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To describe the worldwide implementation of the WHO Child Growth Standards (‘WHO standards’).
Design
A questionnaire on the adoption of the WHO standards was sent to health authorities. The questions concerned anthropometric indicators adopted, newly introduced indicators, age range, use of sex-specific charts, previously used references, classification system, activities undertaken to roll out the standards and reasons for non-adoption.
Setting
Worldwide.
Subjects
Two hundred and nineteen countries and territories.
Results
By April 2011, 125 countries had adopted the WHO standards, another twenty-five were considering their adoption and thirty had not adopted them. Preference for local references was the main reason for non-adoption. Weight-for-age was adopted almost universally, followed by length/height-for-age (104 countries) and weight-for-length/height (eighty-eight countries). Several countries (thirty-six) reported newly introducing BMI-for-age. Most countries opted for sex-specific charts and the Z-score classification. Many redesigned their child health records and updated recommendations on infant feeding, immunization and other health messages. About two-thirds reported incorporating the standards into pre-service training. Other activities ranged from incorporating the standards into computerized information systems, to providing supplies of anthropometric equipment and mobilizing resources for the standards’ roll-out.
Conclusions
Five years after their release, the WHO standards have been widely scrutinized and implemented. Countries have adopted and harmonized best practices in child growth assessment and established the breast-fed infant as the norm against which to assess compliance with children's right to achieve their full genetic growth potential.
To analyse (i) differences in beverage pattern among Norwegian children in 2001 and 2008; (ii) beverage intake related to gender, parental education and family composition; and (iii) potential disparities in time trends among the different groups.
Design
Within the Fruits and Vegetables Make the Marks (FVMM) project, 6th and 7th grade pupils filled in a questionnaire about frequency of beverage intake (times/week) in 2001 and 2008.
Setting
Twenty-seven elementary schools in two Norwegian counties.
Subjects
In 2001 a total of 1488 and in 2008 1339 pupils participated.
Results
Between 2001 and 2008, a decreased consumption frequency of juice (from 3·6 to 3·4 times/week, P = 0·012), lemonade (from 4·8 to 2·5 times/week, P < 0·001) and regular soft drinks (from 2·7 to 1·6 times/week, P < 0·001), but an increased consumption frequency of diet soft drinks (from 1·2 to 1·6 times/week, P < 0·001), were observed. From 2001 to 2008, boys increased their frequency of juice consumption (from 3·1 to 3·3 times/week) whereas girls decreased their frequency of juice consumption (3·8 to 3·4 times/week; interaction time × gender P = 0·02). Children with higher educated parents increased their frequency of juice consumption (3·6 to 3·8 times/week) whereas those with lower educated parents decreased their frequency of juice consumption (3·3 to 3·0 times/week; interaction time × parental education P = 0·04).
Conclusion
A lower frequency of consumption of sugar-sweetened beverages was observed among pupils in 2008 than in 2001. This is in accordance with the Norwegian health authority's goals and strategies for this time period, and is an important step to improve the dietary health of adolescents.
To assess the magnitude and determinants of vitamin A deficiency (VAD) and coverage of vitamin A supplementation (VAS) among pre-school children.
Design
A community-based cross-sectional study was carried out by adopting a multistage, stratified, random sampling procedure.
Setting
Rural areas of eight states in India.
Subjects
Pre-school children and their mothers were covered.
Results
A total of 71 591 pre-school children were clinically examined for ocular signs of VAD. Serum retinol concentrations in dried blood spots were assessed in a sub-sample of 3954 children using HPLC. The prevalence of Bitot spots was 0·8 %. The total ocular signs were significantly higher (P < 0·001) among boys (2·6 %) compared with girls (1·9 %) and in older children (3–4 years) compared (P < 0·001) with younger (1–2 years), and were also high in children of labourers, scheduled castes and illiterate mothers. The odds of having Bitot spots was highest in children of scheduled caste (OR = 3·8; 95 % CI 2·9, 5·0), labourers (OR = 2·9; 95 % CI 2·1, 3·9), illiterate mothers (OR = 2·7; 95 % CI 2·2, 2·3) and households without a sanitary latrine (OR = 5·9; 95 % CI 4·0, 8·7). Subclinical VAD (serum retinol level <20 μg/dl) was observed in 62 % of children. This was also relatively high among scheduled caste and scheduled tribe children. The rate of coverage of VAS was 58 %.
Conclusions
The study revealed that VAD is a major nutritional problem and coverage of VAS was poor. The important determinants of VAD were illiteracy, low socio-economic status, occupation and poor sanitation. Strengthening the existing VAS programme and focused attention on dietary diversification are essential for prevention of VAD.
Nutrition label use could help consumers eat healthfully. Despite consumers reporting label use, diets are not very healthful and obesity rates continue to rise. The present study investigated whether self-reported label use matches objectively measured label viewing by monitoring the gaze of individuals viewing labels.
Design
The present study monitored adults viewing sixty-four food items on a computer equipped with an eye-tracking camera as they made simulated food purchasing decisions. ANOVA and t tests were used to compare label viewing across various subgroups (e.g. normal weight v. overweight v. obese; married v. unmarried) and also across various types of foods (e.g. snacks v. fruits and vegetables).
Setting
Participants came to the University of Minnesota's Epidemiology Clinical Research Center in spring 2010.
Subjects
The 203 participants were ⩾18 years old and capable of reading English words on a computer 76 cm (30 in) away.
Results
Participants looked longer at labels for ‘meal’ items like pizza, soup and yoghurt compared with fruits and vegetables, snack items like crackers and nuts, and dessert items like ice cream and cookies. Participants spent longer looking at labels for foods they decided to purchase compared with foods they decided not to purchase. There were few between-group differences in nutrition label viewing across sex, race, age, BMI, marital status, income or educational attainment.
Conclusions
Nutrition label viewing is related to food purchasing, and labels are viewed more when a food's healthfulness is ambiguous. Objectively measuring nutrition label viewing provides new insight into label use by various sociodemographic groups.