To determine the relative validity of the culture-sensitive quantitative food frequency questionnaire (QFFQ) developed for the Transition, Health and Urbanisation in South Africa (THUSA) study by 7-day weighed food records, urinary nitrogen excretion and basal metabolic rate (BMR).

A cross-sectional study.

A community-based study in a population stratified according to level of urbanization.

Residents of the North West Province, South Africa, aged between 15 and 65 years. The weighed food record study comprised 74 participants while 104 participants collected 24-hour urine samples.

All participants were interviewed using the QFFQ. For the weighed food record study, participants kept detailed weighed food diaries for seven consecutive days. For the urinary nitrogen study, participants made one 24-hour urine collection. Completeness of the urine collections was checked against 240 mg para-aminobenzoic acid. BMR was estimated by the Schofield equations.

Spearman rank correlation coefficients between the QFFQ and weighed food record ranged between 0.14 (fibre) and 0.59 (vitamin C). The QFFQ tended to underestimate intakes compared with the weighed records. Quintile distributions were similar for both methods. The correlation between urinary nitrogen excretion and dietary intake was poor. Possible underreporting was identified for 43% of the participants with the QFFQ and 28% with the weighed food record.

The QFFQ appeared to be a relatively valid instrument for the assessment of dietary intakes of the population of the North West Province. The use of biomarkers in this population was difficult and needs further investigation.

To measure mineral intakes and the contribution of different food groups to mineral intakes in adults aged 18–64 years in Ireland. Intakes are reported for Ca, Mg, P, Fe, Cu and Zn. The adequacy of mineral intakes in the population and the risk of occurrence of excessive intakes are also assessed.

Food consumption was estimated using a 7-day food diary for a representative sample (n = 1379; 662 men, 717 women) of 18–64-year-old adults in the Republic of Ireland and Northern Ireland selected randomly from the electoral register. Mineral intakes (Ca, Mg, P, Fe, Cu and Zn) were estimated using tables of food composition.

Mean nutrient density of intakes was higher for women than men for Ca and Fe and increased with age for all minerals, except Ca for men and Fe for women. Meat and meat products were the major contributor to mean daily intakes of Zn (38%), P (23%), Fe (18%), Cu (15%) and Mg (13%); dairy products (milk, yoghurt and cheese) to Ca (44%), P (22%), Zn (14%) and Mg (11%); bread and rolls to Fe (21%), Cu (18%), Ca and Mg (17%), Zn (13%) and P (12%); potatoes and potato products to Cu (16%), Mg (14%) and Fe (10%); and breakfast cereals to Fe (13%). In women of all ages nutritional supplements contributed 7.6%, 4.4%, 3.6% and 2.2% of mean daily intake of Fe, Zn, Cu and Ca, respectively, while in men of all ages, nutritional supplements contributed 2.7%, 2.3%, 1.7% and 0.6%, respectively, to mean daily intakes of Fe, Zn, Cu and Ca. Adequacy of minerals intakes in population groups was assessed using the average requirement (AR) as a cut-off value. A significant prevalence of intakes below the AR was observed for Ca, Fe, Cu and Zn but not P. A higher proportion of women than men had intakes below the AR for all minerals. Almost 50% of 18–50-year-old females had intakes below the AR for Fe, while 23%, 23% and 15% of women of all ages had intakes below the AR for Ca, Cu and Zn, respectively. For men of all ages, 11%, 8% and 13% had intakes below the AR for Ca, Cu and Zn, respectively. There appears to be little risk of excessive intake of Ca, Mg, P, Cu or Zn in any age/sex category. However, 2.9% of women of all ages had intakes above the tolerable upper intake level for Fe (45 mg) due to supplement use.

Almost 50% of women aged 18–50 years had Fe intakes below the AR and relatively high proportions of women of all ages had intakes below the AR for Ca, Cu and Zn. With the possible exception of iron intake from supplements in women, there appears to be little risk of excessive intake of minerals in the adult population. Meat and meat products, dairy products (milk, cheese and yoghurt), Keywords bread and rolls, potatoes and potato products and breakfast cereals are important Mineral intake sources of minerals; nutritional supplements make only a small contribution to Ireland mineral intakes in the population as a whole but may contribute significantly to Food consumption survey intakes among supplement users.

As beliefs and knowledge about the possible effects of foods on health can influence food behaviours, this study examined selected dietary beliefs in the Baltic countries and the association of beliefs related to salt intake and to types of fat with food behaviours.

A cross-sectional study.

Data from three surveys conducted in Estonia, Latvia and Lithuania in the summer of 1997 were used to describe the prevalence of dietary beliefs in these countries and to investigate the association between beliefs and behaviours (using logistic regression).

Representative national samples of adults were selected in each country (Estonia, n=2018; Latvia, n=2308; Lithuania, n=2153).

Misunderstood concepts (myths) related to dietary salt, types of fat, meat consumption and bread and potatoes were observed in high proportions of the population. Education level was an important correlate of beliefs related to salt intake and types of fat, people with a higher education level being more likely to be familiar with these issues. Correct beliefs were not consistently associated with healthier behaviours (e.g. less frequent use of salt at the table and use of non-animal fats for cooking), except for salt intake in Estonia.

Several misunderstood dietary concepts (myths) are still prevalent in the Baltic countries. Correct beliefs related to salt intake and types of fat were not consistent predictors of healthier food behaviours. In-depth qualitative investigations are needed to better describe and understand dietary beliefs and attitudes in the Baltic countries, and to identify barriers to the adoption of healthy food habits.

The aims of the present study were (1) to evaluate the degree to which underreporting of energy intake by repeated 24-hour recalls was related to gender, age, weight status, day of interview, educational level, smoking habits and area of living, and (2) to compare the dietary characteristics of underreporters with those of others.

Cross-sectional study. Ten 24-hour recalls were performed during a one-year period.

The Västerbotten intervention programme of cardiovascular disease and diabetes in Northern Sweden.

Ninety-four men and 99 women in four age groups: 30, 40, 50 and 60 years.

The prevalence of men and women with a food intake level (FIL; reported energy intake divided by estimated basal metabolic rate) below 1.2 was 44% and 47%, respectively. The youngest age group had higher FIL values than the oldest age group for both men (1.5 versus 1.1) and women (1.4 versus 1.1). The prevalence and magnitude of underreporting were directly related to body mass index (BMI; correlation coefficient: -0.47 (men) and -0.55 (women)). Smokers had a lower FIL value (1.1) than non-smokers (1.3). The nutrient density was lower for the group with high FIL values for protein and calcium and higher for fat and sucrose. The upper FIL group often had higher intake frequencies and larger portion sizes than the lower FIL group.

Underreporting of energy intake is prevalent when 24-hour recalls are used, but the prevalence differs between sub-groups in the population. BMI was the main predictor of underreporting but also old age and smoking seem to contribute in this aspect. Socially desirable food items were not underreported to the same extent as socially undesirable food items. The intake frequencies and portion sizes partly explained the differences in FIL.

To assess how the dental status of older people affected their stated ability to eat common foods, their nutrient intake and some nutrition-related blood analytes.

Cross-sectional survey part of nation-wide British National Diet and Nutrition Survey: people aged 65 years and older. Data from a questionnaire were linked to clinical data and data from four-day weighed dietary records. Two separate representative samples: a free-living and an institutional sample. Seven-hundred-and-fifty-three free-living and 196 institution subjects had a dental exam and interview.

About one in five dentate (with natural teeth) free-living people had difficulty eating raw carrots, apples, well-done steak or nuts. Foods such as nuts, apples and raw carrots could not be eaten easily by over half edentate (without natural teeth but with dentures) people in institutions. In free-living, intakes of most nutrients and fruit and vegetables were significantly lower in edentate than dentate. Perceived chewing ability increased with increasing number of teeth. Daily intake of non-starch polysaccharides, protein, calcium, non-haem iron, niacin, vitamin C and intrinsic and milk sugars were significantly lower in edentate. Plasma ascorbate and retinol were significantly lower in the edentate than dentate. Plasma ascorbate was significantly related to the number of teeth and posterior contacting pairs of teeth.

The presence, number and distribution of natural teeth are related to the ability to eat certain foods, affecting nutrient intakes and two biochemical measures of nutritional status.

To develop and validate a new dietary assessment tool, the focused recall, and to use this to measure co-consumption of carotenoid-containing fruits and vegetables with savory snacks.

Participants completed a telephone-administered focused recall and a 24-hour recall on the same day. We compared mean estimates of fruit, vegetable, savory snack and carotenoid consumption from both instruments. We also assessed the ability of each method to measure co-consumption of carotenoids with full-fat, reduced/non-fat and olestra-containing savory snacks.

Data are from 245 male and 244 female adult participants in the Olestra Post-Marketing Surveillance Study (OPMSS).

The mean (± SD) intake of fruit was 1.8 (1.1) servings day−1 from the focused recall and 1.6 (1.4) servings day−1 from the 24-hour recall (r = 0.56). The mean vegetable intake was 2.1 (1.3) and 2.2 (1.7) servings day−1 (r = 0.42), respectively, from each instrument. Estimates of total carotenoid and β-carotene intake were within 5% of each other (r = 0.63 for total carotenoids and r = 0.70 for β-carotene). Both instruments estimated that approximately 14% of total daily carotenoids were co-consumed with savory snacks (r = 0.63).

The focused recall provides valid information about fruit, vegetable and savory snack consumption and allows researchers to examine associated eating patterns more easily.

To validate the use of supermarket receipts as an index of fat and energy intake in a population that buys most of its food from supermarkets.

Cross-sectional, prospective dietary survey – feasibility study.

Households situated within a 20-mile radius of a large (Tesco) supermarket in Leeds.

Two hundred and fourteen households who spend ≥=60% of their food purse in (Tesco and other) supermarkets.

Mean daily household purchase of fat, energy and percentage energy from fat contained in food from supermarkets were 185 g, 19.2 MJ and 35.9%. Mean daily household intakes of fat and energy were 190 g and 20.7 MJ, and 35% of energy was derived from fat. Mean household size was 2.4 persons. The association between the amount of fat and energy purchased from supermarkets and the amount of fat and energy consumed by households was strong. 0.90 MJ (95% confidence interval (CI): 0.8–1.0) of energy were consumed for every 1 MJ purchased from supermarkets and 0.76 g (95% CI: 0.64–0.87) of fat were consumed for every 1 g of fat purchased.

The results show a strong association between estimates of the intakes of fat and energy and percentage energy from fat using 4-day food diaries and 28 days of receipts, in populations who buy most of their food from supermarkets. They also show that the fat content of total food purchases from supermarkets is 35.9% energy from fat compared with 33% energy from fat recommended by the Department of Health. This preliminary research indicates the feasibility of and potential for utilising large quantities of readily available data generated from supermarket checkouts in dietary surveys.

To describe the current use of nutritional supplements and their contribution to micronutrient intakes in a representative sample of Irish adults, to evaluate the impact of supplement use on the adequacy of micronutrient intakes and to assess the risk to supplement users of exceeding tolerable upper intake levels (UL).

Food intake data were collected in 1379 (662 male and 717 female) randomly selected Irish adults aged 18 to 64 years using a 7-day food diary. The current use of nutritional supplements was assessed using a selfadministered questionnaire and respondents entered each supplement as it was consumed into the food diary.

Twenty-three per cent of respondents regularly used nutritional supplements. Twice as many women used supplements as men. The intakes of micronutrients were significantly higher (P < 0.001) in supplement users than in non-users. Micronutrient intakes from food sources were similar in male users and non-users of supplements, but were significantly higher (P < 0.01) in female users, by 3 to 13%, for Fe, Mg, Mn, vitamins C and E and niacin than in non-users. The percentage of female users between 18 and 50 years who had mean Fe intakes below the average requirement (AR) (10 mg) decreased from 50 to 25 when the contribution from supplements was included. The use of supplements reduced the percentage of men who had mean intakes below the AR for Zn from 19 to 13, for riboflavin from 14 to 6 and for vitamin A from 20 to 5, and reduced the percentage of women with intakes below the AR for Ca from 23 to 16 and for riboflavin from 23 to 14. Twenty-one women out of 80 aged between 18 and 50 years, who consumed supplemental folate, achieved the intake of 600 |xg recommended to prevent neural tube defects. Twenty-two per cent of the women who took iron and 15% of the women who took vitamin B$ in supplemental form had mean daily intakes that exceeded that UL for these nutrients. Supplement users did not exceed the UL for the other micronutrients.

Supplementation appears to be beneficial in promoting adequate intakes of some micronutrients, particularly Fe and folate in women aged 18–50 years and vitamin A in men. There appears to be little risk to supplement users of experiencing adverse side effects due to excessive intakes of micronutrients.

To assess the fat intake and knowledge about the fat content of foods consumed by a sample of self reported users of reduced-fat dairy products.

Cross-sectional study of a population-based sample of women shoppers.

A small, rural town (population approximately 6000) in central Victoria, Australia.

Seventy-eight women aged 25–50 years, who regularly used at least one reduced-fat dairy product.

Mean reported intake of total fat was lower while intake of dairy fat was similar to that of a national sample of women of the same age both in the whole sample and when under-reporters were excluded. The ability to identify major sources of fat in the diet as reported appeared to be limited. Less than half of the subjects were able to correctly estimate the fat content of reduced-fat dairy products relative to regular products and about one quarter of subjects reported replacing one kind of oil or fat with another as a strategy to reduce fat intake. Subjects were generally aware of the need to ‘eat less fat’ but few could articulate specific recommendations. A number of subjects reported using low fat diets to control their weight but few subjects appeared to understand the connection between fat intake and energy intake.

The findings of this study raise important questions about how nutrition advice is understood and implemented by consumers, particularly the message to reduce fat intake and the role of energy balance in weight management. They also highlight the difficulty of interpreting information on food intake, in subjects who have modified their diet by reducing intake of specific foods.

To determine the prevalence of vegetarianism and compare food habits among vegetarian and omnivorous adolescents in Sweden and Norway.

Cross-sectional study by questionnaire in Sweden and Norway to gather information about food habits.

The municipalities of Umeå and Stockholm in Sweden, and Bergen in Norway.

In total 2041 ninth-grade students (578 from Umeå, 504 from Stockholm and 959 from Bergen), mean age 15.5 years, were included. The response rate was 95% in Umeå, 91% in Stockholm and 83% in Bergen.

There was a significantly higher prevalence of vegetarianism in Umeå (15.6%) than in Stockholm (4.8%) and Bergen (3.8%). Vegetarians generally wanted more information about a healthy diet and vegetarian females ate dietary supplements to prevent deficiencies more often than omnivorous females (P < 0.01). The young male vegetarians more or less excluded animal products from their diet without changing their food frequency intake or modifying their dietary habits in other respects, while the young female vegetarians more often consumed vegetables and dietary supplements (P < 0.05). However, there was no difference between the intake of fruits/berries, alcoholic beverages, ice cream, sweets/chocolates and fast foods by vegetarians compared with omnivores.

There were three to four times more vegetarians in Umeå than in Stockholm and Bergen. The food habits of the young vegetarians differed from those of omnivorous adolescents and also in some respects from previously published comparative studies of vegetarians' and omnivores' food habits. It is uncertain whether the health benefits shown in previous studies on vegetarianism will be experienced by this young generation of vegetarians.

To examine the changes in Portuguese household food availability from 1990 to 1995.

Using the DAta Food NEtworking (DAFNE) classification scheme for nutritional and socio-economic variables, data from the Portuguese Household Budget Surveys collected in 1989/90 and 1994/95 were analysed. The mean availability (quantity person−1 day−1) for the total population, by locality and by level of education of the household head, was computed for each of the main food and beverage groups.

Portugal, 1989 to 1995.

Although still among one of the countries with high availability of cereals, pulses, fish and seafood and olive oil, Portugal is gradually moving away from the traditional ‘Mediterranean diet’. Between 1989 and 1995, the availability of complex carbohydrates and olive oil was reduced, while the availability of protein-supplying food groups increased. Considerable disparities can be observed by locality and by the level of education of the household head. Households in urban areas and of higher socio-economic status are the main actors of the changes in ‘traditional’ food habits.

Although these findings are based on household food availability rather than consumption, they indicate the direction of the changes taking place in the Portuguese diet and can be used effectively by agriculture specialists, nutrition experts and policy makers.

To assess the association between nutrition and health in an adult urban homeless population.

Cross-sectional – nutritional state (body mass index (BMI), triceps skinfold (TSF), upper arm circumference), dietary habits (food frequency), socio-demographic data and self-stated diseases were assessed.

Four sites for homeless people in Kiel and Hamburg, Germany.

Sample of 75 homeless people (60 males, 15 females) aged 19–62 years.

A lack of food was not found in the majority of the homeless. Seventy-six per cent of the study population showed a normal dietary pattern. Critical food groups were fresh fruit and vegetables, rice and noodles. However, 52 or 29% of the homeless were malnourished (i.e. they were below the 25th or 5th percentile of arm muscle area). In addition, 22.7% of the homeless were obese (i.e. BMI>30 kg m−2 and/or TSF>90th percentile). Almost two-thirds of the population suffered from at least one chronic disease (prevalence of nutrition-related disorders 33.3%, gastrointestinal disorders 32.0%, dental diseases 22.7%, psychiatric disorders 18.7%, wasting diseases 6.7%). Smoking (prevalence rate 82%), drinking alcohol (51%) and drug abuse (20%) were frequent among homeless people. Food intake was not related to nutritional state, the prevalence of chronic diseases or addiction habits. By contrast, a poor nutritional state was associated with drug abuse and the prevalence of wasting diseases.

Prevention of nutritional problems should be directed to health-related problems such as the prevention or treatment of chronic diseases and addiction habits.