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Philip W. J. Harvey

Other affiliations: University of Queensland
Bio: Philip W. J. Harvey is an academic researcher from Johns Hopkins University. The author has contributed to research in topics: Population & Public health. The author has an hindex of 14, co-authored 30 publications receiving 1170 citations. Previous affiliations of Philip W. J. Harvey include University of Queensland.

Papers
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Journal ArticleDOI
TL;DR: The results verity that it is possible to use relatively simple, but comprehensive, self‐administered FFQs to study nutrient exposures in large‐scale epidemiological studies of the elderly and to expect reasonably high FFQ response rates.
Abstract: This study assesses the validity and reproducibility of a 145-item self-administered food frequency questionnaire (FFQ) in a representative older population aged 63 to 80. Semi-quantitative FFQs were completed by 89% of 3,654 residents attending a community-based eye study in Sydney, Australia. The FFQ's validity was assessed against three, four-day weighed food records (WFRs) completed four months apart by 79 people. A further 152 subjects completed a repeat FFQ about a year after the baseline FFQ, of whom 131 completed a second repeat FFQ about six weeks later. Both short and long-term reproducibility of the FFQ were assessed using data from these subjects. Comparison of the FFQ with the average of the three, four-day weighed food records resulted in energy-adjusted Spearman correlations above 0.5 for most of the nutrients. The proportion of subjects correctly classified to within one quintile category for each nutrient intake ranged from 57% for zinc to 82% for vitamin C. with most nutrients correctly classified within one quintile for about 70% of subjects. Quadratic weighted kappas were reasonable, between 0.3 and 0.5 for most nutrients. The FFQ was highly reproducible in the short term, with correlations for most nutrients about 0.70 to 0.80 and acceptably reproducible in the longer term, with correlations mostly 0.60 to 0.70. The results verify that it is possible to use relatively simple, but comprehensive, self-administered FFQs to study nutrient exposures in large-scale epidemiological studies of the elderly and to expect reasonably high FFQ response rates.

222 citations

Journal ArticleDOI
TL;DR: In examining the effect of sex on the economic and social costs of micronutrient deficiencies, the paper found that there is also an urgent need for increased effort to demonstrate the cost of these deficiencies, as well as the benefits of addressing them, especially compared with other health and nutrition interventions.
Abstract: Vitamin and mineral deficiencies adversely affect a third of the world's people. Consequently, a series of global goals and a serious amount of donor and national resources have been directed at such micronutrient deficiencies. Drawing on the extensive experience of the authors in a variety of institutional settings, the article used a computer search of the published scientific literature of the topic, supplemented by reports and published and unpublished work from the various agencies. In examining the effect of sex on the economic and social costs of micronutrient deficiencies, the paper found that: (1) micronutrient deficiencies affect global health outcomes; (2) micronutrient deficiencies incur substantial economic costs; (3) health and nutrition outcomes are affected by sex; (4) micronutrient deficiencies are affected by sex, but this is often culturally specific; and finally, (5) the social and economic costs of micronutrient deficiencies, with particular reference to women and female adolescents and children, are likely to be considerable but are not well quantified. Given the potential impact on reducing infant and child mortality, reducing maternal mortality, and enhancing neuro-intellectual development and growth, the right of women and children to adequate food and nutrition should more explicitly reflect their special requirements in terms of micronutrients. The positive impact of alleviating micronutrient malnutrition on physical activity, education and productivity, and hence on national economies suggests that there is also an urgent need for increased effort to demonstrate the cost of these deficiencies, as well as the benefits of addressing them, especially compared with other health and nutrition interventions.

208 citations

Journal ArticleDOI
TL;DR: Iron–folic acid supplementation is an under-resourced, affordable intervention with substantial potential for contributing to Millennium Development Goal 5 (maternal mortality reduction) in countries where iron intakes among pregnant women are low and anemia prevalence is high.
Abstract: BackgroundAccording to a World Health Organization (WHO) review of nationally representative surveys from 1993 to 2005, 42% of pregnant women have anemia worldwide. Almost 90% of anemic women reside in Africa or Asia. Most countries have policies and programs for prenatal iron–folic acid supplementation, but coverage remains low and little emphasis is placed on this intervention within efforts to strengthen antenatal care services. The evidence of the public health impact of iron–folic acid supplementation and documentation of the potential for scaling up have not been reviewed recently.ObjectiveThe purpose of this review is to examine the evidence regarding the impact on maternal mortality of iron–folic acid supplementation and the evidence for the effectiveness of this intervention in supplementation trials and large-scale programs.MethodsThe impact on mortality is reviewed from observational studies that were analyzed for the Global Burden of Disease Analysis in 2004. Reviews of iron–folic acid supplem...

130 citations

Journal ArticleDOI
TL;DR: The possibility that a diet high in vegetable intake may help improve survival is suggested, as much remains to be learned about the influence of nutritional factors after a diagnosis of ovarian cancer.
Abstract: We evaluated the effects of various food groups and micronutrients in the diet on survival among women who originally participated in a population-based case-control study of ovarian cancer conducted across 3 Australian states between 1990 and 1993. This analysis included 609 women with invasive epithelial ovarian cancer, primarily because there was negligible mortality in women with borderline tumors. The women's usual diet was assessed using a validated food frequency questionnaire. Deaths in the cohort were identified using state-based cancer registries and the Australian National Death Index (NDI). Crude 5-year survival probabilities were estimated using the Kaplan-Meier technique, and adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were obtained from Cox regression models. After adjusting for important confounding factors, a survival advantage was observed for those who reported higher intake of vegetables in general (HR = 0.75, 95% CI = 0.57-0.99, p-value trend 0.01 for the highest third, compared to the lowest third), and cruciferous vegetables in particular (HR = 0.75, 95% CI = 0.57-0.98, p-value trend 0.03), and among women in the upper third of intake of vitamin E (HR = 0.76, 95% CI = 0.58-1.01, p-value trend 0.04). Inverse associations were also seen with protein (p-value trend 0.09), red meat (p-value trend 0.06) and white meat (p-value trend 0.07), and modest positive trends (maximum 30% excess) with lactose (p-value trend 0.04), calcium and dairy products. Although much remains to be learned about the influence of nutritional factors after a diagnosis of ovarian cancer, our study suggests the possibility that a diet high in vegetable intake may help improve survival.

98 citations

Journal ArticleDOI
TL;DR: The strong inverse relation between high intakes of polyunsaturated fatty acids and melanoma adds sufficient weight to prior findings for this persisting causal hypothesis to be abandoned, and data fit with prior speculation that antioxidants, zinc, and iron warrant further investigation.
Abstract: This population-based case-control study contrasted nutrient intakes of 41 women with cutaneous malignant melanoma to those of 297 women sampled from the same community (Brisbane, Australia). Diet was assessed by a comprehensive food frequency questionnaire. The strong inverse relation we observed between high intakes of polyunsaturated fatty acids and melanoma (P or = 15 g daily versus < 5 g) suggests the effects of marine oils and omega-3 fatty acids may deserve specific attention.

84 citations


Cited by
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Journal ArticleDOI
TL;DR: In this article, the authors did a comprehensive update of interventions to address undernutrition and micronutrient deficiencies in women and children and used standard methods to assess emerging new evidence for delivery platforms.
Abstract: Maternal undernutrition contributes to 800,000 neonatal deaths annually through small for gestational age births; stunting, wasting, and micronutrient deficiencies are estimated to underlie nearly 3·1 million child deaths annually. Progress has been made with many interventions implemented at scale and the evidence for effectiveness of nutrition interventions and delivery strategies has grown since The Lancet Series on Maternal and Child Undernutrition in 2008. We did a comprehensive update of interventions to address undernutrition and micronutrient deficiencies in women and children and used standard methods to assess emerging new evidence for delivery platforms. We modelled the effect on lives saved and cost of these interventions in the 34 countries that have 90% of the world's children with stunted growth. We also examined the effect of various delivery platforms and delivery options using community health workers to engage poor populations and promote behaviour change, access and uptake of interventions. Our analysis suggests the current total of deaths in children younger than 5 years can be reduced by 15% if populations can access ten evidence-based nutrition interventions at 90% coverage. Additionally, access to and uptake of iodised salt can alleviate iodine deficiency and improve health outcomes. Accelerated gains are possible and about a fifth of the existing burden of stunting can be averted using these approaches, if access is improved in this way. The estimated total additional annual cost involved for scaling up access to these ten direct nutrition interventions in the 34 focus countries is Int$9·6 billion per year. Continued investments in nutrition-specific interventions to avert maternal and child undernutrition and micronutrient deficiencies through community engagement and delivery strategies that can reach poor segments of the population at greatest risk can make a great difference. If this improved access is linked to nutrition-sensitive approaches--ie, women's empowerment, agriculture, food systems, education, employment, social protection, and safety nets--they can greatly accelerate progress in countries with the highest burden of maternal and child undernutrition and mortality.

2,016 citations

01 Jan 2013
TL;DR: Improved access for nutrition-sensitive approaches can greatly accelerate progress in countries with the highest burden of maternal and child undernutrition and mortality, if this improved access is linked to nutrition- sensitive approaches.
Abstract: has grown since The Lancet Series on Maternal and Child Undernutrition in 2008. We did a comprehensive update of interventions to address undernutrition and micronutrient defi ciencies in women and children and used standard methods to assess emerging new evidence for delivery platforms. We modelled the eff ect on lives saved and cost of these interventions in the 34 countries that have 90% of the world’s children with stunted growth. We also examined the eff ect of various delivery platforms and delivery options using community health workers to engage poor populations and promote behaviour change, access and uptake of interventions. Our analysis suggests the current total of deaths in children younger than 5 years can be reduced by 15% if populations can access ten evidence-based nutrition interventions at 90% coverage. Accelerated gains are possible and about a fi fth of the existing burden of stunting can be averted using these approaches, if access is improved in this way. The estimated total additional annual cost involved for scaling up access to these ten direct nutrition interventions in the 34 focus countries is Int$9·6 billion per year. Continued investments in nutrition-specifi c interventions to avert maternal and child undernutrition and micronutrient defi ciencies through community engagement and delivery strategies that can reach poor segments of the population at greatest risk can make a great diff erence. If this improved access is linked to nutrition-sensitive approaches—ie, women’s empowerment, agriculture, food systems, education, employment, social protection, and safety nets—they can greatly accelerate progress in countries with the highest burden of maternal and child undernutrition and mortality.

1,887 citations

Journal ArticleDOI
TL;DR: The American Cancer Society (ACS) conducted a study with a group of experts in nutrition, physical activity, and cancer survivorship to evaluate the scientific evidence and best clinical practices related to optimal nutrition and physical activity after the diagnosis of cancer.
Abstract: Cancer survivors are often highly motivated to seek information about food choices, physical activity, and dietary supplements to improve their treatment outcomes, quality of life, and overall survival. To address these concerns, the American Cancer Society (ACS) convened a group of experts in nutrition, physical activity, and cancer survivorship to evaluate the scientific evidence and best clinical practices related to optimal nutrition and physical activity after the diagnosis of cancer. This report summarizes their findings and is intended to present health care providers with the best possible information with which to help cancer survivors and their families make informed choices related to nutrition and physical activity. The report discusses nutrition and physical activity guidelines during the continuum of cancer care, briefly highlighting important issues during cancer treatment and for patients with advanced cancer, but focusing largely on the needs of the population of individuals who are disease free or who have stable disease following their recovery from treatment. It also discusses select nutrition and physical activity issues such as body weight, food choices, food safety, and dietary supplements; issues related to selected cancer sites; and common questions about diet, physical activity, and cancer survivorship.

1,570 citations

Journal ArticleDOI
TL;DR: There is no gold standard for directly assessing the validity of FFQs, but guidance on the development, validation and use of food-frequency questionnaires for different study designs should help those wishing to develop or adapt an FFQ to validate it for its intended use.
Abstract: Objective: The purpose of this review is to provide guidance on the development, validation and use of food-frequency questionnaires (FFQs) for different study designs. It does not include any recommendations about the most appropriate method for dietary assessment (e.g. food-frequency questionnaire versus weighed record). Methods: A comprehensive search of electronic databases was carried out for publications from 1980 to 1999. Findings from the review were then commented upon and added to by a group of international experts. Results: Recommendations have been developed to aid in the design, validation and use of FFQs. Specific details of each of these areas are discussed in the text. Conclusions: FFQs are being used in a variety of ways and different study designs. There is no gold standard for directly assessing the validity of FFQs. Nevertheless, the outcome of this review should help those wishing to develop or adapt an FFQ to validate it for its intended use.

1,166 citations

Journal ArticleDOI
12 Feb 2010-Science
TL;DR: This work states that estimated prevalence rates and patterns remain tenuous because measuring food security, an elusive concept, remains difficult.
Abstract: Food security is a growing concern worldwide. More than 1 billion people are estimated to lack sufficient dietary energy availability, and at least twice that number suffer micronutrient deficiencies. Because indicators inform action, much current research focuses on improving food insecurity measurement. Yet estimated prevalence rates and patterns remain tenuous because measuring food security, an elusive concept, remains difficult.

1,011 citations