterized by the consumption of pasta, tubers and roots, other meats, fish, eggs, fruits and green vegetables and legumes and explained 6.1% of the model variance. All food groups had positive saturation in at least one of the three dietary patterns retained and only three groups had communalities below 0.20 (processed foods, pasta and coffee). However, it was decided that these items should remain in the model as they were representative of the local culture and allowed to differentiate the dietary patterns identified. The internal consistency values of the factors (Cronbach s alpha index) were acceptable (close to 0.6) (Table 3). Table 4 presents the factors associated with the quartiles of factor scores of Western, traditional, and mixed dietary patterns in the univariate analysis. The Western pattern was associated to adolescents under 15 years-old, going to the school in the afternoon shift, being from higher socioeconomic category, and reporting the intake of alcoholic beverages. The traditional pattern was chosen by males, from public schools, low socioeconomic level, physically actives, and with normal weight. The mixed pattern was associated to males, from public schools, going to the school in the morning shift, non whites, reporting alcoholic beverages intake, which were physically actives. In the multiple linear regression analysis, the Western pattern was associated to the afternoon school shift and to the report of alcoholic beverages intake. Male lowincome students from public school whit normal weight showed greater adherence to the traditional dietary pattern. Also the mixed pattern was associated with physically active male adolescents from public schools. Increasing levels of physical activity, from sedentary to insufficiently active and then to active, was associated with a 10% increase in the mixed pattern scores (Table 5). Discussion The principal component analysis identified three dietary patterns among adolescents living in the city of Cuiabá, namely: Western, traditional, and mixed. The Western pattern, characterized by high consumption of energy-dense foods such as fast foods, sweets and sugar-sweetened beverages, was associated with the afternoon school shift and to the report of alcoholic beverages intake. The traditional pattern, mainly consisting of typical Brazilian foods including rice and beans, had greater adherence among normal weight adolescents. In contrast, the mixed dietary pattern, characterized by high intake of roots and tubers, meat, and fish, was positively associated with the increase in physical activity. Other studies with adolescents have also identified a dietary pattern similar to the Western pattern, including fast foods, soft drinks, sweets, cakes, cookies, French fries, refined grains, high-fat foods, dairy products, processed red meat, sauces, and salty snacks. 4,6,8,9,16-18 These foods have been 667
7 Table 2 - Distribution of adolescents according to socio-economic, demographic, and lifestyle variables and nutritional status, Cuiabá, Mato Grosso, 2008 (n = 1,139). Tabela 2 Distribuição dos adolescentes segundo as variáveis socioeconômicas e demográficas, estilo de vida e estado nutricional, Cuiabá, Mato Grosso, 2008 (n = 1.139). Variables N (%) Gender Male 506 (44.4) Female 633 (55.6) Age 15 years 396 (34.8) > 15 years 743 (65.2) Type of school Private 249 (21.9) Public 890 (78.1) Grade 1st year 504 (44.2) 2st year 384 (33.7) 3st year 251 (22.0) School time Morning 800 (70.2) Afternoon 339 (29.8) Skin color White 338 (29.7) Non-white 801 (70.3) Socioeconomic level* A + B (high-income) 618 (54.3) C + D (low-income) 521 (45.7) Head of household Father 663 (58.2) Mother 381 (33.5) Other person 95 (8.3) Smoking Yes 66 (5.8) No 1073 (94.2) Alcoholic beverage report Yes 431 (37.8) No 708 (62.2) Physical activity level** Sedentary 229 (20.1) Insufficiently active 449 (39.4) Active 461 (40.5) Nutritional status Normal weight (BMI <25 kg/m 2 ) 950 (83.4) Overweight (BMI 25 kg/m 2 ) 189 (16.6) *Segundo os critérios da Associação Brasileira de Empresas de Pesquisa 24 que classifica as famílias segundo as categorias econômicas, A e B são os grupos com maior poder aquisitivo, C e D incluem classe média e classe média baixa. * According to criteria of the Brazilian Association of Research Companies 24 which classifies households according to economic categories, A and B are groups with high purchasing power, C and D include the middle class and lower middle class. **A atividade física foi avaliada combinando o tempo e a frequência com que foram realizadas tais atividades, sendo que o tempo de atividade acumulada foi quantificado somando-se o tempo gasto com essas atividades nos últimos sete dias. 22 ** Physical activity was assessed by combining the time and frequency of exercising, and accrued physical activity time was calculated by summing the time spent on these activities in the past seven days
8 Table 3 - Rotated factorial matrix, factor loads and communalities (h 2 ) estimated for the three dietary patterns identified among adolescents, Cuiaba, Mato Grosso, 2008 (n = 1,139). Tabela 3 Matriz fatorial rotada, cargas fatoriais e comunalidades (h 2 ) estimadas para os três padrões alimentares identificados em adolescentes, Cuiabá, Mato Grosso, 2008 (n = 1.139). Food groups Factor loads Patterns Communalities Western Traditional Mixed Fast-food Sweets Deli meats Cakes, cookies, crackers Sugar-sweetened beverages Fried banana Dairy products Processed foods Rice Bean Breads Butter and margarine Coffee Milk Beef Tubers and roots Fishs Other meats Fruits Green vegetables and legumes Eggs Pasta Eigenvalues % of explained variance % of accumulated explained variance Cronbach alpha index associated with sedentarism 6, increased risk of metabolic disorders, 8,18 increased weight gain 8,18 in both male and female adolescents, as well as high waist circumference among female 18 and smoking among male adolescents. 6 The association of the Western pattern with the afternoon school shift may be reflecting the influence of social and cultural factors on eating habits. Possibly, adolescents attending the school in the afternoon are likely to have more opportunities to have out-of-home eating, favoring the choice of the convenience foods included in the Western pattern. This assumption is supported by Bezerra and Sichieri 30 who found that in Brazil out-of-home eating is strongly associated with the consumption of soft drinks, fried snacks, and sweets (POF ). The current study found that normal weight adolescents had greater adherence to the traditional dietary pattern. These results are consistent with other studies on dietary patterns among Brazilian adults that also observed a protective effect on body weight related to the traditional pattern. 10,14 Since this dietary pattern was also associated with lower socioeconomic condition, the association with normal weight can be linked to a less varied diet and lower exposure to more expensive 669
9 Table 4 Distribution (%) of adolescents according to the scores of dietary patterns classified in quartiles and to sociodemographic and lifestyle characteristics, and nutritional status, Cuiabá, Mato Grosso, 2008 (n = 1,139). Tabela 4 Distribuição (%) dos adolescentes segundo os escores dos padrões de consumo alimentar categorizados em quartis e as características sociodemográficas, de estilo de vida e estado nutricional, Cuiabá, Mato Grosso, 2008 (n = 1.139). Variables Western pattern (%) Traditional pattern (%) Mixed pattern (%) Q1 Q2+Q3 Q4 Q1 Q2+Q3 Q4 Q1 Q2+Q3 Q4 Scores ( -0.67) ( ) ( 0.50) p-valor * ( -0.79) ( ) ( 0.65) p-valor * ( -0.64) ( ) ( 0.40) p-valor * Gender Age Male (n=506) < < 0.01 Female (n=633) years (n=396) > 15 years (n=743) Type of school Private (n=249) < Public (n=890) Grade 1st year (n=504) st year (n=384) st year (n=251) School time Morning (n=800) Afternoon (n=339) Skin color White (n=338) < 0.01 Non-white (n=801) Socioeconomic level ** A + B (n=618) < C + D (n=521) Head of household Father (n=663) Mother (n=381) Other person (n=95) Smoking Yes (n=66) No (n=1073) Alcoholic beverage report Yes (n=431) < No (n=708) Physical activity level *** Sedentary (n=229) < <0.01 Insufficiently active (n=449) Active (n=461) Nutritional status Normal weight (n=950) < Overweight (n=189) *Teste do Qui-quadrado / *Chi-square test. **Segundo os critérios da Associação Brasileira de Empresas de Pesquisa 24 que classifica as famílias segundo as categorias econômicas, A e B são os grupos com maior poder aquisitivo, C e D incluem classe média e classe média baixa. **According to the criteria of the Brazilian Association of Opinion Poll Companies 24 which classifies households according to economic categories, A and B are groups with high purchasing power, C and D include the middle class and lower middle class. ***A atividade física foi avaliada combinando o tempo e a freqüência com que foram realizadas tais atividades, sendo que o tempo de atividade acumulada foi quantificado somando- -se o tempo gasto com essas atividades nos últimos sete dias. 22 *** Physical activity was assessed by combining the time and frequency of exercising, and the accrued physical activity time was calculated by summing the time spent on these activities in the past seven days
10 Table 5 - Multiple linear regression models for factors associated with dietary patterns scores in adolescents, Cuiabá, Mato Grosso, 2008 (n = 1,139). Tabela 5 Modelos de regressão linear múltipla * para fatores associados aos escores dos padrões alimentares de adolescentes, Cuiabá, Mato Grosso, 2008 (n = 1.139). β 95%CI ** p-value School time [morning (reference category) / afternoon] ; 0.34 < 0.01 Alcoholic beverage report [Yes (reference category) / No] ; < 0.01 Traditional pattern 2 Gender [male (reference category) / female] ; < 0.01 Type of school [private (reference category) / public] ; 0.43 < 0.01 Socioeconomic status [A+B (reference category) / C+D]*** ; Nutritional status [Non-overweight (reference category) / Overweight] ; < 0.01 Mixed pattern 3 Gender [male (reference category) / female] ; < 0.01 Type of school [private (reference category) / public] ; 0.36 < 0.01 Physical activity [sedentary (reference category) / insufficiently active / active]**** ; *Os modelos multilineares foram desenvolvidos como: escore do padrão alimentar (variável contínua) = intercepto + (coeficiente) * variáveis explanatórias. *The multilinear models were developed as: dietary pattern scores (continuous variables) = intercept + (coefficients)* explanatory variables. **Intervalo de Confiança de 95% / **95% Confidence Interval. ***Segundo os critérios da Associação Brasileira de Empresas de Pesquisa 24, que classifica as famílias segundo as categorias econômicas, A e B são os grupos com maior poder aquisitivo; C e D incluem classe média e classe média baixa. ***According to the criteria of the Brazilian Association of Opinion Poll Companies 24 which classifies the families according to economic categories, A and B are groups with high purchasing power; C and D include the middle class and lower middle class. ****A atividade física foi avaliada combinando o tempo e a frequência em que foram realizadas tais atividades, sendo que o tempo de atividade acumulada foi quantificado somando-se o tempo gasto com essas atividades nos últimos sete dias. 22 ****Physical activity was assessed by combining the time and frequency of exercising practices, and the accrued physical activity time was calculated by summing the time spent on these activities in the past seven days Ajustado por sexo, idade, tipo de escola, série, turno, cor da pele, categoria socioeconômica, consumo de bebidas alcoólicas, padrão misto e padrão tradicional. 1 Adjusted by sex, age, type of school, grade, shift, ethnicity, social class, alcohol consumption, mixed pattern and traditional pattern. 2 Ajustado por sexo, idade, tipo de escola, categoria socioeconômica, atividade física, estado nutricional, padrão ocidental e padrão misto. 2 Adjusted by sex, age, type of school, social class, physical activity, nutritional status, western pattern and mixed pattern. 3 Ajustado por sexo, idade, tipo de escola, série, turno, cor da pele, categoria socioeconômica, tabagismo, consumo de bebidas alcoólicas, atividade física, estado nutricional, padrão ocidental e padrão tradicional. 3 Adjusted by sex, age, type of school, grade, shift, ethnicity, social class, smoking, alcohol consumption, physical activity, n utritional status, western pattern and traditional pattern. high-energy density foods. This pattern included cheaper foods contrasting with the Western pattern that included more expensive processed foods. Although this pattern also included butter and margarine and beef, these foods had smaller factor loadings (0.59 and 0.37, respectively) compared to rice and beans (0.67 and 0.64, respectively). Story et al. 31 have claimed that differences in food consumption between social classes can be explained by several interacting factors, for example, the availability and access to a larger variety of foods 4. Our study also found that the dietary pattern including healthy foods, such as fruits, vegetables and fish, also included pork, sausage and pasta; therefore, it was named as a mixed pattern. Nevertheless, the association between the mixed dietary pattern and increased levels of physical activity may be reflecting healthy food choices. While no other studies have identified a mixed dietary pattern among adolescents, other studies with adults have also identified dietary patterns similar to the mixed pattern described in this study, which were commonly characterized by high consumption of cereals, meat, eggs, fruit, fish, caffeinated beverages and vegetables. 10,14,32,33 They also found an inverse association of the mixed pattern with the body mass index (BMI), 32,33 blood pressure, and waist and abdominal circumference. 33 The current study was limited by the 671
11 use of a cross-sectional design, the use of self-reported weight and height, and by the constraints observed in the methods used for food intake assessment and in the analysis of dietary data. The purpose of a cross-sectional design study is to examine associations between variables, but it does not allow to making inferences on causal relationships. Thus, the apparent protective effect against excess weight of the traditional pattern needs to be further explored in longitudinal studies. The use of self-reported weight and height has been validated in adolescents, including in Brazil 20. This alternative can be used to estimate BMI in epidemiological studies when these measures cannot be easily taken 34. However, some differences between self-reported and measured weights and heights still can be observed 34. The FFQ is a largely used method designed to estimate usual food intake, but it has some limitations, including the fact that its understanding and interpretability. In addition, individual food preferences and availability can affect the retrospective report of food consumption. 35 On the other hand, the FFQ is a useful tool in epidemiological studies, as it is a low-cost field method and allows an easy data analysis process; moreover, it is not subject to the within-subject variability. Factor analysis have been the most widely used technique to identify dietary patterns. 36 However, its application requires making arbitrary decisions, though based on scientific knowledge on nutrition and diet, such as grouping food items, determining retention patterns, and interpreting results. Thus, the comparison of dietary patterns of different populations is limited because the patterns identified are specific to the population studied. Final considerations The three dietary patterns identified in adolescents of the city of Cuiabá were internally consistent and comparable to those identified in similar studies conducted in Brazil. This study showed that the Western pattern, characterized by high intake of energy-dense foods, fats, sugars and sodium, explained in most the variation in food consumption among adolescents. These findings point out to the need for healthy life style promotion actions targeted to Brazilian adolescents, including healthy eating, since these foods are associated with adverse outcomes such as metabolic disorders, hypertension, diabetes and cardiovascular disease. The main finding of this study was the protective effect against excess weight of the traditional dietary pattern characterized mainly by high intake of a combination of rice and beans, which are typical Brazilian staple foods. This same effect was previously seen in adults, and it stresses the importance of actions aimed at encouraging Brazilians to maintain traditional healthy eating habits, which has been being replaced by globalized dietary habits, especially among adolescents. Referências 1. Nicklas TA, Baranowski T, Cullen KW, Berenson G. Eating patterns, dietary quality and obesity. J Am Coll Nutr 2001; 20(6): Olinto MTA, Padrões alimentares: análise de componentes principais. In: Kac G, Sichieri R, Gigante DP (Org,). Epidemiologia Nutricional. Rio de Janeiro: FIOCRUZ e ATHENEU; p Hu FB. Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 2002; 13(1): Aranceta J, Perez-Rodrigo C, Ribas L, Serra-Majem LI. Sociodemographic and lifestyle determinants of food patterns in Spanish children and adolescents: the enkid study. Eur J Clin Nutr 2003; 57(S1):
12 5. McNaughton AS, Ball K, Mishra GD, Crawford DA. Dietary patterns of adolescents and risk of obesity and hypertension. J Nutr 2008; 138(2): Kourlaba G, Panagiotakos DB, Mihas K, Alevizos A, Marayiannis K, Mariolis A et al. Dietary patterns in relation to socio-economic and lifestyle characteristics among Greek adolescents: a multivariate analysis. Public Health Nutr 2008; 12(9): Kant AK. Dietary patterns and health outcomes. J Am Diet Assoc 2004; 104(4): Song Y, Park MJ, Paik H-Y, Joung H. Secular trends in dietary patterns and obesity-related risk factors in Korean adolescents aged years. Int J Obes 2010; 34(1): Cutler GJ, Flood A, Hannan P, Neumark-Sztainer D. Major patterns of dietary intake in adolescents and their stability over time. J Nutr 2009; 139(2): Sichieri R. Dietary patterns and their associations with obesity in the Brazilian city of Rio de Janeiro. Obes Res 2002; 10(1): Sichieri R, Castro JFG, Moura AS. Factors associated with dietary patterns in the urban Brazilian population. Cad Saúde Pública 2003; 19 (S1): Marchioni DML, Latorre MRDO, Eluf-Neto J, Wünsch- Filho V, Fisberg RM. Identification of dietary patterns using factor analysis in an epidemiological study in São Paulo. São Paulo Med J 2005; 123(3): Alves ALS, Olinto MTA, Costa JSD, Bairros FS, Balbinotti MAA. Dietary patterns of adult women living in an urban area of Southern Brazil. Rev Saúde Pública 2006; 40(5): Cunha DB, Almeida RMVR, Sichieri R, Pereira RA. Association of dietary patterns with BMI and waist circumference in a low-income neighbourhood in Brazil. Br J Nutr 2010; 27: Olinto MTA, Willett WC, Gigante DP, Victora CG. Sociodemographic and lifestyle characteristic in relation to dietary patterns among young Brazilian adults. Public Health Nutr 2011; 14 (1): Li J, Wang Y. Tracking of dietary intake patterns is associated with baseline characteristics of urban lowincome African-American adolescents. J Nutr 2008; 138(1): Ambrosini GL, Oddy WH, Robinson M, O Sullivan TA, Hands BP, Klerk NH et al. Adolescent dietary patterns are associated with lifestyle and family psycho-social factors. Public Health Nutr 2009; 12(10): Ambrosini GL, Huang R-C, Mori TA, Hands BP, O Sullivan TA, Klerk NH et al. Dietary patterns and markers for the metabolic syndrome in Australian adolescents. Nutr Metab Cardiovasc Dis 2010; 20: Brener ND, McManus T, Galuska DA, Lowry R, Wechsler H. Reliability and validity of self-reported height and weight among high school students. J Adolesc Health 2003; 32(4): Farias-Júnior JC. Validity of self-reported weight and height for adolescent nutritional status diagnosis. Rev Bras Saúde Matern Infant 2007; 7(2): Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmanna J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ 2007; 85: Currie C, Roberts C, Morgan A, Smith R, Settertobulte W, Samdal O, et al. Young people s health in context: Health Behaviour in Schoolaged Children (HBSC) study: international report from the 2001/2002 survey. Copenhagen: World Health Organization; p. 23. World Health Organization. Guidelines for controlling and monitoring the tobacco epidemic. Geneva; Associação Brasileira de Empresas de Pesquisa ABEP: Critério de Classificação Econômica Brasil; Disponível em critério_brasil_2008.pdf [Acessado em 10 de fevereiro de 2011] 25. Ferreira MG, Silva NF, Schmidt FD, Gonçalves-Silva RMV, Sichieri R, Guimarães LV, et al. Development of a food frequency questionnaire for adults in a populationbased sample in Cuiabá, mid-western region of Brazil. 2010; 13(3): Araújo MC, Yokoo EM, Pereira RA. Validation and calibration of a semiquantitative food frequency questionnaire designed for adolescents. J Am Diet Assoc 2010; 110: Sichieri R, Everhart JE. Validity of a Brazilian food frequency questionnaire against dietary recalls and estimated energy intake. Nutr Res 1998; 18(10): Cattel RB. The screen test for the number of factors. Multivariate Behavioral Research 1966; 1: Basilevsky AT. Statistical Factor Analysis and Related Methods Theory and Application. New York: Wiley Interscience; Bezerra IN, Sichieri R. Eating out of home and obesity: a Brazilian nationwide survey. Public Health Nutr 2009; 12(11): Story M, Neumark-Sztainer D, French S. Individual and environmental influences on adolescent eating behaviors. J Am Diet Assoc 2002; 102 (S3): Mishra GD, McNaughton SA, Bramwell GD, Wadsworth MEJ. Longitudinal changes in dietary patterns during adult life. Br J Nutr 2006; 96:
13 33. McNaughton SA, Mishra GD, Stephen AM, Wadsworth MEJ. Dietary patterns throughout adult life are associated with body mass index, waist circumference, blood pressure, and red cell folate. J Nutr 2007; 137: Fonseca H, Silva AM, Matos MG, Esteves I, Costa P, Guerra A et al. Validity of BMI based on self-reported weight and height in adolescents. Acta Paediatr 2010; 99(1): Drewnovski A. Diet image: a new perspective on the food-frequency questionnaire. Nutr Rev 2001; 59(11): Newby PK, Tucker KL. Empirically derived eating patterns using factor or cluster analysis: A review. Nutr Rev 2004; 62(5): Recebido em: 28/02/11 Versão final apresentada em: 09/07/11 Aprovado em: 31/08/11 674
Carbohydrate counting a pocket guide
counting a pocket guide www.bayerdiabetes.ca Contents Starches 3 Vegetables 4 Fruit/Fruit juices 5 Milk/Yoghurt 5 Fast foods 6 Proteins (meat/meat substitutes) 6 Drinks 6 Sweets/Sugary foods 7 CombinationMore information
Eat More, Weigh Less?
Eat More, Weigh Less? How to manage your weight without being hungry 607 calories 293 calories Department of Health and Human Services Centers for Disease Control and Prevention Can you weigh less withoutMore information
Healthy Eating During Pregnancy
Healthy Eating During Pregnancy Pregnancy is a time of great change. Your body is changing to allow your baby to grow and develop. Good nutrition will help you meet the extra demands of pregnancy whileMore information
My Diabetic Meal Plan during Pregnancy
My Diabetic Meal Plan during Pregnancy When you have diabetes and are pregnant, you need to eat small meals and snacks throughout the day to help control your blood sugar. This also helps you get in enoughMore information
DIETS AND DIET MODIFICATION LIST. Pudding: Liquids that have been thickened to a pudding consistency. They remain on the spoon in a soft mass.
DIETS AND DIET MODIFICATION LIST I. LIQUIDS a. Thick Liquids Pudding: Liquids that have been thickened to a pudding consistency. They remain on the spoon in a soft mass. Honey: Liquids that have been thickenedMore information
Healthy Eating for Diabetes
Healthy Eating for Diabetes What is diabetes? Diabetes is when your blood sugar (glucose) levels are higher than normal. For some people, this is because the insulin in their body doesn t work as wellMore information
Committee on Medical Aspects of Food and Nutrition Policy
Nutrient Intakes Last updated: December 2014 This paper describes how nutrient intakes are calculated from food purchases and how they are compared to nutrient recommendations and other dietary guidelines.More information
CALORIE NEEDS Minimum: Current weight (lb) x 20 = number of calories for males Current weight ( lb) x 15 = number of calories for females
NUTRITION CONDITIONING GOALS FOR ATHLETES Leslie Bonci, M.P.H., R.D. (412)432-3674 or email: email@example.com Director- Sports Medicine Nutrition University of Pittsburgh Medical Center Health SystemMore information
DIABETES & HEALTHY EATING Food gives you the energy you need for healthy living. Your body changes most of the food you eat into a sugar called glucose. (glucose) Insulin helps your cells get the sugarMore information
Ready, Set, Start Counting!
Ready, Set, Start Counting! Carbohydrate Counting a Tool to Help Manage Your Blood Glucose When you have diabetes, keeping your blood glucose in a healthy range will help you feel your best today and inMore information
When you have diabetes be careful about what you eat to help you control your blood sugar.
PART 5 INTRO TO EATING WITH DIABETES When you have diabetes be careful about what you eat to help you control your blood sugar. Foods are in three main groups: Carbohydrates (Carbs) Higher CarbohydratesMore information
Healthy Eating for Diabetes
Healthy Eating for Diabetes What is diabetes and why is it important to manage it? Diabetes occurs when there is too much glucose in the blood. Learning how to manage your diabetes will help you feel betterMore information
Dietary Guidelines For Americans
Dietary Guidelines For Americans Eat a variety of foods Maintain healthy weight Choose a diet low in fat, saturated fat, and cholesterol Choose a diet plenty of vegetables, fruits, and grain products UseMore information
Nonalcoholic Fatty Liver Disease. Dietary and Lifestyle Guidelines
Nonalcoholic Fatty Liver Disease Dietary and Lifestyle Guidelines Risk factors for NAFLD Typically, but not always seen in patients who are overweight. May have Diabetes and or insulin resistance highMore information
gestational diabetes my pregnancy, my baby, and me
gestational diabetes my pregnancy, my baby, and me What is Gestational Diabetes? Gestational diabetes occurs when your body cannot make adequate use of sugar in the blood. It is first found during pregnancy.More information
Eat Smart! Follow the. Healthy Eating. Food Pyramid!
Eat Smart! Follow the Healthy Eating Food Pyramid! Food contains various types of nutrients to keep us healthy. For the sake of health, the nutritional value, functions, freshness and hygiene conditionMore information
FACT SHEET N 394 UPDATED MAY 2015. Healthy diet
FACT SHEET N 394 UPDATED MAY 2015 Healthy diet KEY FACTS n A healthy diet helps protect against malnutrition in all its forms, as well as noncommunicable diseases (NCDs), including diabetes, heart disease,More information
Low Fat Diet after Cardiac Surgery With or Without Chyle Leak
Low Fat Diet after Cardiac Surgery With or Without Chyle Leak What is chyle? Chyle (sounds like kyle) is a milky white fluid that contains protein, fat, cholesterol, lymphocytes, and electrolytes. It isMore information
Boston Public Health Commission Healthy Food Procurement Guidelines. Standards for Purchased Beverages and Foods
Boston Public Health Commission Healthy Food Procurement Guidelines Standards for Purchased Beverages and Foods Boston Public Health Commission Healthy Food Procurement Guidelines Standards for PurchasedMore information
Instructions for Patient CHOLESTEROL/TRIGLYCERIDE LOWERING DIET 1. The purpose of this diet is to achieve and maintain a healthy range of blood fats known as cholesterol and triglycerides. This will lowerMore information
Duke Center for Metabolic and Weight Loss Surgery Pre-op Nutrition Questionnaire
Duke Center for Metabolic and Weight Loss Surgery Pre-op Nutrition Questionnaire Name Date How long have you been considering weight loss surgery? Which procedure are you interested in having? GastricMore information
American Cancer Society. Nutritional Guidelines for Reducing Your Risk of Cancer
American Cancer Society Nutritional Guidelines for Reducing Your Risk of Cancer Cancer Impact More than one million Americans will be diagnosed with cancer this year. Scientific evidence suggests thatMore information
Provider Guide Many families may find it difficult to pay for or get
introduction Hello! Provider Guide Many families may find it difficult to pay for or get access to nutritious foods. In such situations, they may find it especially hard to make healthy choices. As a providerMore information
Healthy eating for toddlers
Healthy eating for toddlers Toddlerhood is a time where children learn about new foods and where life long eating habits are often established. To help children grow up to be healthy adults, it is importantMore information
Nutrition Recommendations and Interventions for Diabetes
Nutrition Recommendations and Interventions for Diabetes S U P P L E M E N T Medical nutrition therapy (MNT) is important in preventing diabetes, managing existing diabetes, and preventing, or at leastMore information
Carbohydrate Counting (Quiz Number: Manatee3032009)
Page 1 The goal of Carbohydrate Counting is to make clear to you which foods affect your blood glucose and then to spread these foods evenly throughout the day (or to match insulin peaks and durations).More information
Nutrition Guidelines for Diabetes
Nutrition Guidelines for Diabetes Eating healthy foods and keeping a healthy body weight are very important parts of a diabetes treatment plan. A healthy diet and weight helps to keep your blood sugarMore information
Very Low Fat Diet for Chyle Leak
Very Low Fat Diet for Chyle Leak As part of your treatment, you are to follow a very low fat diet for 1 to 3 weeks or as directed by your doctor. Your goal is to eat as little fat as possible and no moreMore information
Youth Soccer Players Nutrition Schedule
Youth Soccer Players Nutrition Schedule Pride in the Program This is a guide used to assist in the healthy nutrition of a youth soccer player Table of Contents Typical Training Day Schedule..3 TournamentMore information
Canada s Food Guide Jeopardy
Canada s Food Guide Jeopardy Drafted: July 2008 Revised: December 2012 Eating Well with Canada s Food Guide Veg & Fruit Grain Products Milk & Alternatives Meat & Alternatives Physical Activity MiscellaneousMore information
1200 Calorie Menus Breakfast
1200 Calorie Menus Breakfast Choose one of these menus for breakfast: 1. ½ c. unsweetened 60 15 g. 0 1 fruit pineapple ½ English muffin 60 15 g. 0.5 g. 1 starch 2 tsp. low-sugar jelly 16 4 g. 0 Free CoffeeMore information
Healthy foods and drinks for children aged 1 4 years
Department of Health Healthy foods and drinks for children aged 1 4 years 13 Growing Strong Feeding you and your baby Great state. Great opportunity. 1 By the time your child is one year old, they shouldMore information
RÉVEILLON 2016. Hotel Apartamento Paraíso de Albufeira
RÉVEILLON 2016 PROGRAM 8 pm Cocktail Shows 9 pm Buffet Dinner Table wines, juices, mineral water, coffee and after dinner drinks Shows Midnight Sparkling wine service with raisins Open bar 02 am SupperMore information
Try pancakes, waffles, french toast, bagels, cereal, English muffins, fruit or juice. These foods are all high in carbohydrates.
Healthy Meals for Swimmers on the Go Notes on BREAKFAST - Start your day off right! Try pancakes, waffles, french toast, bagels, cereal, English muffins, fruit or juice. These foods are all high in carbohydrates.More information
The glycemic index (GI) is a ranking of foods based on their potential to raise blood glucose.
What is the Glycemic Index? The glycemic index (GI) is a ranking of foods based on their potential to raise blood glucose. Why is the level of blood glucose important in regards to eczema? A high bloodMore information
Lesson Overview. Learning Goals BASIC NUTRITION: GUIDELINES FOR BALANCED MEALS AND SPECIAL DIETS LESSON PLAN
BASIC NUTRITION: GUIDELINES FOR BALANCED MEALS AND SPECIAL DIETS LESSON PLAN Lesson Overview Time: One Hour This lesson covers the basics of good nutrition, recommendations for a balanced diet, and specialMore information
Will the cholesterol in my diet raise my blood cholesterol?
Healthy eating for your heart What does heart healthy eating mean to me? Heart healthy eating is an important part of a healthy lifestyle. Heart healthy eating, along with regular physical activity andMore information
Guidelines for Controlling Potassium
POTASSIUM Potassium is a mineral, which is found in all cells of the body and a certain level in the blood. Potassium helps to maintain fluid balance and normal muscle function. If your kidneys are unableMore information
Understanding the Carbohydrate Portions in Gluten Free Foods 1 Portion/Exchange = 15g
Understanding the Carbohydrate Portions in luten Free Foods 1 Portion/Exchange = 15g Know your Carbohydrate Foods Dairy Fruit Starchy vegetables Breads, cereals, rice, pasta/noodles, biscuits, flour(s)More information
NIT 5: Food I like. Debbie: Do you want some chocolate, Leo?
NIT 5: Food I like UNIT L e s s o n 1 1.vv vvlisten and read Debbie: Do you want some chocolate, Leo? Leo: No, thank you. I love chocolate but I can t eat it. I want to be a football player and sport menMore information
Belly fat is worse for you than fat elsewhere on your body. Excess accumulation of belly fat is more dangerous than excess fat around your hips and thighs. Belly fat is associated with serious health problems,More information
Mountain State Blue Cross Blue Shield Catering Menu
Mountain State Blue Cross Blue Shield Catering Menu Beverages Freshly Brewed Taylor & Byrnes Coffee Domesetic & Herbal Teas Served with hot water, honey and lemon. Assorted Canned Soft Drinks AssortedMore information
Good Foods for Young Mums-to-be
WOMEN AND NEWBORN HEALTH SERVICE King Edward Memorial Hospital Good Foods for Young Mums-to-be PREGNANCY Delivering a Healthy WA It is important to eat well when you are pregnant so that you and your babyMore information
Swimmers Nutrition. OBJECTIVE: To provide basic information on how proper eating and hydration can improve health and swimming performance.
Swimmers Nutrition OBJECTIVE: To provide basic information on how proper eating and hydration can improve health and swimming performance. BASIC NUTRIENTS Carbohydrates, fat and protein supply energy (orMore information
A Guide to Reducing Dietary Sodium Intake
Salt and High Blood Pressure A Guide to Reducing Dietary Sodium Intake A Look at the DASH eating plan My Plate Basics Sodium is a mineral element most commonly found in salt (sodium chloride) Sodium occursMore information
Carbohydrate Counting for Patients with Diabetes. Lauren Dorman, MS RD CDE Registered Dietitian & Certified Diabetes Educator
Carbohydrate Counting for Patients with Diabetes Lauren Dorman, MS RD CDE Registered Dietitian & Certified Diabetes Educator Program Purpose To increase knowledge of carbohydrate counting skills for nursesMore information
Carbohydrate Counting for Pediatric Patients With Type 1 Diabetes. Review Date 4/08 K-0591
Carbohydrate Counting for Pediatric Patients With Type 1 Diabetes Review Date 4/08 K-0591 Program Purpose To increase knowledge of carbohydrate counting and insulin management skills for those caring forMore information
Ready, Set, Start Counting!
Ready, Set, Start Counting! Carbohydrate Counting a Tool to Help Manage Your Blood Glucose When you have diabetes, keeping your blood glucose in a healthy range can help you feel your best today and inMore information
Instructions for Using the Meal Plan and Daily Food Checklist:
Instructions for Using the Meal Plan and Daily Food Checklist: 1. Start by selecting your calorie level based on the below chart. For example, if you would like to maintain your body weight, find yourMore information
TABLE OF CONTENTS. Self-Care
TABLE OF CONTENTS Self-Care Self-Care...3 The Major Food Groups...4 Meal Planning...9 Meal Planning Worksheet...12 Smart Shopper Worksheet...15 Personal Hygiene...17 Health Care...21 Medical Care Basics...23More information
The South African Guidelines for Healthy Eating and Food Guide
The South African Guidelines for Healthy Eating and Food Guide For more information contact: Department of Health. Directorate: Nutrition Private Bag X828; Pretoria 0001. This information pamphlet providesMore information
Do children with diabetes need a special diet?
Do children with diabetes need a special diet? No! The basic nutritional needs of a child or adolescent with diabetes is the same as their peers Healthy eating is important for all children Children withMore information
Low Oxalate Diet. Cereals and Cereal Products. Milk and Milk Products
Low Oxalate Diet Oxalate can be found in healthy plant foods. What can become confusing for some patients is that they have already been put on dietary restrictions because of some other medical conditionsMore information
LARGE GROUP PRESENTATION: PRESENTER S NOTES Introduce yourself. Welcome! We are so glad you are here to learn about fruits and vegetables. Icebreaker Handout: Fruit or Vegetable: Parts of Many Words ReadMore information
Take Control Nutrition Tools for Diabetes. 50/50 plate Portions Servings
Take Control Nutrition Tools for Diabetes 50/50 plate Portions Servings Eat more Vegetables Especially non starchy vegetables Choosing Foods to manage blood glucose Select a variety of colors and typesMore information
Eating Well with. Canada s Food Guide
Eating Well with Canada s Food Guide Recommended Number of Food Guide Servings per Day Children Teens Adults Age in Years Sex 2-3 4-8 9-13 14-18 19-50 51+ Girls and Boys Females Males Females Males FemalesMore information
FOOD COUNTABLE AND UNCOUNTABLE NOUNS Student s name Date Grade COUNTABLE NOUS Nouns you can count You can use a / an in front of countable nouns. Nouns that have a plural form. UNCOUNTABLE NOUNS NounsMore information
Fertile Food Can you eat your way to pregnancy? Tracy Cherry, RD, CDN University of Rochester Women s Lifestyle Center
Fertile Food Can you eat your way to pregnancy? Tracy Cherry, RD, CDN University of Rochester Women s Lifestyle Center Fertility Food Folklore Almonds a fertility symbol throughout the ages. The aromaMore information
MANAGING HYPERTENSION INTRODUCTION Having high blood pressure (hypertension) greatly increases your risk of heart disease stroke and renal disease. It is very important to modify factors in your lifestyleMore information
How healthy is your diet? Questionnaire
This questionnaire is designed to allow you to assess the nutritional value of your diet. Answer yes or no to the questions below and then read the supplementary information that will help you to considerMore information
10 Week Nutrition Plan
10 Week Nutrition Plan Welcome and thank you for your interest in taking the next step to health! We hope you find this eating plan a starting point to making healthier food choices and a tool to reachMore information
Level 2 Dysphagia Mechanically Altered*
Level 2 Dysphagia Mechanically Altered* This diet consists of foods that are moist, soft-textured and easily formed into a bolus. All foods on Level 1 are. Meats and other select foods may be ground orMore information
Diet plan: What foods should I eat on a renal diet? Information for patients, relatives and carers
Diet plan: What foods should I eat on a renal diet? Information for patients, relatives and carers The information in this leaflet includes a diet that is low potassium, phosphate and salt. It also includesMore information
KEEPING OUR SEA DRAGONS FUELED Sea Dragons Swim Team Nutritional Guide MORGAN FAMILY YMCA YMCA Youth Swimmers Guide to Healthy Living Keeping fueled and ready to be active at all times of day can be aMore information
Low Glycemic Index food (less than 55) Foods with GI index between 55 and 70 are consider intermediate High Glycemic Index food GI (more than 70)
WHAT IS GLYCEMIC INDEX? Glycemic Index or GI Index is a ranking of carbohydrates on a scale from 0 to 100 according to the extent to which they raise blood sugar levels. It measures how much your bloodMore information
Help yourself to a healthy diet with diabetes
Help yourself to a healthy diet with diabetes This booklet is designed to help you eat a healthy diet when you have diabetes - getting started This booklet was given to you by: Name: Contact Tel No: IntroductionMore information
Nutrition and Chronic Renal Failure
Nutrition and Chronic Renal Failure A Guide for Patients/Families Department of Nutrition and Food Services A Unit of The Aga Khan Hospital and Medical College Foundation; Licensed under Section 42 ofMore information
FOOD QUESTIONNAIRE RESULTS QUESTION 1 How many meals do you usually eat every day? At what times do you eat your meals? STUDENTS ANSWERS 3-4 meals a day Breakfast 7.00 Lunch 12.00 Dinner- 16-20.00 SupperMore information
Days 1 and 2: Bariatric Clear Liquids
Gastric Bypass Diet Days 1 and 2: Bariatric Clear Liquids Duration: 2 days Food consistency: Bariatric clear liquids, which includes clear, non-carbonated, noncalorie, caffeine-free liquids such as: oMore information
It is important to know that some types of fats, like saturated and trans fat, can raise blood cholesterol levels.
Healthy Eating You are what you eat! So before you even shop for food, it is important to become a well informed, smart food consumer and have a basic understanding of what a heart healthy diet looks like.More information
Nutritional Glossary. Index of Contents
Nutritional Glossary This glossary provides nutrition information about the nutrients commonly found in fruits, vegetables, and other plant foods Each glossary definition has a long and a short version.More information
Healthy Menu Planning
Healthy Menu Planning Please save paper and print the pages of this resource back-to-back! Table of Contents Considerations for Planning Menus... 4 Menu Planning Principles... 4 Menu Cycling...5 GuidelinesMore information
High Calorie, High Protein, Puréed Diet for Head and Neck Cancer Patients
PATIENT EDUCATION patienteducation.osumc.edu High Calorie, High Protein, Puréed Diet for Head and Neck Cancer Patients This type of diet will help you make sure you meet your energy needs and get enoughMore information
Nutritional Guidelines for Roux-en-Y, Sleeve Gastrectomy and Duodenal Switch. Gastric Restrictive Procedures. Phase III Regular Consistency
Nutritional Guidelines for Roux-en-Y, Sleeve Gastrectomy and Duodenal Switch Gastric Restrictive Procedures Phase III Regular Consistency The University of Chicago Hospitals Center for the Surgical TreatmentMore information
TABLE OF CONTENTS. This chapter will provide information about the socio-demographic details of the pre-school children who participated in the NPNS.
TABLE OF CONTENTS CHAPTER 1 INTRODUCTION AND METHODOLOGY This chapter provides a detailed description of the background information and methodology used in the National Pre-School Nutrition Survey (NPNS).More information
MEAL PLANNING FOR MECHANICAL SOFT DIET Definition of Terms Calories Protein Blenderized Pureed Units of energy. A nutrient used by your body for growth and repair. The best sources are milk, meats, fish,More information
Now that I have diabetes, do I have to give up my favorite foods?
14 STAYIng HeALTHY with Diabetes: Simple Steps for HeALTHY Eating Eating healthy can keep your blood sugar in good control. Eating healthy also helps avoid weight gain. These simple steps will get youMore information
Heart healthy diet: 8 steps to prevent heart disease
Heart healthy diet: 8 steps to prevent heart disease Changing your eating habits can be tough. Start with these eight strategies to kick start your way toward a heart healthy diet. By Mayo Clinic StaffMore information
Using Factor Analysis and Cronbach's Alpha to Ascertain Relationships Between Questions of a Dietary Behavior Questionnaire
Using Factor Analysis and Cronbach's Alpha to Ascertain Relationships Between Questions of a Dietary Behavior Questionnaire Eric Grau Mathematica Policy Research, 600 Alexander Park, Princeton, NJ, 08543More information
Learning Objectives. ADA Diet vs. Medical Nutrition Therapy. In Diabetes, Food IS Medicine: Current Trends In Diabetes Nutrition Management
In Diabetes, Food IS Medicine: Current Trends In Diabetes Nutrition Management Laurel Najarian RD, CDE, M.ED Learning Objectives 1. Discuss the rationale and importance for the use of carbohydrate countingMore information
1. Deciding on the Food Budget and Which Foods to Spend Most Money on.
Ideas Meal and planning tips for to fit eating your budget together Here is a plan to help you make the most of your food budget to promote health and well being for you and your family. Try working throughMore information
Lunch/Dinner Nutritional Analysis
Lunch/Dinner Menu Food Item, Portion Calories Total Fat Lunch/Dinner Nutritional Analysis Calories from Fat Sat Fat Salads Chef Salad, 1 order, 20 oz 988 57.5 533 30.5 0 493 2153 12 3 7 94 Yes Famous SaladMore information
NUTRITION AFTER LUNG TRANSPLANT. Nutritional Guidelines Following Lung Transplant. Quick Tips. You Should Know
NUTRITION AFTER LUNG TRANSPLANT Nutritional Guidelines Following Lung Transplant Healthy eating habits are an important link to maintaining good physical condition. It also helps to reduce your risk ofMore information
National Heart Foundation of Australia
Background A number of dietary electrolytes have been associated with a rise in blood pressure (BP). Raised blood pressure is a major, preventable risk factor for cardiovascular (CVD) including: stroke,More information
Food Security Indicators
Food Security Indicators Elliot Vhurumuku Senior Regional VAM Advisor WFP East and Central Africa Bureau, Nairobi For the Integrating Nutrition and Food Security Programming for Emergency response workshopMore information
Save Time and Money at the Grocery Store
Save Time and Money at the Grocery Store Plan a Grocery List Making a list helps you recall items you need and also saves you time. Organize your list according to the layout of the grocery store. ForMore information
Making Healthy Food Choices. Section 2: Module 5
Making Healthy Food Choices Section 2: Module 5 1 Nutrition For Health What is healthy Tips on planning meals Making a shopping list/ Bulk orders Using WIC foods Cook and freeze What foods to choose HowMore information
Original Date: May 20, Introduction
Introduction Eating well when pregnant is one of the first and best gifts you can give to your baby. What you choose to eat will influence your health and his. You might be unsure about what is right forMore information
Guidelines for Offering Healthy Foods at Meetings, Seminars and Catered Events
Guidelines for Offering Healthy Foods at Meetings, Seminars and Catered Events Guidelines for Offering Healthy Foods at Meetings, Seminars and Catered Events The School of Public Health at the UniversityMore information
Lesson 3 Assessing My Eating Habits
Lesson 3 Assessing My Eating Habits Overview This lesson introduces the federal guidelines for healthy eating. Students assess their eating habits against these guidelines and make suggestions for improvement.More information
Healthy Foods for my School
yum, yum, yum, yum, yum, yum, yum, yum, yum, yum, yum, yum, yum, yum, yum, yum, yum, yum, yum, yum, yum, Healthy Foods for my School Nutrition Standards for Saskatchewan Schools Schools are an ideal placeMore information
High School. Sports Nutrition and Performance
High School Sports Nutrition and Performance Project Sponsors USDA Project funded through the Supplemental Nutrition Assistance Program (SNAP) School District of Philadelphia Department of Nutrition Sciences,More information
1 Breakfast Pizza Fresh Fruit Milk Juice. 8 Breakfast Pizza Peaches Milk Juice. 15 Breakfast Pizza Grapes Milk Juice
September 0 C. C. Lee Elementary August ABC Crackers Fresh s Cinnamon Snack Or 0 Mixed is available every day. Menus are subject to change without notice. Available Cereal: Whole Grain, Rice Krispy, FrootMore information
CORPORATE HEALTH LOWERING YOUR CHOLESTEROL & BLOOD PRESSURE What is Cholesterol? What s wrong with having high cholesterol? Major risk factor for cardiovascular disease Higher the cholesterol higher theMore information
The Five Food Groups and Nutrition Facts
session 4 The Five Food Groups and Nutrition Facts (Note to the presenter: Comments in parentheses are instructions to follow while giving the presentation. Do not read the comments to participants. ThisMore information
Increasing calories and protein in your diet
Increasing calories and protein in your diet A patient s guide 1 We all need to eat a balanced diet for health. When you are unwell and do not feel like eating as much as usual, you may lose weight. ItMore information
Bellevue Hospital Center. Bariatric Surgery Nutrition and Exercise Guide
Bellevue Hospital Center Bariatric Surgery Nutrition and Exercise Guide Nutrition and Exercise Guide Table of Contents Pre-Op Liquid Diet 2 Post-Op Liquid Diet 3 Pureed Diet 4 Regular Diet 5 General DietMore information
Healthy eating for breastfeeding mothers
Healthy eating for breastfeeding mothers Healthy eating is important when you are breastfeeding. Your body has a greater need for most nutrients. Some of the extra energy required for breastfeeding comesMore information
Resources for Carbohydrate Counting
Resources for Carbohydrate Counting The Diabetes Carbohydrate and Fat Gram Guide By LeaAnn Holzmeister, RD, CDE American Diabetes Association See contact information below The Doctor s Pocket Calorie,More information
100 Gram Fat Diet for 72 hour Fecal Fat Collection
100 Gram Fat Diet for 72 hour Fecal Fat Collection The fecal fat test will help find out if you have steatorrhea (that is, excess fat in bowel movements due to the body not being able to absorb fat). ToMore information


text:
Minhaj Welfare Foundation Celebrates the Wedding Ceremony of 23 Couples
Click for Video Report
Minhaj Welfare Foundation is a multi-dimensional religious and cultural movement striving hard for promoting Islamic social and cultural values round the globe. Beside that, it is also helping the poor and the needy to come out of poverty and is unfolding new aspects of healthy life to them.
Minhaj Welfare Foundation provided an encouraging opportunity to the young guys and girls for getting married at very low cost. It was celebrated in a huge gathering held at the Central Secretariat of MQI on the 6th of May 2007. 23 couples benefited from the opportunity and started their new lives. The ceremony was really suit to the occasion. They have arranged bands to exalt and magnify it. They have also arranged a big feast of Walima to entertain the guests who came to share the joys of young couples. What was interesting here was the gathering continued to echo with the slogans of the people chanting "long live long live, Tahir-ul-Qadri Tahir-ul-Qadri; the blossoming flower of Mustafa, Tahir-ul-Qadri Tahir-ul-Qadri".Aqil Malik, Nazim Minhaj Welfare Foundation, told the vast majority of people that it cost the Foundation almost one hundred thousand rupees on the gift to one couple. He also told the names of the couples with their native town and cities they belong to the audience. He said that the couple belonged to Lahore, Sawwabi, Rawalpindi, Manga Mundi, Jhang, Naarung Mandi, Okara, Muzzafar Abad, Pak Pattan Sharif, Gojar Khan, Deepalpur and Larkana.
Dr. Raheeq Ahmad Abbasi presided over the ceremony. A well known jurist and president of Minhaj House of Islamic Jurisprudence, read the address of Nikkah of every young couple separately.
Aaqil Malik in his speech said, that they have manage the gift package consisting on following things: a jewelry set, dinner set, sewing machine, washing machine, color TV and DVD, iron, suit case, double bed, table and chairs, oven, blankets, cloths and a watch gift for Bridegrooms and many other things of daily use.
He further shed light on the services rendered by Minhaj Welfare Foundation. He told the audience that Minhaj Welfare Foundation is running almost five hundred and seventy two schools and one hundred and two dispensary in all the four corners of the Pakistan. He also said that Minhaj Welfare Foundation is always ready to help the suffering humanity whether they are the victims of earthquake or Tsunami. He said it had helped almost 1500 families in rehabilitation and established 13 tent towns where they had arranged the schooling of their children, providing all the health facilities and other concerns of life. He said that they had spent 25 million rupees to the earth quake victims.
Mohammad Aaqil Malik thanked Sajid Mahmood Bhatti for his cooperation in this regard.
Dr. Raheeq Ahmad Abbasi, Nazim-e-Aala Minhaj-ul-Quran International, said in his speech that helping the suffering humanity is an act of excellence in the court of Allah Almighty and His messenger and Beloved Hazrat Mohammad (SAW). He said that he was speaking on behalf of Shaykh-ul-Islam who always laid emphasis over human rights. He says offering prayers five time in a day, paying Zakat, keeping fast in the Holy Month of Ramadhan and performing pilgrimage all are the rights of Allah but Islam Advocates beside them the Rights of people so Minhaj-ul-Quran is endeavoring to uplift the poor and bring them out of their miseries. He says Minhaj-ul-Quran wants to establish peace, harmony and tolerance in the society and this is only possible when we comfort the poor people.
He also told that they had made the marriage of 23 couples in relation with the celebration of Mawlid-un-Nabi (SAW). As Minhaj Welfare Foundation has been celebrating the birthday of the Holy Prophet (SAW) from the last 23 years. He said that they had made the marriages of 275 couples through out Pakistan and they are determine to continue that practice in the years to come. He prayed to Allah for his unfathomable help and favour to make settle to the daughters with poor background.
Dr. Raheeq Ahmad Abbasi said that they feel positive sense of pride to help the suffering humanity at the time of test and trial. Their only mission is to share joys with the poor and miserable people. He also said that they are very much lucky to have Dr. Tahir-ul-Qadri, a leader of International repute, as their guide and lead.
MNA, Robina Shahin Vutto, The Chairperson of Amir Begum Welfare Trust said in her speech, that she would like to congratulate Dr. Tahir-ul-Qadri for his endeavour of par excellence for providing an opportunity to the poor young girls and boys to start a new life that would help them to complete their faith and the way he has managed to give a new hope to our youth is really praiseworthy.
Shaista Bukhari, Director of Women Rights Association said that she felt a strange sense of spiritual bliss and happiness being the part of the ceremony. She said that it is a great service on part of Dr. Tahir-ul-Qadri that he has extended to the poor families. He also prayed to Allah Almighty to help him in his cause and mission to serve sustaining mankind round the globe. She said that he had set an example for the religious scholars to follow and they should also come forward and do like him and promote tolerance and peace in the society.
She also urged well -to-do people to come forward and join the hands of Dr. Tahir-ul-Qadri in his noble cause and mission that he has started for the Muslims. Allama Miskeen Faiz-ur-Rehman Durrani, Brigadier Iqbal Ahmad, G M Malik, Ghulam Rabbani Taymoor, Ali Ghuzanfar Kararvi and many others central leader of Minhaj-ul-Quran Inetrnational expressed their thoughts and feelings on the occasion.

subset: commoncrawl


text:
Dobby Vinyl Figure 17 Harry PotterFunko Pop!
£ 9.99
Product Details
|Outer material
|Funko Pop!
|Fan merch, Film
|Available since
|Product code
Harry Potter - Funko Pop! - Dobby
- collectible figurine
- height about 10 cm
- vinyl figurine no. 17
Collect them all! The Funko Pop! collection figurines rock! Whether you put them on your desk, in the car, on the shelf or in the loo: With the Funko Pop! figurines your favourite heroes accompany you wherever you go - perfect to collect!
Along with Harry, Ron and Hermione you have strolled through Diagon Alley, met ghostly creatures in the Forbidden Forest and have learned plenty of spells at Hogwarts. If you can't get enough of Harry Potter too, we have the house elf Dobby for you as a Funko Pop collectible figurine in our shop. Particularly cool: The 10 cm high figurine is delivered in a stylish window box.
Customer rating about "Dobby Vinyl Figure 17"
- 2
- 0
- 0
- 0
- 0
Tell us what you think about "Dobby Vinyl Figure 17" and receive a 10% voucher within 24 hours.
Write a customer review
Thank you!
Written on:
Was this review helpful to you?
Enter your comment below:
Written on:
Can you refill the stock?
Was this review helpful to you?
Enter your comment below:
Log in now
Please log in with your username and password. You received your username and password with your registration.Register


text:
Mexico Quarterly Beverage Tracker Report Q4 2012
Published by Canadean, this Quarterly Beverage Tracker report provides a detailed analysis of the latest developments in the Mexico beverage market SUMMARY
Why was the report written? In the current climate of economic uncertainty and market volatility companies need to know about more than just data. This report provides a complete overview of all commercial beverage consumption trends, latest market developments and an economic mood indicator What is the current market landscape and what is changing? The Mexican economy reported stable growth and ended 2012 positively at around 3.8%. Tourism has shown a solid performance in Q4-12, boosting consumption in the on-premise channel. Warm weather conditions during the quarter favored the beverage industry. Carbonates recorded a positive result at the end of the year, which was better than had been expected. What are the key drivers behind recent market changes? Increase in hotel occupancy in touristic destinations as well as a registered positive trend of passengers' arrivals in airports since the beginning of the year boosted consumption in the on-premise channel. The warmest quarter was noted since 2006, with rain levels down more than 20% compared to the previous year, creating an incentive towards increased beverage consumption. What makes this report unique and essential to read? Designed for clients who want to understand the latest trends in the Mexico beverage industry and want more detail and analysis on this data. Canadean's Mexico Quarterly Beverage Tracker report is ideal for benchmarking total market vs retail audit data and is an essential tool for keeping up-to-date with the latest industry and market developments
Readers are provided with a summary snap shot table showing category growth in Q4 2012 vs Q4 2011, together with provisional 2012 volumes and latest 2013 forecasts An economic mood indicator, completed by Canadean's local consultant, examines (on a scale of one to five) whether confidence levels in the industry are better or worse than the previous quarter, whether net prices are rising or falling and how Private Label products have performed versus the rest of the market. Selected retail pricing data is given for the most recent quarter and the previous four quarters, enabling analysis of price movements. Key highlights of the last quarter's commercial beverage performance are identified and the key market drivers examined Volumes for Q4 2012 vs Q4 2011, Provisional 2012 volumes, moving annual totals (MAT) and 2013 forecasts are provided for each individual beverage category, together with supporting text on quarterly performance and forecast assumptions. More granular data is provided for the Carbonates category, with data split by regular vs low calorie, and by key flavours. Significant activity in the soft drinks industry is covered including recent new product introductions (detailing flavour, pack type, pack size, retail price and selected pack shots). Not Applicable


text:
Apple Cuts Component Orders By 10%: Trouble Ahead For Apple Stock?
- Apple stock has been moving lower after Credit Suisse said that its checks with Apple suppliers have revealed that Apple had cut orders by 10%.
- Recent results and guidance by major Apple suppliers such as Skyworks Solutions and Qorvo, however, reveal that their businesses are still going strong.
- Dialog Semiconductor, a German-based company that supplies power management chips for Apple's iPhones and iPads, is the only Apple supplier to have issued weak Q4 2015 guidance.
- It's likely that Apple's order cuts are in relation to older iPhone models due to the popularity of newer iPhone models. As such, there is no good reason for long-term Apple investors to panic.
Apple (NASDAQ:AAPL) shares have been moving lower after Credit Suisse said that its checks with Apple suppliers revealed that Apple had cut component orders by 10%. Apple stock is down 5% over the past few days as investors seem to be interpreting the commentary by Credit Suisse to mean that Apple anticipates lower iPhone and iPad sales in the future. The stocks of Apple's suppliers have also been hit.
While this assumption by investors may be valid, there are quite a few reasons that make us believe that it could be off the ballpark, the key reason being the kind of outlook that Apple's leading suppliers gave during their latest earnings calls. Skyworks Solutions (NASDAQ:SWKS) and Qorvo (NASDAQ:QRVO), two of Apple's largest suppliers, recently delivered healthy Q3 2015 results with both companies managing to top expectations.
Skyworks, which is on of the principal RF chip supplier to Apple, delivered revenue of $880.4 million, up 22.6% Y/Y and above consensus of $887.4 million. EPS of $1.52 was in-line with estimates. Skyworks provided fourth quarter guidance of $925 million-$930 million, higher than consensus of $921.5 million while EPS guidance of $1.60 was $0.03 better than the consensus.
Meanwhile, Qorvo (formed in January 2015 through a merger between RF Micro and Triquint) reported revenue of $708.3 million, which was higher than the consensus by $8.87 million while EPS of $1.22 was double the consensus estimate. But, just as was the case for the second quarter, Qorvo issued weak revenue guidance of $725 million-$730 million for the third quarter, considerably below analysts' estimates of $741.6 million. The mid-point of the company's EPS guidance of $1.25-$1.30 was, however, above consensus of $1.26.
But, unlike the first quarter when its shares got hammered after issuing weak guidance, Qorvo shares rallied 20% post earnings call. The company had cited weakness in the Chinese market as reason for its weak guidance, but all indications (including the company's own results as well as those by Apple, Skyworks, and a host of other American companies with huge exposure in China) have shown that the Chinese market is much stronger than earlier feared. Investors believe that Qorvo deliberately lowballed its guidance to give itself a good chance to beat it come fourth quarter earnings call, which was, quite likely, a correct observation.
The only major Apple supplier to issue weak guidance during the current earnings season is German-based Dialog Semiconductor. Dialog derives 70% of its revenue from Apple, and the soft guidance led to a severe hammering of its shares. Dialog Semiconductor supplied power management chips for Apple's iPhone and iPads. The company reported revenue of 330 million, good for 18% Y/Y growth but a drastic Q/Q slowdown compared to the second quarter when the company's top line expanded 44%. But what's worse was that Dialog guided for revenue growth of just -1% to +6% for the fourth quarter.
But Dialog is a much smaller supplier of Apple components compared to Skyworks, Qorvo and Avago Technologies (NASDAQ:AVGO). Recent iPhone 6S teardowns turned up filters, switches, Wi-Fi power amplifiers, and power amplifier modules by Skyworks, Qorvo, and Avago.
The most feasible reason for Apple order cuts could be in relation to the company's projections regarding future sales for older iPhone models. The new iPhone models have proven to be very popular, and could be badly depressing sales of older models. It's not exactly clear whether Dialog Semiconductor supplies power management chips for newer or older iPhone models. But there is reason to believe that it's more likely for the latter.
Apple has many component suppliers and the Credit Suisse report does not shed any light into the kind of components for which Apple has slashed orders. Apple's U.S. suppliers have, however, in the past proven to be a pretty reliable barometer that has helped investors gauge the health of Apple's business. Current indications are that Apple's business remains in the pink of health, and there is no good reason for long-term investors to panic.