A variety of methods are available for defining undernutrition (thinness/underweight/under-fat) and overnutrition (overweight/obesity/over-fat). The extent to which these definitions agree is unclear. The present cross-sectional study aimed to assess agreement between widely used methods of assessing nutritional status in children and adolescents, and to examine the benefit of body composition estimates.

The main objective of the cross-sectional study was to assess underweight, overweight and obesity using four methods: (i) BMI-for-age using WHO (2007) reference data; (ii) BMI-for-age using Cole et al. and International Obesity Taskforce cut-offs; (iii) weight-for-age using the National Centre for Health Statistics/WHO growth reference 1977; and (iv) body fat percentage estimated by bio-impedance (body fat reference curves for children of McCarthy et al., 2006). Comparisons were made between methods using weighted kappa analyses.

Rural South Africa.

Individuals (n 1519) in three age groups (school grade 1, mean age 7 years; grade 5, mean age 11 years; grade 9, mean age 15 years).

In boys, prevalence of unhealthy weight status (both under- and overnutrition) was much higher at all ages with body fatness measures than with simple anthropometric proxies for body fatness; agreement between fatness and weight-based measures was fair or slight using Landis and Koch categories. In girls, prevalence of unhealthy weight status was also higher with body fatness than with proxies, although agreement between measures ranged from fair to substantial.

Methods for defining under- and overnutrition should not be considered equivalent. Weight-based measures provide highly conservative estimates of unhealthy weight status, possibly more conservative in boys. Simple body composition measures may be more informative than anthropometry for nutritional surveillance of children and adolescents.

To assess the association of the acute-phase protein biomarkers, C-reactive protein (CRP) and α1-acid glycoprotein (AGP), with anaemia in children aged 6–59·9 months in Papua New Guinea.

A nationally representative household-based cross-sectional survey of children aged 6–59·9 months was used to assess the relationships between various combinations of elevated CRP (>5 mg/l) and AGP (>1·2 g/l) with anaemia. Logistic regression was used to determine if other factors, such as age, sex, measures of anthropometry, region, urban/rural residence and household size, modified or confounded the acute-phase protein–anaemia association.

Papua New Guinea.

A total of 870 children aged 6–59·9 months from the 2005 Papua New Guinea National Micronutrient Survey were assessed.

The following prevalence estimates were found: anaemia 48 %; elevated CRP 32 %; and elevated AGP 33 %. Children with elevated CRP had a prevalence of anaemia of 66 % compared with children with normal CRP who had a prevalence of 40 %. Corresponding estimates for AGP were 61 % and 42 %, respectively. Similar results were found with combinations of elevated CRP and AGP. The higher prevalence of anaemia in children with elevated CRP and/or AGP was still present after controlling for confounders.

Elevated levels of CRP and AGP were significantly associated with a higher prevalence of anaemia in the children surveyed. There are no expert group recommendations on whether to or how to account for markers of inflammation in presenting results on anaemia prevalence. Additional research would be helpful to clarify this issue.

The present study investigates the changes and tracking of dietary behaviours in Norwegian 11-year-olds and examines the association between parental education and dietary tracking over a time period of 20 months.

Longitudinal data from the Norwegian HEalth In Adolescents (HEIA) cohort study followed up at three time points (2007–2009).

Intakes of fruits, vegetables and snacks were assessed by frequency and intakes of sugar-sweetened soft drinks and squash were assessed by frequency and amount. Tracking of dietary behaviours was assessed by adolescents’ relative position in rank over time and Cohen's kappa was used to measure tracking coefficients. Multinomial logistic regression analyses were performed to assess the association between parental education and the tracking of dietary behaviours.

In total, 885 adolescents from the HEIA cohort study participated by answering Internet-based questionnaires at three time points.

The results indicated that boys and girls maintained their relative position in rank of dietary intake over time, when grouped by baseline consumption. Fair to moderate tracking coefficients of dietary variables were observed. An inverse association was found between parental education and stability of soft drink and squash consumption during the 20 months.

The observed tracking pattern indicates the importance of promoting healthy dietary behaviours at an even earlier age. Furthermore, interventions should focus particularly on adolescents from families with low parental education and their consumption of sugar-sweetened beverages.

A low socio-economic status (SES) is related to less healthy dietary habits, but the reasons for this remain unclear. We examined whether the absolute or relative importance of various food choice motives contributed to SES disparities in vegetable/fruit and energy-dense food intake.

We analysed cross-sectional data from the FINRISK Study 2007 by means of structural equation modelling and used a shortened version of the Food Choice Questionnaire to assess the absolute importance of health, pleasure, convenience, price, familiarity and ethicality motives. We calculated the relative importance of each motive by dividing the participant's rating of it by his/her mean score on all motives. Dietary intake was measured with an FFQ.

A population-based survey in Finland.

Men (n 1691) and women (n 2059) aged 25–64 years.

Higher education and income were related to a greater vegetable/fruit intake (β = 0·12, P < 0·001), while education was associated negatively with the consumption of energy-dense foods (β = −0·09, P < 0·001). Socio-economically disadvantaged individuals considered price and/or familiarity more important in their food choices in both absolute and relative terms. A higher income was related to a greater relative importance of health considerations. Relative motives were more strongly associated with vegetable/fruit and energy-dense food consumption than absolute motives and the relative importance of price, familiarity and health partly mediated the effects of the SES indicators on the consumption of these food items.

Individual priorities in food choice motives, rather than the absolute importance of single motives, play a role in producing SES disparities in diet.

A diet rich in phyto-oestrogens has been suggested to protect against a variety of common diseases but UK intake data on phyto-oestrogens or their food sources are sparse. The present study estimates the average intakes of isoflavones, lignans, enterolignans and coumestrol from 7 d food diaries and provides data on total isoflavone, lignan and phyto-oestrogen consumption by food group.

Development of a food composition database for twelve phyto-oestrogens and analysis of soya food and phyto-oestrogen consumption in a population-based study.

Men and women, aged 40–79 years, from the general population participating in the Norfolk arm of the European Prospective Investigation into Cancer and Nutrition (EPIC-Norfolk) between 1993 and 1997, with nutrient and food data from 7 d food diaries.

A subset of 20 437 participants.

The median daily phyto-oestrogen intake for all men was 1199 μg (interquartile range 934–1537 μg; mean 1504 μg, sd 1502 μg) and 888 μg for all women (interquartile range 710–1135 μg; mean 1205 μg, sd 1701 μg). In soya consumers, median daily intakes were higher: 2861 μg in men (interquartile range 1304–7269 μg; mean 5051 μg, sd 5031 μg) and 3142 μg in women (interquartile range 1089–7327 μg; mean 5396 μg, sd 6092 μg). In both men and women, bread made the greatest contribution to phyto-oestrogen intake – 40·8 % and 35·6 %, respectively. In soya consumers, vegetable dishes and soya/goat's/sheep's milks were the main contributors – 45·7 % and 21·3 % in men and 38·4 % and 33·7 % in women, respectively.

The ability to estimate phyto-oestrogen intake in Western populations more accurately will aid investigations into their suggested effects on health.

The current study examined the impact of television and Internet food advertising on Australian parents and children.

Parents and their children aged 8 to 14 years were exposed to a television advertisement, an Internet advertisement or a control picture for four commonly advertised energy-dense, nutrient-poor foods.

Online web panel survey, Australia.

Parents (n 1302) and their children aged 8 to 14 years (n 1302).

After a single exposure to each advertisement, parent respondents in the two exposure conditions evaluated the products more favourably, had a greater desire to consume the products and thought the product could be consumed more frequently than those in the control condition. Similar trends were observed among children, although the differences were statistically significant only for the frequency of food consumption in the Internet advertisement condition and the evaluation of one product.

The results have implications for assumptions of adults’ immunity to advertising. This is of particular importance in efforts to address child obesity and the reliance on parents to mediate the effects of food advertising.

The purpose of the present study was to assess the nutritional quality of foods and beverages listed on menus serving children in government-sponsored child-care centres throughout Mexico.

For this cross-sectional menu assessment, we compared (i) food groups and portion sizes of foods and beverages on the menus with MyPlate recommendations and (ii) macronutrients, sugar and fibre with Daily Reference Intake standards.

Menus reflected foods and beverages served to children attending one of 142 government-sponsored child-care centres throughout Mexico.

There were fifty-four distinct menus for children aged 4–6 months, 7–9 months, 10–12 months, 13–23 months, 24–47 months and 48–72 months.

Menus included a variety of foods meeting minimum MyPlate recommendations for each food category except whole grains for children aged 48–72 months. Menus listed excessive amounts of high-energy beverages, including full-fat milk, fruit juice and sugar-sweetened beverages for children of all ages. The mean daily energy content of menu items yielded an average of 2·76 MJ for infants, 4·77 MJ for children aged 13–23 months, 5·36 MJ for children aged 24–47 months and 5·87 MJ for children aged 48–72 months. Foods and beverages on menus provided sufficient grams of carbohydrate and fat, but excessive protein.

Menus provided a variety of foods but excessive energy. Whole grains were limited, and high-energy beverages were prevalent. Both may be appropriate targets for nutrition intervention. Future studies should move beyond menus and assess what children actually consume in child care.

The current research aims to describe the weight-control strategies and family support for young people reporting sustained weight loss in a large, population-based sample.

Data were collected as part of Youth'07, a nationally representative survey of the health and well-being of New Zealand youth.

New Zealand secondary schools, 2007.

Secondary-school students (n 9107).

Among young people who attempted weight loss in the previous year, 51 % reported long-term weight loss (lost weight and maintained weight loss for 6 months). Students reporting long-term weight loss were more likely to be male, but did not differ by age, ethnicity, socio-economic deprivation or measured weight status from students who reported temporary/recent weight loss or no weight loss. Students with long-term weight loss also reported healthier weight-control strategies (e.g. exercising, eating fewer fatty foods, eating fewer sweets), high parental support for healthy eating/activity and were less likely to report being teased about their weight by their family and having junk food available at home than students with temporary/recent weight loss or no weight loss.

Approximately 50 % of young people attempting weight loss reported sustained weight loss. Young people who reported sustained weight loss appeared to have more family support than those who did not achieve this, suggesting the importance for weight-control services and interventions in adolescents of actively engaging the family.

To examine the association between frequency of assisting with home meal preparation and fruit and vegetable preference and self-efficacy for making healthier food choices among grade 5 children in Alberta, Canada.

A cross-sectional survey design was used. Children were asked how often they helped prepare food at home and rated their preference for twelve fruits and vegetables on a 3-point Likert-type scale. Self-efficacy was measured with six items on a 4-point Likert-type scale asking children their level of confidence in selecting and eating healthy foods at home and at school.

Schools (n 151) located in Alberta, Canada.

Grade 5 students (n 3398).

A large majority (83–93 %) of the study children reported helping in home meal preparation at least once monthly. Higher frequency of helping prepare and cook food at home was associated with higher fruit and vegetable preference and with higher self-efficacy for selecting and eating healthy foods.

Encouraging children to be more involved in home meal preparation could be an effective health promotion strategy. These findings suggest that the incorporation of activities teaching children how to prepare simple and healthy meals in health promotion programmes could potentially lead to improvement in dietary habits.

To examine household food insecurity and coping mechanisms in two relatively politically stable states of South Sudan.

Cross-sectional assessment including structured interviews and focus group discussions with food aid programme beneficiaries and staff. Structured interview findings were analysed with descriptive statistics using the statistical software package STATA version 11.

Rural households in four payams (sub-county administrative districts) benefiting from a multi-year assistance programme funded by the US Agency for International Development. The study was conducted in January 2012, six months after independence.

Study subjects included eighty mothers of children aged 6–23 months in structured interviews and eight focus groups, each with six to ten participants, of mothers of children aged 6–23 months.

Ninety-three per cent of households surveyed in Warrap and 100 % of households in Northern Bahr el Ghazal states were severely food access insecure. Nearly all households (97·5 %) surveyed in both states reported there were months in 2011 without enough food to eat. The majority of households (88 %) reported sometimes or often going to bed hungry in the month preceding the study. A number of coping mechanisms were used when households did not have enough food, including reduced meal size, skipping meals, selling assets and engaging in some kind business in order to generate money to buy food.

Given the highly volatile political, economic and humanitarian situation in South Sudan, the priorities of the international community are understandably focused on securing greater stability in South Sudan and preventing humanitarian needs from escalating significantly. There is a need, however, for simultaneous emphasis on food assistance and longer-term development strategies throughout South Sudan, particularly in areas of agriculture, livelihoods and food security.

To investigate the relationship between the intake of sugar-containing beverages (SCB) at the age of 13 years and adult weight status 24–30 years later.

A longitudinal study with 30 years of follow-up from adolescence (age 13 years in 1976) to adulthood (up to 2000 and 2006). Dietary intake was assessed through cross-check dietary history face-to-face interviews by a dietitian. Beverages were divided into two categories: (i) total SCB and (ii) SCB excluding 100 % fruit juices. Percentage of total fat (%total fat) and percentage of trunk fat (%trunk fat) were obtained through dual-energy X-ray absorptiometry measurements; body weight and height were measured by trained staff.

Amsterdam Growth and Health Longitudinal Study, the Netherlands.

One hundred and fourteen males and 124 females.

In males, but not in females, each additional daily serving of SCB excluding 100 % fruit juices at 13 years was associated with 1·14 % higher %total fat (95 % CI 0·04, 2·23 %; P = 0·04) and 1·62 % higher %trunk fat (95 % CI 0·14, 3·10 %; P = 0·03) in adulthood after correction for confounders. No statistically significant relationship was found between the intake of SCB excluding 100 % fruit juices at the age of 13 and BMI in both sexes. In addition, no statistically significant relationships were found between the intake of total SCB and all measures of adult weight status in both sexes.

Intake of SCB excluding 100 % fruit juices at the age of 13 years was positively associated with adult %total fat and %trunk fat in males, but not in females.

Results of the WHO European Childhood Obesity Surveillance Initiative indicated that on average one out of four primary-school children is overweight or obese. Portugal presented one of the highest prevalences of obesity. Childhood obesity prevention and treatment should be a top priority. The aim of the present study was to evaluate the effectiveness of Program Obesity Zero (POZ), a multi-component, community-, family- and school-based childhood obesity intervention.

Parents and children attended four individual nutrition and physical activity counselling sessions, a one-day healthy cooking workshop and two school extracurricular sessions of nutrition education. Waist circumference, BMI, physical activity level, sedentary behaviours, and nutrition and physical activity knowledge, attitudes and behaviour were assessed at baseline and after 6 months. Diet was assessed using two 24 h recalls, at baseline and at 6 months.

Five Portuguese municipalities and local communities.

Two hundred and sixty-six overweight children (BMI ≥ 85th percentile) aged 6–10 years, from low-income families in five Portuguese municipalities, were assigned to the intervention.

Children showed reductions in waist circumference (−2·0 cm; P < 0·0001), mean BMI (−0·7 kg/m2; P < 0·0001) and BMI-for-age percentile (−1·7; P < 0·0001) at 6 months. Overall, children's intake of fruit and vegetables was <400 g/d throughout the intervention. After 6 months, higher fibre consumption and an apparent decrease in sugary soft drinks intake to a quarter of that observed at baseline (mean intake: 198 ml/d at baseline), with improvements in physical activity levels and screen time <2 h/d, were also observed.

The findings suggested that POZ is a promising intervention programme, at municipality level, to tackle childhood overweight and obesity.

The study aimed to test the reliability of a nutrition questionnaire and to assess potential associations between nutrition knowledge, food consumption and lifestyle behaviours, controlling for sociodemographic factors.

Cross-sectional survey.

Comprehensive school in the municipality of Butera, a rural area of Sicily, South Italy.

The survey was conducted between March and May 2010 on 445 students (4–16 years).

All constructs of the questionnaire had statistically significant Cronbach's α and Pearson's correlation coefficients, showing good internal consistency and temporal stability. After controlling for covariates, nutrition knowledge was positively associated with pasta/rice, fish, vegetable and fruit intakes, and negatively with sweets, snacks, fried foods and sugary drinks consumption. Moreover, students whose parents were in the highest educational and occupational categories reported eating significantly more fruits and vegetables and less meat, sweets, snacks, fried foods and sugary drinks. Students with higher nutrition knowledge scores were less likely to have two or more snacks daily and to spend more than 3 h in sedentary activities daily (OR = 0·89, 95 % CI 0·83, 0·97 and OR = 0·92, 95 % CI 0·86, 0·99, respectively). High parental education was associated with less frequent snacking and more frequent weekly physical activity, compared with lower categories, whereas high parental occupational category was associated with daily breakfast.

Improving nutrition knowledge in children and young adolescents may translate into educating them in good dietary habits. Moreover, nutrition intervention programmes should also involve parents to improve dietary quality and nutritional habits of the entire family.

To assess change in the 4-year prevalence (2006–2009) of the use of food in school fundraising and as rewards and incentives for students, following implementation of federal legislation in the USA in 2006.

Serial cross-sectional design using trend analysis to assess school-level data collected over four consecutive years from 2006/2007 to 2009/2010.

Minneapolis/St. Paul, MN.

Convenience sample of middle and high schools participating in two longitudinal, aetiological studies that examined youth, their environment and obesity-related factors.

A significant and sustained decrease was demonstrated in the use of low-nutrient, energy-dense foods in school fundraising activities and the use of food and food coupons as rewards and incentives by teachers and school staff.

Results support the utility of policy and legislative action as a tool for creating healthy, sustainable environmental change.

To assess the most important sociodemographic determinants of age at introduction of complementary foods in infancy.

A prospective birth cohort with increased risk of type 1 diabetes, recruited between 1996 and 2004. The families completed at home a follow-up form on the age at introduction of new foods and, for each clinic visit, a structured dietary questionnaire with 3 d food records.

Data from the Type 1 Diabetes Prediction and Prevention (DIPP) Project, Finland.

A cohort of 5991 infants (77 % of those invited) belonging to the DIPP Nutrition Study.

Sixty-three per cent of the infants were introduced to complementary foods, including infant formula, before the age of 4 months. The median age at introduction of infant formula was 1·5 months (range 0–18 months) and that of the first other complementary food 3·5 months (range 0·7–8 months). All sociodemographic and lifestyle factors studied were associated with the age at introduction of infant formula and/or first other complementary food. Female sex of the infant, being born in the southern region of Finland, living in a rural municipality, the presence of siblings, the mother or the father being a high-school graduate, high maternal professional education and maternal non-smoking during pregnancy predicted later introduction of complementary foods.

Compliance was relatively poor with the current recommendations for the age of introducing complementary foods. Small-sized young families with less well-educated parents were most prone to introduce complementary foods early.

To evaluate whether food behaviours of parents are associated with children's dietary intakes outside the child-care setting, and to compare children's dietary intakes at home with foods and beverages consumed when they are at child-care centres.

In 2005–2006, a survey was completed by parents of at least one child between 3 and 5 years old who attended group child-care centres. Surveys about nutrition practices were completed by centre directors. Research assistants observed foods and beverages consumed by children at lunchtime at the centres.

Sixteen licensed group child-care centres in three underserved New York City communities (South Bronx, East/Central Harlem, Central Brooklyn) and the Lower East Side of Manhattan.

Two hundred parents.

Children were more likely to consume healthful foods including fruits or vegetables if parents reported purchasing food from produce stands/farmers’ markets, shopped for frozen or canned fruits frequently and ate family meals or meals prepared at home daily. Children were more likely to consume less healthful foods such as French fries, or fruit drinks, more frequently if parents reported eating meals from fast-food or other restaurants at least once weekly, or if children ate while watching television. Types of foods and beverages offered to children at home (e.g. higher-fat milk, soft drinks and desserts) were less healthful than those offered at child-care centres.

Children's dietary intakes at home need to be improved. Parents need to understand the importance of providing home environments that support healthful food behaviours in children.

To describe shared meal patterns and examine associations with dietary intake among young adults.

Population-based, longitudinal cohort study (Project EAT: Eating and Activity in Teens and Young Adults).

Participants completed surveys and FFQ in high-school classrooms in Minneapolis/St. Paul, MN, USA in 1998–1999 (mean age = 15·0 years, ‘adolescence’) and follow-up measures online or by mail in 2008–2009 (mean age = 25·3 years, ‘young adulthood’).

There were 2052 participants who responded to the 10-year follow-up survey and reported on frequency of having shared meals.

Among young adults, the frequency of shared meals during the past week was as follows: never (9·9 %), one or two times (24·7 %), three to six times (39·1 %) and seven or more times (26·3 %). Having more frequent family meals during adolescence predicted a higher frequency of shared meals in young adulthood above and beyond other relevant sociodemographic factors such as household composition and parental status. Compared with young adults who never had family meals during adolescence, those young adults who reported seven or more family meals per week during adolescence had an average of one additional shared meal per week. Having more frequent shared meals in young adulthood was associated with greater intake of fruit among males and females, and with higher intakes of vegetables, milk products and some key nutrients among females.

Nutrition professionals should encourage families of adolescents to share meals often and establish the tradition of eating together, and work with young adults to ensure that healthy food and beverage choices are offered at mealtimes.

To identify food sources of Na in a group of community-dwelling women in Adelaide, South Australia. A secondary aim was to measure Na excretion in this group.

Survey.

Community setting, Adelaide, South Australia.

Seventy healthy women (mean age 48·6 (sd 8·1) years, mean BMI 28·6 (sd 6·3) kg/m2) living in metropolitan Adelaide, South Australia and participating in a validation study of an FFQ. Dietary intake was derived from two 4 d weighed food records. Foods from the 4 d weighed food records were grouped according to foods or food groups to establish contributors to Na intake. Na excretion was measured in two 24 h urine samples. Completeness of urine collections was verified using creatinine excretion.

Bread alone contributed 19·0 % of Na intake, with an overall contribution from the breads and cereals group of 32·5 %. Meat products contributed 14·4 % of intake, the dairy and eggs group (excluding cheese) 9·6 % and combination dishes (e.g. pizza, quiche, sandwiches and stir fry dishes) 8·4 %. Na excretion was 126 (sd 42) mmol/d, i.e. approximately 7·6 (sd 2.5) g salt/d. Seventy per cent of participants (n 48) had Na excretion ≥100 mmol/d (146 (sd 34) mmol/d).

Effective Na reduction could be achieved by reducing the amount in staple foods such as bread and meat products.

To determine (i) the importance of parents’ motives for everyday family food choices; and (ii) the relationship between parental food choice motives and eating patterns of 12- to 13-year-old children.

Cross-sectional study. A modified version of the Food Choice Questionnaire was used to determine parental motives for food choices. The children's food and drink intake was reported by their parents using a retrospective FFQ. Eating patterns were derived using principal component analysis. The association between food choice motives and eating patterns was examined using multiple linear regression analysis.

Primary schools, Telemark County, Norway.

In total, 1095 children aged 12–13 years and their parents.

The parental motive ‘sensory appeal’ was the most important for food choice, followed by ‘health’, ‘convenience’, ‘natural content’ and ‘weight control’. The food choice motives were associated with the eating patterns of the children, independent of background variables. The motive ‘health’ was most strongly associated with a ‘varied Norwegian’ eating pattern, representing a diverse diet and regular meals, while the motive ‘convenience’ appeared to be the most important barrier to this eating pattern. ‘Weight control’ was not associated with the ‘varied Norwegian’ eating pattern.

To encourage parents to make healthy food choices for their children, health promotion activities should focus on the health benefits of a diverse diet and regular meals, rather than weight control. Recommended food products should be made more convenient and easily available for families with children.

To investigate maintenance of changes in food intake and motivation for healthy eating at follow-up 2 data collection after a lifestyle intervention among Pakistani immigrant women.

A culturally adapted lifestyle intervention, aiming at reducing the risk of type 2 diabetes mellitus. Data collection including FFQ and questions on intentions to change dietary behaviour was completed at baseline, right after the 7 ± 1 month intervention (follow-up 1) and 2–3 years after baseline (follow-up 2).

Oslo, Norway.

Pakistani women (n 198), aged 25–60 years, randomized into control and intervention groups.

From follow-up 1 to follow-up 2 there was a shift from action to maintenance stages for intention to reduce fat intake (P < 0·001), change type of fat (P = 0·001), increase vegetable intake (P < 0·001) and reduce sugar intake (P = 0·003) in the intervention group. The reduction in intakes of soft drinks with sugar, fruit drinks with sugar and red meats, and the increase in intakes of vegetables and fish from baseline to follow-up 1 were maintained (significant change from baseline) at follow-up 2 in the intervention group. The intake of vegetables was higher (P = 0·019) and the intake of fruit drinks with sugar lower (P = 0·023) in the intervention group compared with the control group at follow-up 2.

The culturally adapted intervention had the potential of affecting intentions to change food behaviour among Pakistani immigrant women long after completion of the intervention and also of leading to long-term maintenance of beneficial changes in diet.