The present study aimed to evaluate the nutritional status of pregnant women in Colombia and the associations between gestational BMI and sociodemographic and gestational characteristics.

Cross-sectional study. A secondary analysis was made of data from the 2005 Demographic and Health Survey of Colombia.

Bogotá, Colombia.

Pregnant adolescents aged 13–19 years (n 430) and pregnant women aged 20–49 years (n 1272).

The gestational BMI and sociodemographic characteristics of the adolescents differed from those of the pregnant adult women. Thirty-one per cent of the adolescents were underweight for gestational age, compared with 14·5 % of the adult women. Eighteen per cent of adolescents were overweight for gestational age, in contrast to 37·3 % of adult women. The overall prevalence of anaemia was 44·7 % and the prevalence of low serum ferritin was 38·8 %. Women within the high quintiles of the wealth index (prevalence odds ratio (POR) = 0·56; 95 % CI 0·34, 0·91, P < 0·02) had lower odds of being underweight. Women who received prenatal care (POR = 2·17; 95 % CI 1·48, 3·09, P < 0·001) and were multiparous (POR = 2·10; 95 % CI 1·43, 3·15, P < 0·0 0 1) had higher odds of being overweight. Women in extended families (POR = 0·63; 95 % CI 0·50, 0·95, P < 0·025) had lower odds of being overweight.

Underweight in pregnant adolescents and overweight in adult women coexist as a double burden in Colombia. Factors associated with malnutrition among pregnant women and adolescents should be considered for future interventions in countries experiencing nutritional transition.

According to the 2007–2008 National Health and Nutrition Examination Survey, the prevalence of obesity in the US population was 33·8 %; 34·3 % and 38·2 %, respectively, in middle-aged men and women. We asked whether available blood donor data could be used for obesity surveillance.

Cross-sectional study of BMI and obesity, defined as BMI ≥ 30·0 kg/m2. Adjusted odds ratios (aOR) were calculated with logistic regression.

A network of six US blood centres.

Existing data on self-reported height and weight from blood donors, excluding persons deferred for very low body weight.

Among 1 042 817 donors between January 2007 and December 2008, the prevalence of obesity was 25·1 %; 25·7 % in men and 24·4 % in women. Obesity was associated with middle age (age 50–59 years v. <20 years: aOR = 1·92 for men and 1·81 for women), black (aOR = 1·57 for men and 2·35 for women) and Hispanic (aOR = 1·47 for men and 1·49 for women) race/ethnicity compared with white race/ethnicity, and inversely associated with higher educational attainment (college degree v. high school or lower: aOR = 0·56 for men and 0·48 for women) and double red cell donation and platelet donation.

Obesity is common among US blood donors, although of modestly lower prevalence than in the general population, and is associated with recognized demographic factors. Blood donors with higher BMI are specifically recruited for certain blood collection procedures. Blood centres can play a public health role in obesity surveillance and interventions.

Locale-specific data on BMI and overweight/obesity are necessary to understand how the obesity epidemic is evolving in each setting. We aimed to describe the temporal trends of mean BMI and prevalences of overweight/obesity in studies that evaluated Portuguese adults and older people.

Systematic review, conducted via a PubMed search up to January 2011 and independent reference screening and data extraction. Twenty-one eligible studies were identified. Data were extracted from the published reports and obtained from the authors of seven of the largest studies. Adjusted ecological estimates of mean BMI and prevalences of overweight/obesity were computed by linear regression.

Between 1995 and 2005, when using data obtained from anthropometric measurements, overweight prevalence increased by 3·2 % and 3·5 % and obesity prevalence by 7·4 % and 1·3 % among women and men, respectively, while mean BMI did not vary meaningfully. When using self-reported information, mean BMI increased by 0·8 kg/m2 and 0·9 kg/m2, overweight prevalence by 3·5 % and 3·7 % and obesity prevalence by 5·8 % and 5·5 % among women and men, respectively. Results from the 20-year-old conscripts (1960–2000) showed a marked increase in these outcomes in the last decades.

Our results show an important increase in overweight/obesity in younger ages. The trends in the indicators derived from self-reported data suggest an increase in awareness of the importance of overweight/obesity among the population.

We explored the use of feedback in interactive web-based questionnaires for collecting data on lifestyle factors in epidemiological studies.

Here we report from a cohort study on lifestyle factors and upper respiratory tract infections among 1805 men and women. We introduced interactivity in the form of personalized feedback and feedback on a group level regarding dietary intake, physical activity and incidence of infections in web-based questionnaires as incentives for the respondents to continue answering questions and stay in the study.

The study was performed in Sweden.

All participants were randomly selected from the population registry.

Personalized feedback was offered in the baseline questionnaire and feedback on a group level in the five follow-up questionnaires. In total, 88 % of the participants actively chose to get personalized feedback at least once in the baseline questionnaire. The follow-up questionnaires were sent by email and the overall compliance at each follow-up was 83–84 %, despite only one reminder. In total, 74 % completed all five follow-ups. However, the compliance was higher among those who chose feedback in the baseline questionnaire compared with those who did not choose feedback.

The results show that it is possible to use feedback in web questionnaires and that it has the potential to increase compliance. The majority of the participants actively chose to take part in the personalized feedback in the baseline questionnaire and future research should focus on improving the design of the feedback, which may ultimately result in even higher compliance in research studies.

To assess the accuracy and reliability of self-reported weight and height and identify the factors associated with reporting accuracy.

Analysis of self-reported and measured weight and height from participants in the Sister Study (2003–2009), a nationwide cohort of 50 884 women aged 35–74 years in the USA with a sister with breast cancer.

Weight and height were reported via computer-assisted telephone interview (CATI) and self-administered questionnaires, and measured by examiners.

Early enrolees in the Sister Study. There were 18 639 women available for the accuracy analyses and 13 316 for the reliability analyses.

Using weighted kappa statistics, comparisons were made between CATI responses and examiner measures to assess accuracy and CATI and questionnaire responses to assess reliability. Polytomous logistic regression evaluated factors associated with over- or under-reporting. Compared with measured values, agreement was 96 % for reported height (±1 inch (±2·5 cm); weighted κ = 0·84) and 67 % for weight (±3 lb (±1·36 kg); weighted κ = 0·92). Obese women (BMI ≥ 30 kg/m2) were more likely than normal-weight women to under-report weight by ≥5 % and underweight women (BMI < 18·5 kg/m2) were more likely to over-report. Among normal-weight and overweight women (18·5 kg/m2 ≤ BMI < 30 kg/m2), weight cycling and lifetime weight difference ≥50 lb (≥22·68 kg) were associated with over-reporting.

US women in the Sister Study were reasonably reliable and accurate in reporting weight and height. Women with normal-range BMI reported most accurately. Overweight and obese women and those with weight fluctuations were less accurate, but even among obese women, few under-reported their weight by >10 %.

To assess the strength of the relationships between serum carotenoids and three self-reported dietary intake instruments often used to characterize carotenoid intake in studies of diet and disease.

Participants completed a Diet History Questionnaire (DHQ), two 24 h dietary recalls (24HR), a fruit and vegetable screener and a fasting blood draw. We derived dietary intake estimates of α-carotene, β-carotene, cryptoxanthin, lutein, zeaxanthin and lycopene from each diet instrument and calculated sex-specific multivariate correlations between dietary intake estimates and their corresponding serum values.

Montgomery County, Maryland, USA.

Four hundred and seventy women and men aged 40–69 years in the National Cancer Institute's Observing Protein and Energy Nutrition (OPEN) Study.

Serum carotenoids correlated more strongly with the DHQ (r = 0·34–0·54 for women; r = 0·38–0·56 for men) than with the average of two recalls (r = 0·26–0·47 for women; r = 0·26–0·40 for men) with the exception of zeaxanthin, for which the correlations using recalls were higher. With adjustment for within-person variation, correlations between serum carotenoids and recalls were greatly improved (r = 0·38–0·83 for women; r = 0·42–0·74 for men). In most cases, correlations between serum carotenoids and the fruit and vegetable screener resembled serum–DHQ correlations.

Evidence from the study provides support for the use of the DHQ, a fruit and vegetable screener and deattenuated recalls for estimating carotenoid status in studies without serum measures, and draws attention to the importance of adjusting for intra-individual variability when using recalls to estimate carotenoid values.

To identify spatial variation in the risk for metabolic complications (RMC) by means of a semi-parametric approach for multinomial data.

Cross-sectional study.

We visited 730 households selected in the first of a two-stage sample in South health district in Campinas, São Paulo, Brazil, 2006–2007.

We interviewed 651 individuals and obtained their respective anthropometric measures and geographical coordinates of their house location. They were classified according to a combination of BMI and abdominal circumference as having no risk, increased, high or very high RMC.

Gender, age and schooling were associated with RMC. Crude spatial risk for the three levels of RMC in relation to the absence of risk suggested different patterns in each level. Adjusted spatial risk for the RMC showed smaller significant areas, but the pattern remained similar to crude risk.

Spatial point analysis with a multinomial approach improves the understanding of differences in RMC found, as we could identify specific areas in which to intervene. The public health significance of these findings may lie in the additional evidence provided that spatial location and its features can influence patterns of RMC.

The present study analysed the impact of using the 2006 WHO Child Growth Standards (‘the WHO standards’) compared with the 1977 National Center for Health Statistics (NCHS) international growth reference (‘the NCHS reference’) on the calculated prevalence of chronic malnutrition in children aged 6·0–59·9 months.

Anthropometric data were collected as part of a cross-sectional study exploring the association between household environments and nutritional status of children. Z-scores were computed for height-for-age (HAZ), weight-for-age (WAZ) and weight-for-height (WHZ) using each reference/standard. Results were compared using Bland–Altman plots, percentage agreement, kappa statistics, line graphs and proportion of children in Z-score categories.

The study was conducted in thirteen rural villages within Honduras's department of Intibucá.

Children aged 6·0–59·9 months were the focus of the analysis, and households with children in this age range served as the sampling unit for the study.

The WHO standards yielded lower means for HAZ and higher means for WAZ and WHZ compared with the NCHS reference. The WHO standards and NCHS reference showed good agreement between Z-score categories, except for HAZ among males aged 24·0–35·9 months and WHZ among males aged >24·0 months. Using the WHO standards resulted in higher proportions of stunting (low HAZ) and overweight (high WHZ) and lower proportions of underweight (low WAZ). The degree of difference among these measures varied by age and gender.

The choice of growth reference/standard employed in nutritional surveys may have important methodological and policy implications. While ostensibly comparable, data on nutritional indicators derived with different growth references/standards must be interpreted cautiously.

To assess the errors between estimates of amounts based on photographs and actual quantities of food presented to adults or eaten on the previous day.

A photographic atlas was constructed by taking digital photographs of three pre-weighed portion sizes of 212 traditional Lebanese dishes. In a first approach, ten portions of real pre-weighed foods were assessed using the photographic atlas. In a second approach, the participants weighed all foods consumed at one meal and recalled the amount of food that was eaten the previous day using the photographic atlas. Differences between actual quantities and estimation were assessed using a signed rank test (P < 0·05). Spearman's correlation coefficients and bias (Bland–Altman plot) between the methods were calculated.

Lebanese university canteen and Lebanese homes.

Forty adults (twenty males, twenty females) completed the first protocol and fifty adults (twenty-five males, twenty-five females) completed the second protocol; all were volunteers aged 21 to 62 years.

Mean differences between actual and estimated portion sizes by photographs were between −13·1 % and +24·5 % when pre-weighed foods were presented, and between −10·4 % and +3·8 % when foods were consumed the day before. No significant differences were found between actual and estimated portion sizes except for three dishes (loubieh bil zeit, tabbouleh and yachnet bazella). Bland–Altman plots showed good agreement for all dishes with a negligible bias of −0·2 g between estimated and presented portions, and −6·3 g between estimated and eaten portions.

In the Lebanese diet, food photographs seem a reliable tool for quantification of food portion sizes.

To examine the contribution of selected child-, maternal- and household-related factors to child undernutrition across two different age groups of Kenyan under-5s.

Demographic and Health Survey data, multistage stratified cluster sampling methodology.

Rural and urban areas of Kenya.

A total of 1851 children between the ages of 0 and 24 months and 1942 children between the ages of 25 and 59 months in Kenya.

Thirty per cent of the younger children were stunted, 13 % were underweight and 8 % were wasted. Forty per cent of the older children were stunted, 17 % were underweight and 4 % were wasted. Longer breast-feeding duration, small birth size, childhood diarrhoea and/or cough, poor maternal nutritional status and urban residence were associated with higher odds of at least one form of undernutrition, while female gender, large birth size, up-to-date immunization, higher maternal age at first birth, BMI and education level at the time of the survey and higher household wealth were each associated with lower odds of at least one form of undernutrition among Kenyan children. The more proximal child factors had the strongest impact on the younger group of children while the intermediate and more distal maternal and household factors had the strongest impact on child undernutrition among the older group of children.

The present analysis identifies determinants of undernutrition among two age groups of Kenyan pre-school children and demonstrates that the contribution of child, maternal and household factors on children's nutritional status varies with children's age.

The aim of the present study was to investigate dietary sources of Na and K intakes among Flemish pre-school children using multiple linear regression analyses.

Three-day estimated diet records were used to assess dietary intakes. The contribution to Na and K intakes of fifty-seven food groups was computed by summing the amount provided by the food group for all individuals divided by the total intake for all individuals.

A random cluster sampling design at the level of schools, stratified by province and age, was used.

A representative sample of 696 Flemish pre-school children aged 2·5–6·5 years was recruited.

Mean Na intake was above and mean K intake was largely below the recommendation for children. Bread (22 %) and soup (13 %) were main contributors to Na intake followed by cold meat cuts and other meat products (12 % and 11 %, respectively). Sugared milk drinks, fried potatoes, milk and fruit juices were the main K sources (13 %, 12 %, 11 % and 11 %, respectively). Although Na and K intakes were positively correlated, several food categories showed Na:K intake ratio well above one (water, cheeses, soup, butter/margarine, fast foods and light beverages) whereas others presented a ratio well below one (oil & fat, fruits & juices, potatoes, vegetables and hot beverages).

Flemish pre-school children had too high Na and too low K intakes. The finding that main dietary sources of Na and K are clearly different indicates the feasibility of simultaneously decreasing Na and increasing K intake among children.

To examine the roles of child cognitions and parental feeding practices in explaining child intentions and behaviour regarding fruit and vegetable consumption.

Cross-sectional surveys among pre-adolescent children and their parents.

The child questionnaire included measures of fruit and vegetable consumption and cognitions regarding fruit and vegetable consumption as postulated by the Attitude–Social Influence–Self-Efficacy (ASE) model. The parent questionnaire included measures of parental feeding practices derived from the Comprehensive Feeding Practices Questionnaire (CFPQ).

In total, 963 parents and 796 students in grades 5 and 6 from eighteen schools in the south-western part of Norway participated.

A large portion of child intention to eat fruit and child fruit consumption was explained by child cognitions (29 % and 25 %, respectively). This also applied to child intention to eat vegetables and child vegetable consumption (42 % and 27 %, respectively). Parent-reported feeding practices added another 3 % to the variance explained for child intention to eat fruit and 4 % to the variance explained for child vegetable consumption.

The results from the present study supported the application of the ASE model for explaining the variance in child intentions to eat fruit and vegetables and in child consumption of fruit and vegetables. Furthermore, our findings indicated that some parental feeding practices do have an influence on child intentions and behaviour regarding fruit and vegetable consumption. However, the role of parental feeding practices, and the pathways between feeding practices and child eating intentions and behaviour, needs to be further investigated.

The present study aimed to investigate the individual and family determinants of being overweight among children younger than 10 years of age.

Cross-sectional survey. Direct data on children's age, food intake, physical activity, type of transportation used and anthropometric measurements, as well as the education level of the mothers, were collected by trained interviewers.

Population-based study in the city of Santos, Brazil.

A total of 531 children under 10 years of age (302 aged <6 years, 229 aged ≥6 years), living in the city of Santos.

The overall prevalence of overweight and obesity (BMI-for-age Z-score >1) was 35·4 % for children under 6 years and 38·9 % for children aged 6–10 years. The socio-economic status of the family was associated with being overweight for both age groups. Logistic regression analysis showed that the lower the socio-economic status, the higher the likelihood of being overweight, among both younger children (OR = 7·73; P = 0·02) and older children (OR = 1·98; P = 0·04). The use of active transportation was associated with a lower likelihood of being overweight, but only among younger children (OR = 1·70; P = 0·05).

Socio-economic status seems to be an important individual-level determinant of overweight in children. Public policies should consider promoting the use of active transportation, as the results showed it to have a positive effect on reducing overweight issues. The high prevalence of overweight in younger children suggests that this age group should be a priority in health-promoting interventions.

We examined the distribution of diabetes and modifiable risk factors to provide data to aid diabetes prevention programmes in India.

Population-based cross-sectional survey of men and women included in India's third National Family Health Survey (NFHS-3, 2005–2006).

The sample is a multistage cluster sample with an overall response rate of 98 %. All states of India are represented in the sample (except the small Union Territories), covering more than 99 % of the country's population.

Women (n 99 574) and men (n 56 742) aged 20–49 years residing in the sample households.

Prevalence of diabetes was 1598/100 000 (95 % CI 1462, 1735) among men and 1054/100 000 (95 % CI 974, 1134) among women in India. Rural–urban and marked geographic variation were found with higher rates in south and north-eastern India. Weekly and daily fish intake contributed to a significantly higher risk of diabetes among both women and men. Risks of diabetes increased with increased BMI, age and wealth status of both women and men, but no effects of the consumption of milk/curd, vegetables, eggs, television watching, alcohol consumption or smoking were found. Daily consumption of pulse/beans or fruits was associated with a significantly reduced risk of diabetes among women, whereas non-significant inverse associations were observed in the case of men.

Prevalence was underestimated using self-reports. The wide variation in self-reported diabetes is unlikely to be due entirely to reporting biases or access to health care, and indicates that modifiable risk factors exist. Prevention of diabetes should focus on obesity and target specific socio-economic groups in India.

Major depressive disorder (MDD) during pregnancy increases the risk of adverse maternal and infant outcomes. Maternal nutritional status may be a modifiable risk factor for antenatal depression. We evaluated the association between patterns in mid-pregnancy nutritional biomarkers and MDD.

Prospective cohort study.

Pittsburgh, Pennsylvania, USA.

Women who enrolled at ≤20 weeks’ gestation and had a diagnosis of MDD made with the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th edition) at 20-, 30- and 36-week study visits. A total of 135 women contributed 345 person-visits. Non-fasting blood drawn at enrolment was assayed for red cell essential fatty acids, plasma folate, homocysteine and ascorbic acid; serum 25-hydroxyvitamin D, retinol, vitamin E, carotenoids, ferritin and soluble transferrin receptors. Nutritional biomarkers were entered into principal components analysis.

Three factors emerged: Factor 1, Essential Fatty Acids; Factor 2, Micronutrients; and Factor 3, Carotenoids. MDD was prevalent in 21·5 % of women. In longitudinal multivariable logistic models, there was no association between the Essential Fatty Acids or Micronutrients pattern and MDD either before or after adjustment for employment, education or pre-pregnancy BMI. In unadjusted analysis, women with factor scores for Carotenoids in the middle and upper tertiles were 60 % less likely than women in the bottom tertile to have MDD during pregnancy, but after adjustment for confounders the associations were no longer statistically significant.

While meaningful patterns were derived using nutritional biomarkers, significant associations with MDD were not observed in multivariable adjusted analyses. Larger, more diverse samples are needed to understand nutrition–depression relationships during pregnancy.

The study evaluated the association between consumption frequencies of the major food categories and the risk of new depression four years later in older Taiwanese.

A prospective cohort study with multistage random sampling. Logistic regression analysis evaluated the significance of the longitudinal associations of intake frequencies of the major food categories with future (4 years later) risk of new depression, controlled for possible confounding factors with or without adjustment for cognitive status.

Population-based free-living elderly.

Men and women (n 1609) ≥65 years of age.

In a regression model that controlled for demographic, socio-economic, lifestyle and disease/health-related variables but not cognitive status, both fruits (OR = 0·66, 95 % CI 0·45, 0·98, P = 0·038) and vegetables (OR = 0·38, 95 % CI 0·17, 0·86, P = 0·021) were protective against depressive symptoms 4 years later. However, when the same regression model was also adjusted for cognitive status, only vegetables (OR = 0·40, 95 % CI 0·17, 0·95, P = 0·039) were protective against depressive symptoms. Higher consumption of eggs was close to being significant in both regression models (P = 0·087 and 0·069, respectively). Other food categories including meat/poultry, fish, seafood, dairy, legumes, grains and tea showed no significant associations.

Results suggest that although confounding factors cannot be totally ruled out, more frequent consumption of vegetables seems to be protective against depressive symptoms in the elderly. Further studies are needed to elucidate the causal role and the mechanism of the association.

To describe the vitamin D status of Belgian children and examine the influence of non-nutritional determinants, in particular of anthropometric variables.

Cross-sectional data of Belgian participants of the EU 6th Framework Programme IDEFICS (Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants) Study.

25-Hydroxyvitamin D (25(OH)D) was measured using RIA. Vitamin D status was categorized as deficient (<25 nmol/l), insufficient (25–50 nmol/l), sufficient (50–75 nmol/l) and optimal (≥75 nmol/l). Anthropometric measurements included height, weight, waist and hip circumferences and triceps and subscapular skinfold thicknesses.

Children (n 357) aged 4–11 years.

Serum 25(OH)D ranged from 13·6 to 123·5 nmol/l (mean 47·2 (sd 14·6) nmol/l); with 5 % deficient, 53 % insufficient, 40 % sufficient and 2 % optimal. No significant differences were found by age and gender. Significant differences in 25(OH)D were observed for month of sampling (P < 0·001), number of hours playing outside per week (r = 0·140), weight (r = −0·121), triceps (r = −0·112) and subscapular (r = −0·119) skinfold thickness, sum of two skinfold thicknesses (r = −0·125) and waist circumference (r = −0·108). Linear regression analysis of 25(OH)D adjusted for age, month of sampling and hours playing outside per week suggested that (i) weight, (ii) BMI Z-score, (iii) waist circumference and (iv) triceps and subscapular skinfold thickness (as well as the sum of both) independently influenced 25(OH)D.

The majority of Belgian children had a suboptimal vitamin D status, with more than half having an insufficient status in winter and spring. Month of the year, weekly number of hours playing outside and body composition – both central and abdominal obesity – were identified as important determinants of vitamin D status in Belgian children.

To examine the effects of animal-source foods on toddler growth.

A 5-month comparison feeding intervention study with one of three millet-based porridges randomized to eighteen feeding stations serving 303 children aged 11–40 months. Feeding stations served plain millet porridge (Plain group), porridge with milk (Milk group) or porridge with beef (Meat group). Anthropometry, morbidity and food intake were measured at baseline and regular intervals. Longitudinal mixed models were used to analyse growth.

Embu, Kenya.

Two hundred and seventy-four children were included in final analyses.

Linear growth was significantly greater for the Milk group than the Meat group (P = 0·0025). Slope of growth of mid-arm muscle area of the Plain group was significantly greater than in the Meat group (P = 0·0046), while the Milk group's mid-upper arm circumference growth rate was significantly greater than the Meat group's (P = 0·0418). The Milk and Plain groups’ measures did not differ.

Milk and meat porridges did not have a significantly greater effect on growth than plain porridge in this undernourished population. Linear growth was influenced by more than energy intakes, as the Plain group's total body weight-adjusted energy intakes were significantly greater than the Meat group's, although linear growth did not differ. Energy intakes may be more important for growth in arm muscle. The diverse age distribution in the study makes interpretation difficult. A longer study period, larger sample size and more focused age group would improve clarity of the results.