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To estimate the contribution of television (TV) food advertising to the prevalence of obesity among 6–11-year-old children in Australia, Great Britain (England and Scotland only), Italy, The Netherlands, Sweden and the United States.
Design
Data from contemporary representative studies on the prevalence of childhood obesity and on TV food advertising exposure in the above countries were entered into a mathematical simulation model. Two different effect estimators were used to calculate the reduction in prevalence of overweight and obesity in the absence of TV food advertising in each country; one based on literature and one based on experts’ estimates.
Setting
Six- to eleven-year-old children in six Western countries.
Results
Estimates of the average exposure of children to TV food advertising range from 1·8 min/d in The Netherlands to 11·5 min/d in the United States. Its contribution to the prevalence of childhood obesity is estimated at 16 %–40 % in the United States, 10 %–28 % in Australia and Italy and 4 %–18 % in Great Britain, Sweden and The Netherlands.
Conclusions
The contribution of TV advertising of foods and drinks to the prevalence of childhood obesity differs distinctly by country and is likely to be significant in some countries.
To measure dietary salt intake in a Swedish population.
Design
A cross-sectional study with measured 24 h urinary excretion of Na and K. Completeness of urine collection was assessed using p-aminobenzoic acid. The subjects were interviewed on their habitual food intake.
Setting
Sahlgrenska University Hospital, Gothenburg, Sweden.
Subjects
Eighty-six young men (age 18–20 years), randomly selected from the population of Gothenburg. Seven men were excluded due to incomplete urine collection.
Results
The mean excretion of Na and K over 24 h was 198 and 84 mmol, respectively (corresponding to 11·5 g NaCl and 3·3 g K). The mean 24 h excretion in the highest quartile of Na excretion was 297 mmol Na and 105 mmol K, and in the lowest quartile, 100 mmol Na and 68 mmol K. The mean Na:K ratio was 2·3, and respectively 3·2 and 1·8 in the highest and lowest Na excretion quartiles. Calculated energy intake did not differ between the highest and lowest quartiles of Na excretion, but body weight, BMI and the intake of certain foods known to be Na-rich did.
Conclusions
Salt intake in young men was alarming high and even subjects in the lowest quartile of Na excretion did not meet present recommendations to limit salt intake to 5–6 g/d. At this point we can only speculate what the consequences of the high salt intake may be for CVD and stroke later in life. Regulation of the salt content in processed and fast food and in snacks is advocated, to curtail the salt burden on society imposed by the food industry.
To study how individual and regional characteristics might explain regional variations in breast-feeding rates in maternity units and to identify outlier regions with very low or high breast-feeding rates.
Design
Individual characteristics (mother and infant) were collected during hospital stay. All newborns fed entirely or partly on breast milk were considered breast-fed. Regional characteristics were extracted from census data. Statistical analysis included multi-level models and estimation of empirical Bayes residuals to identify outlier regions.
Setting
All births in all administrative regions in France in 2003.
Subjects
A national representative sample of 13 186 live births.
Results
Breast-feeding rates in maternity units varied from 43 % to 80 % across regions. Differences in the distribution of individual characteristics accounted for 55 % of these variations. We identified two groups of regions with the lowest and highest breast-feeding rates, after adjusting for individual-level characteristics. In addition to maternal occupation and nationality, the social characteristics of regions, particularly the population’s educational level and the percentage of non-French residents, were significantly associated with breast-feeding rates.
Conclusions
Social characteristics at both the individual and regional levels influence breast-feeding rates in maternity units. Promotion policies should be directed at specific regions, groups within the community and categories of mothers to reduce the gaps and increase the overall breast-feeding rate.
To assess progress in the protection, promotion and support of breast-feeding in Europe.
Design
Data for 2002 and 2007 were gathered with the same questionnaire. Of thirty countries, twenty-nine returned data for 2002, twenty-four for 2007.
Results
The number of countries with national policies complying with WHO recommendations increased. In 2007, six countries lacked a national policy, three a national plan, four a national breast-feeding coordinator and committee. Little improvement was reported in pre-service training; however, the number of countries with good coverage in the provision of WHO/UNICEF courses for in-service training increased substantially, as reflected in a parallel increase in the number of Baby Friendly Hospitals and the proportion of births taking place in them. Little improvement was reported as far as implementation of the International Code on Marketing of Breastmilk Substitutes is concerned. Except for Ireland and the UK, where some improvement occurred, no changes were reported on maternity protection. Due to lack of standard methods, it was difficult to compare rates of breast-feeding among countries. With this in mind, slight improvements in the rates of initiation, exclusivity and duration were reported by countries where data at two points in time were available.
Conclusions
Breast-feeding rates continue to fall short of global recommendations. National policies are improving slowly but are hampered by the lack of action on maternity protection and the International Code. Pre-service training and standard monitoring of breast-feeding rates are the areas where more efforts are needed to accelerate progress.