To develop a targeted FFQ (TFFQ) and evaluate its effectiveness for ranking minority women by their intake of multiple nutrients important to a healthy pregnancy.

In Stage 1, food groups derived from 24 h recall dietary data were entered into a stepwise multiple regression model to identify ‘discriminating’ foods for the TFFQ; in Stage 2, the TFFQ and a 24 h recall were administered to pregnant women. The TFFQ data were used to create a Habitual Multi-Nutrient Intake Scale (H-MNIS) for ranking the women. The effectiveness of the ranking was tested against women’s reported nutrient intakes on the 24 h recall.

Southern Israel.

In Stage 1, 519 Bedouin Arab adults; in Stage 2, 404 pregnant Bedouin women.

Of the ninety-three food groups included in the regression analysis, twenty-eight explained >80 % of the between-person variability in the intake of the target nutrients. Whole-wheat bread was a main discriminator for protein, Fe, Zn, Ca and folate. Fish, poultry and canned tuna explained ≥88 % of the between-person variation in DHA and EPA intakes. The mean daily intakes of pregnant Bedouin women from the 24 h recall data differed significantly across H-MNIS quartiles (P < 0·01) for all but three target nutrients (folate, EPA, DHA); and the P for trend was significant (P < 0·02) for all but EPA.

The TFFQ and H-MNIS represent rapid assessment tools for studying maternal nutrition on a multi-nutrient basis, and effectively ranked pregnant Bedouin women into exposure groups by their intake of the target nutrients.

The present study was conducted to assess the current status of iodine-deficiency disorders (IDD) in the National Capital Region of Delhi (NCR Delhi) and evaluate the implementation and impact of the National Iodine Deficiency Disorders Control Programme (NIDDCP).

Cross-sectional study.

School-going children (n 1230) in the age group of 6–12 years were enrolled from thirty primary schools in the Municipal Corporation of Delhi. Thirty schools were selected using the probability-proportional-to-size cluster sampling methodology. In each identified school forty-one children were surveyed. Urine and salt samples were collected and studied for iodine concentration. A total of sixty salt samples from retail level were also collected.

Schoolchildren aged 6–12 years.

The median urinary iodine excretion (UIE) was found to be 198·4 μg/l. The percentage of children with UIE levels of <20·0, 20·0–49·9, 50·0–99·9 and ≥100·0 μg/l was 1·9, 4·3, 9·5 and 84·2 %, respectively. The proportion of households consuming adequately iodized salt (salt with iodine levels of at least 15 ppm at consumption level) was 88·8 %. The assessment of iodine content of salt revealed that only 6·1 % of the families were consuming salt with iodine content less than 7 ppm. At retail level 88·3 % of salt samples had >15 ppm iodine.

Significant progress has been achieved towards elimination of IDD from NCR Delhi. There is a need for further strengthening of the system to monitor the quality of iodized salt provided to the beneficiaries under the universal salt iodization programme and so eliminate IDD from NCR Delhi.

To explore differences in the prevalence of outdoor food advertising, and the type and nutritional content of advertised foods, according to an area-based marker of socio-economic position (SEP) in a city in Northern England.

All outdoor advertisements in the city were identified during October–December 2009, their size (in m2) estimated and their location determined using a global positioning system device. Advertisements were classified as food or non-food. Food advertisements were classified into one of six food categories. Information on the nutritional content of advertised foods was obtained from packaging and manufacturer's websites. An area-based marker of SEP was assigned using the location of each advertisement, grouped into three affluence tertiles for analysis.

A city in Northern England.

None.

In all, 1371 advertisements were identified; 211 (15 %) of these were for food. The advertisements covered 6765 m2, of which 1326 m2 (20 %) was for food. Total advertising and food advertising space was largest in the least affluent tertile. There was little evidence of socio-economic trends in the type or nutritional content of advertised foods.

Despite an absence of socio-economic differences in the type and nutritional content of advertised foods, there were socio-economic differences in food advertising space. There may also be socio-economic differences in exposure to outdoor food advertising.

To evaluate the utility of the Mini-Nutritional Assessment (MNA) in assessing nutritional, physical and psychosocial functions in community-living elderly individuals.

A cross-sectional study of elderly individuals investigated in August 2007 and August–September 2008. Nutritional status was assessed using serum biomarkers, anthropometric measurements and the MNA. Physical function was assessed by measuring grip strength and both usual and maximum walking speeds. The Geriatric Depression Scale (GDS) was used to measure the individual's depressive state.

Elder-care facilities in Tokyo, Japan.

Community-living elderly individuals aged ≥65 years (n 130).

The MNA evaluation classified twenty-seven (20·8 %) individuals as being at risk for malnutrition (MNA score ≤23·5); these at-risk individuals included a high proportion of the elderly aged ≥75 years. MNA scores correlated with nutritional biomarkers (total protein, albumin, cholinesterase, Hb) and anthropometric measurements (triceps skinfold, subscapular skinfold, mid-arm muscle area) and exhibited a strong correlation with grip strength and GDS score. Multivariate analysis revealed that grip strength, GDS score, marital status and maximum walking speed are strong predictors of MNA score.

The MNA is considerably useful in providing a comprehensive assessment of nutritional status in elderly, community-living Japanese. However, larger-scale epidemiological studies are needed to determine the utility and the appropriate cut-off point of the MNA as a screen for risk of malnutrition.

To assess the available data on the prevalence of metabolic syndrome (MS) in Latin-American countries.

Systematic review. Searches were carried out in PubMed, ISIWeb, SCielo and Redalyc, using ‘metabolic syndrome x’ and ‘prevalence’ as keywords for titles and/or abstracts. Articles selected were cross-sectional studies in Latin-American countries, whose main objective was to study MS and whose study population is described below. MS must be determined using Adult Treatment Panel III criteria. Twelve studies with these criteria were selected, one of which was multi-centric.

Latin America.

Apparently healthy subjects aged 18–65 years (including young adult, mature adult and elderly populations) of both genders.

The general prevalence (weighted mean) of MS in Latin-American countries was 24·9 (range: 18·8–43·3) %. MS was slightly more frequent in women (25·3 %) than in men (23·2 %), and the age group with the highest prevalence of MS consisted of those over 50 years of age. The most frequent components of MS were low HDL cholesterol levels (62·9 %) and abdominal obesity (45·8 %). Similar outcomes were obtained from the multi-centre study on Latin-American populations analysed.

The present review brings us closer to an understanding of the prevalence of MS in Latin-American countries. However, it is not possible to know the full scope of the problem, partly because data from some countries are not available, and because the methodological differences among the studies published up to the present limit a joint analysis of their results.

To compare the general adiposity index (BMI) with abdominal obesity indices (waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR)) in order to examine the best predictor of cardiometabolic risk factors among Hispanics living in Puerto Rico.

Secondary analysis of measurements taken from a representative sample of adults. Logistic regression models (prevalence odds ratios (POR)), partial Pearson's correlations (controlling for age and sex) and receiver-operating characteristic (ROC) curves were calculated between indices of obesity (BMI, WC, WHR and WHtR) and blood pressure, HDL cholesterol (HDL-C), LDL cholesterol (LDL-C), total cholesterol (TC):HDL-C, TAG, fasting blood glucose, glycosylated Hb, high-sensitivity C-reactive protein (hs-CRP), fibrinogen, plasminogen activator inhibitor-1 (PAI-1) and an aggregated measure of cardiometabolic risk.

Household study conducted between 2005 and 2007 in the San Juan Metropolitan Area in Puerto Rico.

A representative sample of 858 non-institutionalized adults.

All four obesity indices significantly correlated with the cardiometabolic risk factors. WHtR had the highest POR for high TC:HDL-C, blood pressure, hs-CRP, fibrinogen and PAI-1; WC had the highest POR for low HDL-C and high LDL-C and fasting blood glucose; WHR had the highest POR for overall cardiometabolic risk, TAG and glycosylated Hb. BMI had the lowest POR for most risk factors and smallest ROC curve for overall cardiometabolic risk.

The findings of the study suggest that general adiposity and abdominal adiposity are both associated with cardiometabolic risk in this population, although WC, WHR and WHtR appear to be slightly better predictors than BMI.

To explore how the quality of school lunch consumed reflected overall eating patterns in school-aged children.

Children filled in an Internet-based questionnaire about their eating patterns. The children were then divided into balanced and imbalanced school lunch eaters on the basis of their responses in the questionnaire. A balanced school lunch consisted of, by the definition used in the present study, a main dish, salad and bread.

Eleven primary schools and one middle school in eastern Finland.

A total of 531 schoolchildren (247 boys and 284 girls) aged 11–16 years.

The school lunch was balanced in 46·5 % of children. Eating a balanced school lunch was associated with overall healthier eating patterns outside school. Children who ate a balanced school lunch had more regular meal times and consumed healthier snacks. They ate fruit or berries and vegetables, dairy products and wholegrain foods more often, consumed fewer salty snacks, pizzas, meat pies and drank fewer soft drinks and energy drinks. Their eating patterns at home were also healthier, with vegetables being offered at every family dinner and fruit being offered daily, whereas soft drinks were offered seldom.

The choices made by children in their school lunch reflect the overall eating patterns among school-aged children. Eating a balanced school lunch is associated with more regular meal patterns, the availability of healthier foods at home and an overall healthier diet, suggesting that healthy eating patterns are learnt at home.

To assess time trends in the contribution of processed foods to food purchases made by Brazilian households and to explore the potential impact on the overall quality of the diet.

Application of a new classification of foodstuffs based on extent and purpose of food processing to data collected by comparable probabilistic household budget surveys. The classification assigns foodstuffs to the following groups: unprocessed/minimally processed foods (Group 1); processed culinary ingredients (Group 2); or ultra-processed ready-to-eat or ready-to-heat food products (Group 3).

Eleven metropolitan areas of Brazil.

Households; n 13 611 in 1987–8, n 16 014 in 1995–5 and n 13 848 in 2002–3.

Over the last three decades, the household consumption of Group 1 and Group 2 foods has been steadily replaced by consumption of Group 3 ultra-processed food products, both overall and in lower- and upper-income groups. In the 2002–3 survey, Group 3 items represented more than one-quarter of total energy (more than one-third for higher-income households). The overall nutrient profile of Group 3 items, compared with that of Group 1 and Group 2 items, revealed more added sugar, more saturated fat, more sodium, less fibre and much higher energy density.

The high energy density and the unfavourable nutrition profiling of Group 3 food products, and also their potential harmful effects on eating and drinking behaviours, indicate that governments and health authorities should use all possible methods, including legislation and statutory regulation, to halt and reverse the replacement of minimally processed foods and processed culinary ingredients by ultra-processed food products.

There is increasing interest in vitamin D and its possible health effects. The aims of the present overview are to summarise the research on common diseases for which there is substantial evidence on vitamin D, identify diseases where vitamin D may be beneficial and discuss the public health implications of these findings.

Literature search of PubMed for the years 2000 to 2010 to identify cohort studies with baseline measures of 25-hydroxyvitamin D (25(OH)D) and randomised controlled trials (RCT) of vitamin D supplementation in relation to fractures, colorectal cancer, CVD and all-cause mortality. Risk ratios of disease from comparisons between 25(OH)D quantiles in these studies were summarised using RevMan software version 5·1 (The Nordic Cochrane Centre, Copenhagen).

Community-based samples recruited into cohort studies from many countries.

Older men and women, mostly above 50 years of age.

When comparing the lowest 25(OH)D category with the highest (or reference), the pooled risk ratio (95 % CI) was: 1·34 (1·13, 1·59) for fractures from nine studies; 1·59 (1·30, 1·95) for colorectal cancer from nine studies; 1·35 (1·17, 1·56) for CVD from twelve studies; and 1·42 (1·23, 1·63) for all-cause mortality from twelve studies.

Cohort studies show that baseline 25(OH)D levels predict increased risk of fractures, colorectal cancer, CVD and all-cause mortality. These associations are weak and could be explained by confounding variables such as obesity and physical activity. Because of their potential public health significance, RCT using vitamin D doses ≥50 μg/d are required to determine whether vitamin D protects against these diseases.

Low bone mass often leads to osteoporosis and increased risk of bone fractures. Soda consumption may contribute to imbalances that lead to decreased bone mineral density (BMD) and general bone health. We examined the relationship between soda consumption and osteoporosis risk in postmenopausal American-Indian women, an at-risk population because of nutritional and other lifestyle-related factors.

Cross-sectional analysis using logistic regression to examine associations between soda consumption and osteoporosis, and linear regression to examine the association between soda consumption and BMD, with and without adjustment for demographic and lifestyle factors. Quantitative ultrasound of the heel was performed to estimate BMD (g/cm2).

American-Indian communities in the Northern Plains and Southwestern USA.

A total of 438 postmenopausal American-Indian women.

Women with osteoporosis were significantly older and had lower BMI, average daily soda intakes, BMD levels and use of hormones than women without osteoporosis (P < 0·05). Soda consumption was not associated with increased odds of osteoporosis in either unadjusted or adjusted models (P > 0·05), although age (increased), BMI (decreased) and past hormone use (decreased) were all significantly associated with osteoporosis risk (P < 0·05).

Although the present study did not find associations between soda consumption and osteoporosis risk in postmenopausal American-Indian women, analyses did confirm confounding between soda consumption and age and BMI. This suggests that any potential effects of soda consumption on bone health are largely mediated through these factors.

To measure folic acid awareness and intake rates among women of childbearing age in certain areas of China with a high prevalence of neural tube defects (NTD).

A cross-sectional survey was carried out utilising a nineteen-item questionnaire enquiring into individual women's knowledge of, attitude towards and practice of folic acid supplementation.

A total of 293 low-income counties in six provinces of China.

Women aged 19–44 years from six provinces with a high prevalence of NTD recruited from June to August 2008.

Among 33 025 participants, 57 % had heard of folic acid but only 15 % knew all of the core information. The intake rate was 12 %; only 8 % took the recommended dose and only 4 % of non-pregnant women took folic acid. Some women did not take folic acid because they did not know that they should take it (49 %) or they had misconceptions about it (24 %). According to logistic regression analysis, rural residence was a risk factor for folic acid awareness. Ethnicity, educational level, average annual income per person and pregnancy were the influencing factors of folic acid awareness and folic acid intake.

Although more than half of the respondents had heard of folic acid, the intake rate was still very low in areas with a high prevalence of NTD. Thus, more efforts are needed to increase folic acid awareness and intake among women of reproductive age in these areas.

To present the Mediterranean diet as an example of a sustainable diet, in which nutrition, biodiversity, local food production, culture and sustainability are strongly interconnected.

Review of notions and activities contributing towards the acknowledgement of the Mediterranean diet as a sustainable diet.

The Mediterranean region and its populations.

Mediterranean populations.

The acknowledgement of the Mediterranean diet as a sustainable diet needs the development of new cross-cutting intersectoral case studies to demonstrate further the synergies among nutrition, biodiversity and sustainability as expressed by the Mediterranean diet for the benefit of present and future generations.

The proportion of the Latin American population aged >60 years is expected to double during the next few decades. Metabolic syndrome (MetS) is associated with high morbidity and mortality worldwide. However, little is known about MetS in Latin America in general, and in Ecuador in particular. The present study aimed to examine the prevalence of MetS and its association with blood micronutrient, homocysteine (Hcy) and C-reactive protein (CRP) concentrations in the elderly living in a low-income urban area.

We performed a cross-sectional study. MetS, using the International Diabetes Federation definition, dietary intake and plasma micronutrient, CRP and Hcy concentrations were assessed.

A total of 352 elderly (≥65 years) Ecuadorians.

Quito, Ecuador.

MetS was prevalent (40 %) – considerably more so among women (81 %) than men (19 %; χ2 = 32·6, P < 0·0001). Further, 53 % of those without MetS exhibited two or more of its components. Micronutrient deficiencies were prevalent, including those of vitamin C, zinc, vitamin B12 and folate. Vitamin C and E concentrations were inversely (OR = 0·78, 95 % CI 0·71, 0·86; OR = 0·16, 95 % CI 0·03, 0·81, respectively) and CRP (OR = 1·79, 95 % CI 1·04, 3·06) was positively associated with MetS.

The coexistence of MetS with micronutrient deficiencies suggests that elderly Ecuadorians suffer from the double burden of diseases that are increasingly being observed in less developed countries. More research is needed to determine the causal factors, but results presented suggest that these older adults would benefit from interventions to reduce the risk factors for MetS, in particular higher consumption of micronutrient-rich foods.

To examine the association of meat consumption with diabetes risk in the Hawaii component of the Multiethnic Cohort and to assess effect modification by ethnicity.

A prospective cohort study. Baseline information on diet and lifestyle was assessed by questionnaire. The cohort was followed up for incident cases of diabetes, which were identified through self-reports, medication questionnaires, or health plan linkages. Cox regression was used to calculate hazard ratios (HR) and 95 % confidence intervals for diabetes associated with quintile of meat consumption.

Hawaii, USA.

A total of 29 759 Caucasian, 35 244 Japanese-American and 10 509 Native Hawaiian men and women, aged 45–75 years at baseline.

During a mean follow-up time of 14 years, 8587 incident diabetes cases were identified. Intake of red meat was positively associated with diabetes risk in men (fifth v. first quintile: HR = 1·43; 95 % CI 1·29, 1·59) and women (fifth v. first quintile: HR = 1·30; 95 % CI 1·17, 1·45) in adjusted models. The respective HR for processed red meat intake were 1·57 (95 % CI 1·42, 1·75) and 1·45 (95 % CI 1·30, 1·62). The association for processed poultry was weaker than for processed red meat, and fresh poultry intake was not associated with diabetes risk. For men only, we observed significant interactions of ethnicity with the red and processed red meat associations, with Caucasians experiencing slightly higher risks than Japanese-Americans.

Our findings support the growing evidence that red and processed meat intake increase risk for diabetes irrespective of ethnicity and level of BMI.

The present study sought to determine the feasibility of an experimental research design to investigate the effects of exposure to magazine advertising on children's food choices.

Children were randomized to read either a magazine with food advertisements or a magazine with no food advertisements. They then chose two food items from the intervention ‘store’ to eat after the session. Data were also collected on attitudes to advertising and snack food preferences. Finally, participants’ parents were provided with a self-completion survey on food choices and other variables (n 24).

Three vacation care centres in regional New South Wales, Australia.

Children aged 5–12 years (n 47).

Children in the experimental condition were more likely to choose advertised foods than those in the control group. Interestingly, the majority reported taste and healthiness as the most important factors in snack food choices; however, when faced with the actual food choice, they predominantly chose unhealthy foods (eighty-two unhealthy and only twelve healthy items were chosen).

This was the first study to assess the effects on children of exposure to food advertising within the context of reading a child-targeted magazine. Importantly, even with the small sample size and venue limitations, we found that exposure to magazine advertising influenced food choices. Children's magazines are an under-researched and poorly regulated medium, with considerable potential to influence children's food choices. The present study shows that the methodology is feasible, and future studies could replicate this with larger samples.

To determine the reproducibility and validity of a short FFQ (SFFQ) for Australian rural children aged 10 to 12 years, particularly Aboriginal and Torres Strait Islander children.

In this cross-sectional study participants completed the SFFQ on two occasions and three 24 h recalls. Concurrent validity was established by comparing results of the first SFFQ against food recalls; reproducibility was established by comparing the two SFFQ.

The north coast of New South Wales in the Australian summer of late 2005.

Two hundred and forty-one children (ninety-two Aboriginal and Torres Strait Islander children and 100 boys) completed two SFFQ and were included in the reproducibility study; of these, 205 participants with a mean age of 10·8 (sd 0·7) years took part in the validity study.

The SFFQ showed moderate to good reproducibility among all children with kappa coefficients for repeated measures between 0·41 and 0·80. Eighteen of twenty-three questions demonstrated good validity against the mean of the 24 h recalls, with statistically significant increasing trends (P ≤ 0·05) for mean daily weight and/or frequency as survey response categories increased. A similar number of short questions showed good validity for Aboriginal and Torres Strait Islander children as for their non-Indigenous counterparts.

Many short questions in this SFFQ are able to discriminate between different categories of food intake and provide information on relative intake within the given population. They can be used to monitor and/or evaluate population-wide health programmes, including those with rural Aboriginal and Torres Strait Islander children.

To describe and compare food and nutrient intakes in New Zealand (NZ) children on schooldays and non-schooldays.

Secondary analysis of cross-sectional data from the NZ 2002 Children’s Nutrition Survey. Dietary intake was assessed using computer-assisted multi-pass 24 h dietary recalls in the home. Data were adjusted for survey weightings to be representative of the NZ population. The effect of day category on nutrient intake, and likelihood of consumption of food categories were determined using linear and logistic regression.

NZ homes and schools.

A total of 2572 children (538 non-schooldays and 2034 schooldays) at the age of 5–14 years.

There were differences in the proportion consuming some food groups between schooldays and non-schooldays, although the majority of nutrient intakes including energy did not differ by day category. Mean cholesterol intake was higher on non-schooldays; dietary fibre and available carbohydrate, in particular sucrose and fructose, were higher on schooldays. Hot chips were twice as likely to be consumed on a non-schoolday. Soft drink consumption was higher on non-schooldays for Māori/New Zealand European and others and powdered drinks/cordial consumption did not vary by day category. More children consumed snack bars (normal weight, obese), fruit, sandwiches, biscuits/crackers and snack foods on schooldays. There was no difference in consumption of pies/sausage rolls by day category.

The proportion of consumers of a variety of foods differed significantly between non-schooldays and schooldays; few nutrient intakes differed. The present study indicates that family food, wherever it is consumed, is the mainstay of nutrition for NZ schoolchildren.

The goal of the present study was to examine the influence of community environment on the nutritional status (weight-for-age and height-for-age) of children (aged 0–59 months) in Bangladesh. In addition, we tested the association between specific characteristics of community environments and child nutritional status.

Cross-sectional survey.

The data are from the nationally representative 2004 Bangladesh Demographic and Health Survey.

Respondents were ever-married women (aged 15–49 years) and their children (n 5731), residing in 361 communities. Child nutritional outcomes are physical measurements of weight-for-age and height-for-age in sd units. We considered the following attributes of community environments potentially related to child nutrition: (i) community water and sanitation infrastructure; (ii) availability of community health and education services; (iii) community employment and social participation; and (iv) education level of the community.

Multilevel regression analysis showed that the spatial distribution of maternal and child covariates did not entirely explain the between-community variation in child nutritional status. The education level of the community emerged as the strongest community-level predictor of child height-for-age (highest v. lowest tertile, β = 0·18 (se 0·07)) and weight-for-age (highest v. lowest tertile, β = 0·21 (se 0·06)). In the height-for-age model, community employment and social participation also emerged as being statistically significant (highest v. lowest tertile, β = 0·13 (se = 0·06)).

The community environment influences child nutrition in Bangladesh, and maternal- and child-level covariates may fail to capture the entire influence of communities. Interventions to reduce child undernutrition in developing countries should take into consideration the wider community context.

To examine the risk of CHD in relation to alcohol intake from three different instruments.

In the European Prospective Investigation into Cancer in Norfolk study, weekly alcohol intake was estimated from a single question in a mail-in health and lifestyle questionnaire (HLQ), a semi-quantitative FFQ, and a 7 d diet diary (7DD). Information on smoking status, physical activity, disease history, social class and medication use was reported in the HLQ. Height, weight, blood pressure and blood lipids were measured at a health check-up. The average length of follow-up was 11 years. The association between alcohol intake and incident fatal and non-fatal CHD in a nested case–control sample was calculated using logistic regression.

Norfolk, England.

A total of 2151 cases of incident fatal and non-fatal CHD and 5354 controls.

The Spearman correlation values between the 7DD, FFQ and HLQ alcohol estimates ranged from r = 0·70 to 0·82 (P < 0·0001 for all r values). Alcohol intake from all instruments was inversely associated with the risk of CHD in age- and multivariate-adjusted models. The relationships between the risk of CHD and alcohol intake from the 7DD, HLQ or FFQ were not significantly different from each other (P >0·10). A marginal difference between men and women was detected for the risk of CHD in relation to HLQ alcohol intake (P = 0·065).

In conclusion, while the instruments were not uniform in their assessment of alcohol intake levels, the 7DD, HLQ and FFQ yielded similar inverse associations between alcohol intake and risk of CHD.