The study determined the impact of a community-based nutrition education programme, using trained community nutrition advisors, on the anthropometric nutritional status of mixed-race children aged between 2 and 5 years.

The programme was implemented over two years in four study areas in the Free State and Northern Cape Provinces. Two control areas were included to differentiate between the effect of the education programme and a food aid programme that were implemented simultaneously. Weight-for-age, height-for-age and weight-for-height were summarised using standard deviations from the NCHS reference median. For each of the indicators, the difference in the percentage of children below minus two standard deviations from the reference NCHS median in the initial and follow-up surveys was determined.

Initially 536 children were measured and, after two years of intervention, 815.

Weight-for-age improved in all areas, but only significantly in boys and girls in the urban study area, and in boys in one rural study area. No significant improvement in height-for-age occurred in any area. Weight-for-height improved significantly in the urban study area.

The education programme in combination with food aid succeeded in improving the weight status of children, but was unable to facilitate catch-up growth in stunted children after two years of intervention.

To determine vitamin A intake of children aged 2–5 years in a rural South African community one year after the implementation of a home-based food production programme targeting β-carotene-rich fruits and vegetables.

Dietary intake of children aged 2–5 years was determined during a cross-sectional survey before and one year after the implementation of a home-based food production programme.

A low socio-economic rural African community, approximately 60 km north-west of the coastal city of Durban in kwaZulu-Natal, South Africa.

Children aged 2–5 years (n=100); 50 children from households with home-gardens producing β-carotene fruits and vegetables (project gardens), and 50 children from households without project gardens.

As compared with baseline data, there was a significant increase in vitamin A intake in children from households with project gardens as well as in children from households without project gardens. However, children from households with project gardens had a significantly higher vitamin A intake than children from households without project gardens. The increased vitamin A intake in those children from households without project gardens can be attributed to the availability of butternuts in the local shop (as a result of the project), and because the mothers negotiated with project garden mothers to obtain these fruits and vegetables for their children.

A home-based food production programme targeting β-carotene-rich fruits and vegetables can lead to an increase in vitamin A intake.

To define a de facto reference body mass index (BMI) for women in developing countries and compare its performance with the Quetelet BMI.

A logarithmic equation for elite wt/ht references was developed using the weight (wt) and height (ht) of 10 524 non-pregnant elite mothers. Functional outcomes were compared using both BMIs.

Forty-six national surveys from 36 developing countries.

Mothers 15–49 years old.

The de facto reference standard deviation showed 2.2% of elite women were undernourished and 6.3% overnourished; lower and upper limits for ‘ideal’ wt/ht were 73% and 137%, respectively. Compared with the age-based and medium frame standards of the First and Second National Health and Nutrition Examination Surveys (NHANES I & II), the de facto reference defined fewer women as undernourished (5.3% vs. 10.5% and 14.4%, respectively), but more as overnourished (20.4% vs. 13.7% and 15.9%, respectively). In the de facto reference, BMI=wt/ht1.6. Using the age-based and medium-frame-based Quetelet BMI (wt/ht2), 28.5% and 31.7% had a low and 13.0% and 14.7% a high BMI, respectively. For the de facto reference, 18.4% of the elite mothers had a low BMI and 19.3% a high BMI. Applying the de facto reference to all women showed that the distribution of BMI was similar irrespective of the reference used. Functional outcomes were similar for both BMIs.

The NHANES I & II growth curves define more women as overnourished than the de facto curve, but the opposite for defining the undernourished. Functional outcomes were similar for both BMIs, suggesting there is no great advantage to using a de facto BMI based on national-level data from these 46 national surveys.

To compare the mortality of British vegetarians and non-vegetarians.

Analysis of original data from two prospective studies each including a large proportion of vegetarians – the Oxford Vegetarian Study and the Health Food Shoppers Study. Standardised mortality ratios (SMRs) compared with the population of England and Wales were calculated from deaths before age 90 for vegetarians and non-vegetarians in each study. Death rate ratios (DRRs) for vegetarians compared with non-vegetarians within each study were calculated for each of 14 major causes of death.

UK.

Twenty-one thousand men and women aged 16–89 years at recruitment, including more than 8000 vegetarians.

SMRs for all causes of death were significantly below the reference level of 100 in both studies: 52 (95% confidence interval (CI) 49–56) based on 1131 deaths in the Oxford Vegetarian Study and 59 (57–61) based on 2346 deaths in the Health Food Shoppers Study. For all causes of death, the DRR for vegetarians compared with non-vegetarians was close to one in both studies: 1.01 (95% CI 0.89–1.14) in the Oxford Vegetarian Study, 1.03 (0.95–1.13) in the Health Food Shoppers Study.

British vegetarians have low mortality compared with the general population. Their death rates are similar to those of comparable non-vegetarians, suggesting that much of this benefit may be attributed to non-dietary lifestyle factors such as a low prevalence of smoking and a generally high socio-economic status, or to aspects of the diet other than the avoidance of meat and fish.

The overall aim of this study was to examine a variety of belief and demographic factors that are associated with the perception that meat is intrinsically unhealthy.

State-wide survey (written questionnaire) that included questions on meat and nutrition beliefs, perceived barriers and benefits of vegetarian diets, personal values, number of vegetarian friends and family members, and use and trust of health/nutrition/food information sources.

South Australia.

Six hundred and one randomly selected South Australians and 106 non-randomly selected vegetarians and semi-vegetarians.

For all respondents considered as a group, the most important predictors of the belief that meat is intrinsically unhealthy were the perceived benefits of vegetarian diets (all positive predictors). These included: (1) the perceived links between vegetarianism, peace and increased contentment; (2) animal welfare and environmental benefits; and (3) health benefits. There were differences between different dietary groups however. For non-vegetarians, social concerns about vegetarianism (positive) were most important, followed by health and non-health benefits (positive) of vegetarianism. Red meat appreciation was the strongest (positive) predictor for vegetarians, with health benefits of vegetarianism (positive) and education (negative predictor) also important.

The implications of the findings for health and other issues are discussed. Judgements about the healthiness of meat are likely to be related to moral and environmental beliefs and, for non-vegetarians, to social concerns about vegetarianism, in addition to health beliefs. These need to be considered if any attempts are made to influence meat consumption.

To study the effect of advice to increase dietary soluble fibre, including fruit and vegetables, on plasma folate and homocysteine in men with angina.

Data were collected on a subset of subjects from the Diet and Angina Randomised Trial (DART II). In a randomised (2 × 2) factorial design, subjects received advice on either, neither or both interventions to: (1) increase soluble fibre intake to 8.0 g day−1 (fruit, vegetables and oats); (2) increase oily fish intake to 2 portions week−1. Those who received soluble fibre advice were compared with those who did not. Subjects were genotyped for C677T variant 5,10-methylenetetrahydrofolate reductase (MTHFR).

Seven hundred and fifty-three male angina patients were recruited from general practice.

Plasma homocysteine concentrations were at the upper end of the normal range (median 11.5, 25% 9.4, 75% 14.0 μmol l−1). Baseline intake of fruit and vegetables was positively correlated with plasma folate (rs = 0.29, P < 0.01). Smokers had lower intakes of fruit and vegetables, lower plasma folate and higher homocysteine (all P < 0.01). Homozygotes for variant MTHFR had higher homocysteine concentrations at low plasma folate (P < 0.01). Reported intakes of fruit and vegetables and estimated dietary folate increased in the intervention group (ca. +75 g day−1, P < 0.01 and ca. +20 g day−1, P < 0.05, respectively). However, neither plasma folate (baseline/follow-up 4.5 vs. 4.4 μg l−1, P = 0.40) nor homocysteine (baseline/follow-up 11.7 vs. 11.7 μmol l−1, P = 0.31) changed.

Plasma homocysteine, a cardiovascular risk factor, is influenced by MTHFR genotype, plasma folate and smoking status. Dietary advice successfully led to changes in fruit and vegetable intake, but not to changes in plasma folate or homocysteine, possibly because the fruits and vegetables that were chosen were not those richest in folate.

To investigate food and nutrient intakes in 3-year-old children.

Eight hundred and sixty-three children resident in South West England (69% of those invited at this age), a randomly selected sub-sample of the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC).

Diet was assessed using a 3-day descriptive food record. Food and nutrient intakes were compared with intakes at 18 months in the same children, with intakes in the British National Diet and Nutrition Survey (NDNS) of pre-school children, and with dietary reference values (DRVs).

Intakes of energy and most nutrients had increased between 18 and 43 months. The macronutrient content of the diet had also changed, the percentage of energy from starch rose from 21 to 23% and from non-milk extrinsic (NME) sugar from 12 to 16%, while the polyunsaturated to saturated fat ratio increased from 0.26 to 0.33. When compared with the NDNS, intakes of energy and all nutrients were higher with the exception of NME sugar. Energy intakes were below the estimated average requirements. Mean intakes of iron and vitamin D were below the Reference Nutrient Intake. Fewer children were eating beef at 43 months than at 18 months. Total daily meat consumption was lower than in the NDNS. The proportion of children consuming any vegetables dropped between 18 and 43 months, although fruit eating remained constant.

The diets of 3-year-olds in this study were adequate in most nutrients. Our results suggest that energy requirements of pre-school children in the 1990s are less than the DRV. Nutrient and food intakes changed between 18 and 43 months. Children were eating less meat than their counterparts in the NDNS.

To examine associations between nutrition screening checklists and the health of older women.

Cross-sectional postal survey including measures of health and health service utilisation, as well as the Australian Nutrition Screening Initiative (ANSI), adapted from the Nutrition Screening Initiative (NSI).

Australia, 1996.

In total, 12 939 women aged 70–75 years randomly selected as part of the Australian Longitudinal Study on Women's Health.

Responses to individual items in the ANSI checklist, and ANSI and NSI scores, were associated with measures of health and health service utilisation. Women with high ANSI and NSI scores had poorer physical and mental health, higher health care utilisation and were less likely to be in the acceptable weight range. The performance of an unweighted score (TSI) was also examined and showed similar results. Whereas ANSI classified 30% of the women as ‘high-risk’, only 13% and 12% were classified as ‘high-risk’ by the NSI and TSI, respectively. However, for identifying women with body mass index outside the acceptable range, sensitivity, specificity and positive predictive values for all of these checklists were less than 60%.

Higher scores on both the ANSI and NSI are associated with poorer health. The simpler unweighted method of scoring the ANSI (TSI) showed better discrimination for the identification of ‘at risk’ women than the weighted ANSI method. The predictive value of individual items and the checklist scores need to be examined longitudinally.

The habitual intake of the conjugated linoleic acid (CLA) isomer C18:2 c9t11 (rumenic acid, RA) was assessed and compared with plasma biomarkers.

The newly developed food-frequency questionnaire (FFQ) comprised 46 food items and was validated by means of a 7-day estimated record (7-d ER). Additionally, the dietary intake results of the FFQ, 7-d ER, the last day (1-d ER) and the last two days (2-d ER) before blood sampling of the 7-d ER were compared to the content of C18:2 c9t11 in plasma phospholipids (PL) and triglycerides (TG) as possible biomarkers.

Metabolic unit of a university institute.

Fifty-seven students completed both dietary instruments. From all participants fasting blood samples were taken.

Mean daily intake of rumenic acid was 246 mg day−1 and 323 mg day−1 as measured by the FFQ and the 7-d-ER, respectively. The degree of correspondence between both assessment methods was acceptable; this is indicated by a total kappa value of κ = 0.31 (P < 0.01) and a Pearson correlation coefficient of r = 0.46 (P < 0.01). Rumenic acid content in plasma triglycerides was twice as high as found in phospholipids. The correlation between the intake results gained with the 7-d ER and the plasma PL contents of C18:2 c9t11 was statistically significant; this was also true for the C18:2 c9t11 values in plasma TG compared with the intake results of one or two days before blood sampling.

Regarding RA intake, the FFQ data revealed an acceptable degree of correspondence with the 7-d ER data but failed to show significant correlations to the potential biomarkers. However, with respect to the results of the 7-d ER, the RA content in plasma PL and TG are possible biomarkers of short-term and medium-term intake, respectively.

To compare thyroid-stimulating hormone (TSH) levels in neonatal cord blood between study sites in Bangladesh, Guatemala and the United States. Also, to compare neonatal TSH results with indicators of iodine deficiency in school children.

Consecutive births and, in school children, cross-sectional surveys.

Savar, Bangladesh; San Pedro Sacatepequez, Guatemala; and Atlanta, United States.

In each study site, cord blood was spotted on to filter paper and TSH levels determined using a sensitive monoclonal assay. In the USA, heel stick blood specimens from newborns spotted on to filter paper were also obtained as well as exposure to iodine-containing antiseptics during the birthing process. Urine specimens were collected from mothers of newborns and tested for iodine concentration. School children in the same areas were surveyed for thyroid size by palpation and ultrasonography, and urine specimens collected for iodine concentration.

Between 141 and 243 cord blood specimens were collected from each study site. The prevalence of elevated cord blood TSH levels (>5 mU l−1) was high in all study sites, from 58% to 84%. All sites would be categorised as having ‘severe’ iodine deficiency based on WHO/UNICEF/ICCIDD criteria. Iodine-containing antiseptics were used during 98% of the births in the USA but not in Bangladesh or Guatemala. The neonatal TSH classification indicated more severe iodine deficiency levels than classifications based on urinary iodine and goitre in school children.

In the USA, elevated TSH levels may be partially attributed to use of beta-iodine-containing antiseptics prior to birth. We recommend the cautious interpretation of TSH results in newborns for the assessment of iodine deficiency disorders when iodine-containing antiseptics are used during the birthing process.