In the fast growing city of Nairobi, women often combine the roles of mother and worker in trying to achieve better standards of living. The objective of this study was to document the effect of returning to work on breast-feeding by mothers in Kenya.

A cross-sectional survey.

Outpatient clinics of two major hospitals in Nairobi, one government hospital in an economically deprived area and one high-fee private hospital.

Four hundred and forty-four working mothers from low and higher socio-economic areas in Nairobi. All working mothers with infants aged 4 to 12 months attending during the survey period were invited to participate.

The prevalence of breast-feeding at the time of interview was found to be 94.1%. The lower socio-economic group exhibited a higher prevalence of breast-feeding (99%), 10% greater than the higher socio-economic group. The mean number of hours the mothers were away from home due to work was 46.2 hours each week. The majority (54.4%) of the mothers employed a ‘house-girl’ to care for their infant while they were at work, while 28.4% were able to take their infants to work. Most of the breast-feeding mothers (95%) breast-fed their infants at least three times a day and only 23 mothers reported not being able to breast-feed their infants during the day. The lower socio-economic group had a mean of 5.09 breast-feeding times per day while the higher socio-economic group had a mean of 3 times a day. In a logistic regression analysis the mode of work (fixed working hours vs. shift working hours) was associated with exclusive breast-feeding at one month (odds ratio (OR) = 0.45) and two months (OR = 0.39).

In Western countries ‘return to work’ is often cited as the reason that breast-feeding is discontinued prematurely. In this study we have shown how mothers in Kenya are able to successfully continue breast-feeding after they have returned to work, often for very long hours.

To determine if social class, education level and group environment (rural and urban) influence particular food habits commonly associated with dental caries incidence among 4–24-month-old black South African children.

Information was collected by trained interviewers using a food-frequency questionnaire from mothers of children in two areas in South Africa: Ndunakazi, a rural area in KwaZulu/Natal (n = 105) and two urban areas in Gauteng – Soweto (low to middle socio-economic area) (n = 100) and the northern suburbs of Johannesburg and Sandton (middle to upper socio-economic area) (n = 101). Education level and occupation of the parents, which define social class, were also recorded. A linear logistic (Proc Catmod) analysis tested social class, education level and group environment as the independent variables and the food habits as the dependent variables.

Group environment was significantly associated with nine of the 18 food habits investigated. More urban than rural mothers added sugar to their child's comforter. More mothers in urban Soweto than in urban Johannesburg were still breast-feeding their infants at 24 months. More rural than urban mothers were giving ‘mutis’ (common and traditional medicines). Together with group environment, education level was significantly associated with giving of ‘mutis’ and the frequency of giving them. Social class was significantly associated with the frequency of breast-feeding and when the child was breast-fed. Mothers from the upper social class breast-fed less frequently than mothers from the lower class.

The study showed a strong influence of rural/urban environment on specific cariogenic food habits among young black South African children, enabling the development and implementation of a nutrition strategy.

The aim of the study was to estimate the prevalence of diarrhoea in children less than two years old and study the relationship between diarrhoeal episodes and action taken for these episodes by their mothers.

The prevalence of diarrhoeal episodes among children and its associations with sociodemographic information and anthropometric measurements of the subjects was examined. Predictive factors for morbidity-associated diarrhoeal disease and actions taken for this were explored.

Primary health care centres (PHCCs) in Riyadh, Kingdom of Saudi Arabia.

Children less than two years of age.

Nearly a quarter of the children contracted diarrhoea during the two weeks preceding the data collection point, giving about six episodes of diarrhoea per child per year. Diarrhoea was more common in children over 6 months of age, in children who had no vaccination or follow-up cards, and in those who were taken care of by friends and neighbours if their mothers were working outside the home. The mothers of the affected children were young, married before 25 years of age with 2–6 years of formal schooling. During diarrhoeal episodes, about 25% of mothers stopped or decreased breast-feeding, 11.3% reduced the volume of fluids given to their children, and 22.7% of children were fed less solid/semi-solid foods. Mothers used oral rehydration salt in more than 40% of diarrhoeal episodes and unprescribed antibiotics were used in 17% of cases. The mothers who were not taking appropriate action included young mothers with low education level and those working outside the home.

Diarrhoea is common in children less than two years old in Riyadh City, and intervention based in PHCCs needs to be undertaken to correct the faulty practices of mothers during diarrhoeal episodes in their children. Health education messages should emphasise feeding during diarrhoeal episodes.

To evaluate whether there was food and nutrient equality across occupational social classes and geographical region for members of the 1946 British birth cohort at age 4 years.

Cross-sectional analysis of selected food groups, energy and nutrients from one-day recall diet records.

England, Scotland and Wales in 1950.

Nationally representative sample of 4419 children aged 4 years in 1950 from the MRC National Survey of Health and Development (NSHD) (1946 Birth Cohort).

Significant food and nutrient inequalities occurred by region and occupational social class of the father. Disparity in fruit and vegetable consumption primarily led to the nutrient differences, especially with respect to lower vitamin C and carotene intakes in children from Scotland and from a manual social class background. Lower energy intake in Scottish children was attributable to inequality in the consumption of foods providing fat, and also to the retention of the traditional Scottish diet that included porridge and soups. Consumption of some rationed foods – bacon, orange juice and tea – was inequitably distributed by father's social class, but others, in particular meat and spreading fats, were consumed more uniformly. In contrast to fruits and vegetables, which showed marked sociodemographic disparities, other non-rationed foods such as bread and potatoes were consumed universally.

Local cultural norms may have played as strong a part in sociodemographic differences in the diet of children in the early 1950s as did the strict, post-war food rationing that prevailed. In consequence, nutritional equality was not achieved, and the relatively low intake of antioxidant vitamins during early childhood in certain population groups may have compromised health in the long term.

To identify the food that has the greatest effect on the variation in the percentage of energy intake derived from fat and saturated fatty acids for the consumption of a Spanish population.

A cross-sectional study of food consumption, using the 24-hour recall method for three non-consecutive days, one of which was a non-working day. Subjects were interviewed by trained interviewers in the subjects' homes. We used multiple linear regression for statistical analysis.

The citizens of Reus.

One thousand and sixty subjects over five years old, randomly selected from the population census of Reus.

In both sexes, the foods that mainly determine a high consumption of fat are oil and red meat while those that determine a lower consumption of fat are bread, savoury cereals and fruit. The foods that mainly determine a high consumption of saturated fatty acids are red meat and whole-fat dairy products while those that determine a low consumption are bread, savoury cereals and fruit.

In our population, feasible variations in the intake of some foods – less than one portion – would reduce the estimated percentage of energy intake derived from fat and saturated fatty acids by a quantity considered important for cardiovascular disease prevention. The periodic identification and quantification of the food that most affects the dietary fat profile will help in drawing up dietary guidelines with more reasonable strategies for consuming a healthier diet and decreasing the risk of developing nutritional disorders.

Our objective was to identify food intake patterns that might be associated with the risk of renal cell carcinoma.

A total of 461 cases (210 females, 251 males) were age frequency matched to population controls. Diet factors were created using factor analysis of 69 food items from a food-frequency questionnaire. These factors were modelled using logistic regression to identify those associated with renal cell carcinoma.

We investigated the role of diet in the aetiology of renal cell carcinoma using a population-based case–control study conducted in Ontario between 1995 and 1996.

Cases were Ontario residents 20 to 74 years of age identified through review of pathology reports in the Ontario Cancer Registry.

A ‘dessert’ diet factor was positively associated with disease for both sexes (odds ratio estimate (OR) for males = 3.7, 95% confidence interval (CI) 2.0–6.9; OR for females = 1.4, 95% CI 0.8–2.2, for the highest vs. lowest quartile). In males, a ‘beef’ diet factor was identified and was associated with an increased risk of renal cell carcinoma. Furthermore, a ‘juices’ diet factor also showed an association with increased risk in males ( OR = 1.8, 95% CI 1.0–3.1). For females, a positive association was observed between renal cell carcinoma and an ‘unhealthy’ diet factor ( OR = 1.4, 95% CI 0.8–2.4).

Our findings confirmed that high-fat and high-protein diets might be risk factors for renal cell carcinoma. The data also suggest an increased risk associated with juice intake, a finding not previously reported.

To assess the relative validity of the second version of a quantitative food-frequency questionnaire (QFFQ), designed to measure the habitual food and nutrient intake in one season in rural populations in Western Mali, West Africa.

The dietary intake during the previous week was assessed with the 164-item QFFQ administered by interview. This was compared with the intake from a 2-day weighed record (WR) with weighed recipes.

The village of Ouassala in the Kayes region, Western Mali.

Thirty-four women and 36 men aged 15–45 years, from 29 households.

The QFFQ gave a lower intake of lunch and dinner and a higher intake of snacks than the WR. The discrepancies were larger for women than for men. The median proportion of subjects classified in the same quartile of intake was 29% for food groups and 36% for energy and nutrients. For classification into extreme opposite quartiles, the median proportion was 6% for food groups and 7% for energy and nutrients. Spearman's rank correlation for energy and nutrients ranged from 0.16 (% energy from protein) to 0.62 (retinol equivalents).

The second version of the QFFQ tends to underestimate total food weight. The methods used for estimating food portion size should therefore be applied with caution. The changes made from the first version had little effect. The ability to rank subjects according to dietary intake is similar with both versions. The improved layout of the new QFFQ makes it a more user-friendly tool for comparing dietary intake between population groups and for measuring changes over time.

To assess the validity of the food-frequency questionnaire used in the European Prospective Investigation of Cancer (EPIC FFQ) for estimating nutrient intake in an adolescent population.

Sixty-seven schoolchildren (mean age: 12.3±0.3 years) were recruited to complete a 7-day weighed dietary record (7-day WDR), the EPIC FFQ and supply one 24-hour urine collection.

Harris Academy in Dundee (UK).

Fifty subjects completed both dietary assessment methods. Thirteen of these were classified as underreporters with energy intake/basal metabolic rate<1.14. The EPIC FFQ showed higher estimates than the 7-day WDR for all nutrients. The median Spearman correlation coefficient for the nutrients examined was found to be 0.31 and increased to 0.48 after adjustment for total energy. The limits of agreement were as far apart as 13.4 MJ, 120 g, 270 g, 120 g and 1170 mg for energy, fat, sugar, protein and calcium, respectively. Correlations between urine and 7-day WDR dietary nitrogen and potassium were found to be statistically significant with r = 0.45 (P<0.05) and r = 0.78 (P<0.001), respectively. The median proportion of subjects that appeared in the same and opposite third of intake was found to be 45.9% and 10.8%, respectively.

The EPIC FFQ seems adequate to correctly classify low, medium and high consumers and might therefore be used to identify adolescent population groups at risk or for differences between populations. However, agreement between the EPIC FFQ and the 7-day WDR was very poor on both a group and an individual basis, and demonstrates that the EPIC FFQ is not an appropriate method for estimating absolute intakes in this age group.

Greater intake of Cruciferous vegetables (e.g. broccoli) may prevent cancer at several sites. Urinary excretion of isothiocyanate conjugates (dithiocarbamates, DTC) provides a specific biomarker of Cruciferous vegetable consumption suitable for epidemiological investigations. However, no gold-standard referent is available for evaluating urinary DTC levels as an estimator of Cruciferous vegetable consumption. We compared urinary DTC levels to intake as measured by two self-reported dietary assessment techniques.

Cruciferous vegetable consumption was measured before and after a behavioural dietary intervention using multiple 24-hour recalls (24HR), a food-counting questionnaire (VFQ) and urinary DTC excretion levels. Analysis included a structural equation approach (Method of Triads) combining these three assessment techniques to estimate the relationship between DTC level and the study population's ‘true’ Cruciferous vegetable intake.

The intervention curriculum assisted participants in consuming about 2 servings per day for a 6-week period. Participants attended four classes emphasising problem-solving skills, dietary counselling and vegetable preparation skills. There were no dietary restrictions.

Thirty-three healthy, free-living, post-menopausal women.

Although few participants reported Cruciferae consumption prior to the intervention, 30 participants reported Cruciferae consumption after the intervention (Post-intervention). Urinary DTC levels were correlated with estimated intake derived from either the 24HR ( r = 0.57; 95% confidence interval (95% CI) 0.28, 0.76) or VFQ ( r = 0.49; 95% CI 0.17, 0.71). The validity coefficient (Method of Triads) between urinary DTC excretion and an index of true Cruciferous intake was stronger than the Pearson correlation ( rv = 0.65; 95% CI 0.35, 0.90), and comparable to estimates derived from the 24HR ( rv = 0.82; 95% CI 0.65, 1.00) or VFQ ( rv = 0.76; 95% CI 0.47, 0.92) method. These associations were not affected by adjustment for body mass index, energy intake, or social approval or desirability response sets.

Food-frequency questionnaires (FFQ) suitable for large epidemiological studies may not be designed to measure all Cruciferae, and cannot capture exposure to phytochemicals derived from those vegetables. Urinary DTC measurement was significantly correlated with Cruciferae intake derived from two dietary assessment approaches, and urinary DTC levels could supplement traditional FFQ data by providing an index of recent Cruciferous vegetable intake not susceptible to reporting biases.

Methods currently used to assess nutritional status during pregnancy have limitations if one wishes to examine the overall quality of the diet. A Diet Quality Index for Pregnancy (DQI-P) was developed to reflect current nutritional recommendations for pregnancy and national dietary guidelines.

Dietary intake was assessed during the second trimester using a food-frequency questionnaire. The DQI-P includes eight components: % recommended servings of grains, vegetables and fruits, % recommendations for folate, iron and calcium, % energy from fat, and meal/snack patterning score. Scores can range from 0 to 80; each component contributed 10 points.

Two public prenatal clinics in central North Carolina.

N = 2063 pregnant women who participated in the Pregnancy, Infection, and Nutrition (PIN) Study.

The DQI-P quantitatively differentiated diets. The mean score for the population was 56.0 (standard deviation 12.0). Women who were <30 years old, <350% of poverty, nulliparous and high school graduates had significantly higher overall DQI-P scores. Higher percentages of recommended vegetable servings were consumed by higher-income, older and better-educated women. Greater percentages of recommended intakes of folate and iron were seen among black, low-income and nulliparous women. Higher iron intakes were also seen among women who graduated high school and were less than 30 years old. Other differences were observed for intake of fat and meal/snack pattern. Because this index was based on national recommendations, the DQI-P may be a useful tool for research and public health settings to evaluating overall diet quality of pregnant women.