To characterise the diets of pregnant women in the Republic of Seychelles and to determine the contribution of fish to intakes of nutrients important for fetal and neonatal development.

Observational, prospective study.

Seychelles Child Development Centre, Mahé, Republic of Seychelles.

Pregnant women (n 300) were recruited at their first visit to an antenatal clinic. At 28 weeks’ gestation subjects completed a 4 d diet diary (n 273) and intakes were analysed using dietary analysis software.

Mean (sd) energy intake was 9·0 (2·5) MJ/d and fat intakes were higher than UK recommendations for almost two-thirds of the cohort. Fish consumption was lower than in previous surveys, suggesting a move towards a more Westernised diet. Low intakes of a number of nutrients important during pregnancy for fetal development (Fe, Zn, Se and iodine) were observed. However, women who met the current recommendations for these nutrients consumed significantly more fish than those who did not (97 v. 73 g/d).

The present study highlights the importance of fish in the diet of pregnant Seychellois women for ensuring adequate intakes of micronutrients important in fetal development. Dietary patterns in Seychelles, however, are in a state of transition, with a move towards a Western-style diet as evidenced by higher fat and lower fish intakes. If these dietary trends continue and fish consumption declines further, micronutrient status may be compromised. These findings suggest caution in establishing public health policies that promote limitation of fish intake during pregnancy.

The relationship between Fe status and HIV infection is complex and poorly understood. While anaemia is a major complication of HIV infection, higher Fe stores may be associated with disease progression. There is limited and conflicting data available from Africa.

Cross-sectional and prospective cohort study.

We examined the association between postpartum Fe status (Hb, serum ferritin (SF) and transferrin receptor (TfR)) and viral load (VL) and HIV-related mortality in 643 HIV-positive Zimbabwean women over a period of 12 months.

In non-anaemic women a log10 increase in SF was associated with a 2·3-fold increase in VL (P = 0·019); this association was absent in anaemic women. In prospective analyses, a log10 increase in SF was associated with a 4-fold increase in mortality by 12 months (P = 0·002). Hb was negatively associated with VL (P = 0·001) and mortality (P = 0·047). The adverse associations between SF and both VL and mortality were found at SF concentrations >45 μg/l (P < 0·05). Controlling for α1 acid glycoprotein, a marker of inflammation, attenuated the association between both SF and VL and mortality, but these remained significant.

These results are consistent with the hypothesis that high Fe stores have adverse consequences in HIV infection. If adverse consequences are real, our data suggest that they occur at SF concentrations exceeding those consistent with adequate Fe nutriture.

Our objective was to assess the distribution of energy, macro- and micronutrient intakes by meal (breakfast, lunch, dinner and combined snacks) in a cross-sectional sample of schoolchildren.

Cross-sectional dietary survey in schoolchildren.

Twelve private and public schools in the urban setting of Quetzaltenango, Guatemala.

A total of 449 schoolchildren (from higher and lower socio-economic strata) were enrolled in the study.

Each child completed a single, pictorial 24 h prospective diary and a face-to-face interview to check completeness and estimate portion sizes. Estimated daily intakes were examined by mealtime as: (i) absolute intakes; (ii) relative nutrient distribution; and (iii) critical micronutrient density (i.e. nutrient density in relation to the WHO Recommended Nutrient Intakes/median age-specific Guatemalan energy requirements).

The daily distribution of energy intake was 24 % at breakfast, 30 % at lunch, 23 % at dinner and 23 % among snacks. Lunch was also the leading meal for macronutrients, providing 35 % of proteins, 27 % of fat and 30 % of carbohydrate. The distribution of selected micronutrients did not follow the pattern of energy, insofar as lunch provided relatively more vitamin C and Zn, whereas breakfast led in terms of vitamins A and D, thiamin, riboflavin, folate, Ca and Fe.

Meal-specific distribution of energy, macro- and micronutrients provides a unique and little used perspective for evaluation of children’s habitual intake, and may provide guidance to strategies to improve dietary balance in an era of coexisting energy overnutrition and micronutrient inadequacy.

To investigate long-term trends in dietary intakes of vitamins A, C and E in Japanese adults.

Time series by community-based nutrition survey.

Two rural communities (Ikawa and Kyowa) between 1974 and 2001 in Japan.

A total of 3713 men and 3726 women aged 40–69 years.

Dietary intake data were collected by the 24 h dietary recall.

In Ikawa, mean intake of vitamin A (β-carotene and retinol) increased by 13–40 %; vitamins C and E increased by approximately 23–33 % among men and women from 1974–1977 to 1998–2000. In Kyowa, mean intake of vitamin A, primarily retinol, increased by 13–21 % among men and women; vitamin C from fruits decreased by 16 % among men; and vitamin E increased by 29 % among women from 1982–1986 to 1998–2001. Mean intake of vitamin E in the latest survey period was lower than the Adequate Intake among men and women in both communities. Generally, there were increased intakes of β-carotene and vitamin C from green/yellow and other vegetables; increased retinol intake from fish/shellfish, eggs, milk/dairy products and fats/oils; and increased vitamin E intake from green/yellow and other vegetables, fish/shellfish, eggs, milk/dairy products and fats/oils.

Mean intakes of the antioxidant vitamins A, C and E increased among middle-aged Japanese men and women between the 1970s and the 1990s except for decreased vitamin C among Kyowa men. The lower mean intake of vitamin E than the Adequate Intake should be considered a potential public health issue for the prevention of CVD.

To investigate differences between dietary habits in Glasgow and those in the rest of Scotland and the role that socio-economic factors have in explaining these.

Data on age, sex, area deprivation, social class, educational qualifications, economic activity, health board region, postcode sector area and informants’ usual intake of foods covering sugary foods, snacks, fibre, starch, meat, fish, spreading fats, dairy products, salt, dietary supplements, fruit and vegetables were available from the 1995, 1998 and 2003 Scottish Health Surveys. Multilevel logistic regression was used to model the relationship between diet and living in Greater Glasgow compared with elsewhere in Scotland, unadjusted and adjusted for age, survey year and socio-economic factors, accounting for the clustering within postcode sector area.

Scotland.

Subjects comprised 11 075 male and 14 052 female respondents.

Lower consumption of high-fibre bread and potatoes/pasta/rice (among men and women), of cakes (men) and of cereals, meat, skimmed/semi-skimmed milk and green vegetables (women) in Glasgow was explained by socio-economic factors, as was higher consumption of non-diet soft drinks among women; lower consumption of ice cream, bread, cereals, meat and green vegetables (men) and high butter and salt consumption (women) in Greater Glasgow were not.

Associations between unhealthy eating and deprivation accounted for much of the tendency of people in Glasgow to have poor diets. Policies are needed to encourage improvements in diet in Glasgow and more effort is required to reduce social inequalities in eating habits. Glasgow’s poor diet will remain unless problems associated with poverty are tackled.

Effective nutrition labels are part of a supportive environment that encourages healthier food choices. The present study examined the use, understanding and preferences regarding nutrition labels among ethnically diverse shoppers in New Zealand.

A survey was carried out at twenty-five supermarkets in Auckland, New Zealand, between February and April 2007. Recruitment was stratified by ethnicity. Questions assessed nutrition label use, understanding of the mandatory Nutrition Information Panel (NIP), and preference for and understanding of four nutrition label formats: multiple traffic light (MTL), simple traffic light (STL), NIP and percentage of daily intake (%DI).

In total 1525 shoppers completed the survey: 401 Maori, 347 Pacific, 372 Asian and 395 New Zealand European and Other ethnicities (ten did not state ethnicity).

Reported use of nutrition labels (always, regularly, sometimes) ranged from 66 % to 87 % by ethnicity. There was little difference in ability to obtain information from the NIP according to ethnicity or income. However, there were marked ethnic differences in ability to use the NIP to determine if a food was healthy, with lesser differences by income. Of the four label formats tested, STL and MTL labels were best understood across all ethnic and income groups, and MTL labels were most frequently preferred.

There are clear ethnic and income disparities in ability to use the current mandatory food labels in New Zealand (NIP) to determine if foods are healthy. Conversely, MTL and STL label formats demonstrated high levels of understanding and acceptance across ethnic and income groups.

We sought to evaluate the relationship between selected lifestyle and socio-economic characteristics and dietary habits of Greek adolescents.

During 2004, 2118 school adolescents were selected from twelve schools in Vyronas region, Athens. Dietary intake was assessed through a semi-quantitative FFQ. Principal components analysis was applied to extract dietary patterns.

Seven components, explaining the 50 % of the total variation in intake, were extracted. Component 1 (‘junk food’ pattern) was heavily loaded by the consumption of ‘sweet’ and ‘salty’ snacks, soft drinks and other ‘fast foods’. Component 2 was characterized as ‘red meat’ consumption pattern. Component 3 was characterized by the consumption of vegetables, fruits and juices. Component 4 was characterized by the intake of dairy products, pasta and wholegrain bread. Component 5 can be described as rice, fish, potatoes and poultry intake. Component 6 was characterized by the consumption of ‘traditional Greek cooked foods’ and legumes, and component 7 was characterized by the consumption of eggs and white bread. Time spent watching television was positively associated with the ‘junk food’ pattern and inversely associated with the ‘vegetarian/healthy’ pattern. Moreover, the ‘junk food’ pattern was positively related to smoking status and the ‘vegetarian/healthy’ pattern was positively correlated with sports activities outside school.

An unhealthy dietary behaviour is associated with an overall unhealthy lifestyle. Taking into account the fact that unhealthy eating habits and sedentary lifestyle have been associated with increased obesity prevalence, school- or community-based programmes should be conducted promoting healthy dietary and lifestyle behaviours.

We evaluated the association of nutrient intake with Fe deficiency with regard to lifestyle factors and health condition in young Japanese women. Uniquely among developed countries, dietary habits render Japanese populations vulnerable to Fe deficiency, owing to their relatively low intake of Fe and high intake of Fe absorption inhibitors, such as green tea and soyabeans.

A cross-sectional study.

The subjects were 1019 female Japanese dietetic students aged 18–25 years. Dietary habits during the preceding month were assessed using a previously validated, self-administered, diet history questionnaire. Blood analysis was performed to assess body Fe status. Subjects were categorized with Fe deficiency when their serum ferritin levels were <12 ng/ml. Twenty-nine dietary variables, i.e. intakes of energy, sixteen nutrients including Fe and twelve food groups, were analysed using multivariate logistic regression models adjusted for possible confounders.

Of the subjects, 24·5 % were categorized with Fe deficiency. However, no dietary factors assessed were significantly associated with Fe deficiency. The risk of Fe deficiency was significantly lower in women with infrequent or no menstrual cycles than in those with regular cycles (OR = 0·58; 95 % CI 0·34, 1·00) and significantly higher in women with heavy menstrual flow than in women with average flow, albeit that these were self-reported (OR = 1·83; 95 % CI 1·35, 2·48).

These results suggest that dietary habits, including Fe intake, do not significantly correlate with Fe deficiency among young Japanese women.

There is growing interest in how the physical environment influences obesity. Few studies have considered how the food retail environment surrounding schools influences overweight in students.

To determine whether there is a relationship between food retailers surrounding schools and overweight among Canadian youth.

Cross-sectional study.

The number of food retailers was obtained within a 1 km and 5 km radius around 178 schools in Canada. Retailers included full-service restaurants, fast-food restaurants, sub/sandwich retailers, doughnut/coffee shops, convenience stores and grocery stores. An index of total food retailer exposure was also created. Multilevel analyses were used to control for individual- and area-level covariates.

None of the individual food retailers was associated with an increased likelihood of overweight. The total food retailer index was most strongly related to overweight, but in the opposite direction to that hypothesized. At 1 km, students attending schools with at least one food retailer had a lower relative odds of overweight (OR = 0·70, 95 % CI 0·61, 0·81). At 5 km, students attending schools with the highest exposure to the total food retailer index had a lower relative odds of overweight (OR = 0·56, 95 % CI 0·47, 0·68) compared with students attending schools with no exposure.

Exposure to various types of food retailers in school neighbourhoods was not associated with an increased likelihood of overweight in Canadian school-aged youth. The opportunity to make healthy choices from a variety of options and the unique Canadian context may explain the findings.

Increase in fibre intake during pregnancy may reduce weight gain, glucose intolerance, dyslipidaemia, pre-eclampsia and constipation. Few studies have evaluated adequacy of fibre intake during pregnancy.

To assess, through an FFQ, the dietary fibre intake of pregnant women receiving prenatal care from general public practices and compare it with current guidelines.

Cross-sectional analyses of a pregnancy cohort study (ECCAGE – Study of Food Intake and Eating Behaviour in Pregnancy) conducted in eighteen general practices in southern Brazil, from June 2006 to April 2007.

Five hundred and seventy-eight pregnant women with mean (sd) age of 24·9 (6·5) years and mean gestational age of 24·5 (5·8) weeks.

The mean energy intake was 11 615 kJ/d (2776 kcal/d). The mean total fibre intake (30·2 g/d) was slightly above the recommended value of 28g/d (P < 0·001), yet 50 % (95 % CI 46, 54) of the women failed to meet the recommendation. Whole-grain fibre constituted only 1 % of total fibre intake in the cereal group. In adjusted Poisson regression analyses, not meeting the recommendation for fibre intake was associated with alcohol intake (prevalence ratio 1·29; 95 % CI 1·11, 1·50) and absence of nutritional guidance (prevalence ratio 1·22; 95 % CI 1·05, 1·42) during pregnancy.

About half of the pregnant women failed to meet the recommended fibre intake, especially those not reporting nutritional guidance during pregnancy. For most women, whole-grain cereal intake was absent or trivial. Taken together, our data indicate the need, at least in this setting, for greater nutritional education in prenatal care.

To determine the current level of activity of Australian local governments in twenty-nine food and nutrition action areas and whether the level of activity had changed between 1995 and 2007.

A cross-sectional study utilising a postal survey was undertaken of all local governments in Australia. The same instrument and protocol were used in 1995 and 2007.

Australian local governments.

Local governments in Australia continue to be engaged in food and nutrition activities. This involvement has constricted in range in the last 12 years but higher levels of engagement are reported for several areas. The levels of involvement of local governments in the different states varied significantly, with Victoria reporting higher levels of involvement in several areas, particularly in food and nutrition activities related to community services. Local governments in New South Wales and Western Australia reported significantly lower levels of involvement in food and nutrition activities. Several factors may have contributed to these differences, including availability of resources and support, mandatory requirements by state governments, different attitudes of General Managers and staff and availability of funds for special projects.

If Australian local governments are to be recognised and supported for their involvements in food and nutrition activities, more in-depth research is required to elucidate the factors that act as barriers or facilitate their on-going involvement in this important area. Support for local governments in rural areas to become or remain engaged in food matters should receive special consideration.

The Mediterranean diet is considered one of the healthiest dietary models. Recent changes in the actual Mediterranean diet include a reduction in energy intake and a higher consumption of foods with low nutrient density (e.g. soft drinks, candy, sweets, etc.). In Spain, in association with cultural and lifestyle changes, there has been a reduction in the intake of antioxidants and vitamins, an increase in the proportion of SFA and a decrease in the consumption of fibre, among other changes. Children and adolescents may be the age groups with the most deteriorated Mediterranean diet. The current paper presents the results of applying the Mediterranean Diet Quality Index for children and adolescents (KIDMED) to a large sample of Spanish schoolchildren.

Data from questionnaires were used to calculate the KIDMED index.

Granada, Southern Spain.

Schoolchildren (n 3190) aged 8–16 years.

Among the 8–10-year-olds, the KIDMED index classification was ‘good’ in 48·6% of the population, ‘average’ in 49·5% and ‘poor’ in 1·6%. Among the 10–16-year-olds, the KIDMED index classification was good in 46·9% of the population, average in 51·1% and poor in 2·0%.

The nutritional behaviour of the present population of schoolchildren is similar to that found in the earlier KIDMED study.

In New Zealand (NZ), Fe deficiency (ID) is present in 14 % of children aged <2 years. Prevalence varies with ethnicity (NZ European 7 %, Pacific 17 %, Maori 20 %). We describe dietary Fe intake, how this varies with ethnicity and whether intake predicts Fe status.

A random sample of children aged 6–23 months. Usual Fe intake and dietary sources were estimated from 2 d weighed food records. Associations were determined between adequacy of Fe intake, as measured by the Estimated Average Requirement (EAR), and ID.

Sampling was stratified by ethnicity. Dietary and blood analysis data were available for 247 children.

The median daily Fe intake was 8·3 mg (age 6–11 months) and 6·3 mg (age 12–23 months). Breast milk and milk formulas (median 58 %; age 6–11 months), and cereals (41 %) and fruit and vegetables (17 %; age 12–23 months), were the predominant dietary sources of Fe. Fe intake was below the EAR for 25 % of the children. Not meeting the EAR increased the risk of ID for children aged 6–11 months (relative risk = 18·45, 95 % CI 3·24, 100·00) and 12–23 months (relative risk = 4·95, 95 % CI 1·59, 15·41). In comparison with NZ European, Pacific children had a greater daily Fe intake (P = 0·04) and obtained a larger proportion of Fe from meat and meat dishes (P = 0·02).

A significant proportion of young NZ children have inadequate dietary Fe intake. This inadequate intake increases the risk of ID. Ethnic differences in Fe intake do not explain the increased risk of ID for Pacific children.

The present study was conducted to determine the impact of a community-based intervention on the nutritional behaviour of a representative sample of Iranian adults.

The Isfahan Healthy Heart Programme (IHHP), a six-year, action-oriented, integrated community-based study aimed at health promotion through the reduction of CVD risk factors, targeted the whole population living in two intervention cities, and compared outcomes with the population of a non-intervention city considered as reference. Dietary interventions were performed as educational, environmental and/or legislative strategies. A global dietary index (GDI) was calculated representing the general dietary behaviour. In addition, two consumption indices were calculated for specific food groups, i.e. meat products and major sources of fat. Univariate AVOVA was conducted to evaluate the impact of the intervention on dietary behaviours.

Isfahan and Najaf-Abad (intervention cities) and Arak (reference city), central Iran.

The baseline survey was conducted among 12514 randomly selected adults aged ≥19 years in both intervention and reference areas. The survey was repeated annually among about 5000 persons (2002–2005) in the intervention and reference communities.

According to significant year × group interactions in mean fat consumption index (FCI) and meat consumption index (MCI) in the total population, a significant improvement in FCI and MCI was found in the intervention areas v. the reference area (P < 0·001). In addition, the GDI improved significantly in the intervention areas v. the reference area (P < 0·001).

The IHHP interventions were effective in improving dietary behaviours at the population level. The highest effectiveness was documented in the change in the type of fat consumed. Such simple and integrated interventions can be adopted in other developing countries with limited financial resources.

To assess the iodine status of Sherpa residents living in Kunde village, Khumbu region, Nepal.

Prevalence of goitre was determined by palpation. Urinary iodine concentrations (UIC) were determined in casual morning samples, and thyroid-stimulating hormone (TSH) in finger-prick blood samples on filter paper. Dietary and demographic data were obtained via questionnaire, and selected foods analysed for iodine.

Khumbu region is an area of low soil iodine in Nepal, where the prevalence of goitre was greater than 90 % in the 1960s prior to iodine intervention.

Two hundred and fifteen of 219 permanent residents of Kunde were studied.

Overall prevalence of goitre was 31 % (Grade 1 goitre, 27·0 %; Grade 2, 4·2 %). When adjusted to a world population, goitre prevalence was 27 % (95 % CI 23, 32 %); Grade 2 goitre prevalence was 2·8 % (95 % CI 1·0, 4·6 %). Median UIC was 97 μg/l, but only 75 μg/l in women of childbearing age. Thirty per cent had UIC < 50 μg/l and 52 % had UIC < 100 μg/l, while 31 % of children aged <14 years had UIC > 300 μg/l. Ten per cent of participants had TSH concentrations >5 μU/ml.

The prevalence of severe iodine deficiency has decreased since the 1960s, but mild iodine deficiency persists, particularly in women of childbearing age. The consumption of high-iodine uncooked instant noodles and flavour sachets by school-aged children contributed to their low prevalence of goitre and excessive UIC values. This finding may obscure a more severe iodine deficiency in the population, while increasing the risk of iodine-induced hyperthyroidism in children. Ongoing monitoring is essential.

To describe homeless youths’ experiences of food insecurity and examine the relation between chronic food deprivation and food acquisition practices.

A cross-sectional survey of homeless youths was conducted in 2003 to assess their nutritional vulnerability and describe their food acquisition practices.

Toronto, Canada.

Two hundred and sixty-one youths, aged 16–24 years, who had spent ten or more of the past thirty nights sleeping in a temporary shelter, public space or friend’s place, because they had no place of their own. Most participant recruitment (70 %) occurred outdoors, but 30 % were recruited in drop-in centres.

Over the past 30 d, 28 % of males and 43 % of females experienced chronic food deprivation (i.e. reduced food intake for ≥10 d), and 32 % of females and 48 % of males reported problems obtaining water to drink. Most youths routinely obtained meals at charitable programmes and panhandled for money for food, and many routinely stole food or ate day-old food obtained from restaurants. In contrast, eating food discarded by others and postponing debt payments were strategies of desperation, more common among youths experiencing chronic food deprivation. Additionally, for males, deliberately seeking the company of friends, relatives or acquaintances to obtain food, and for females, borrowing money or trading sex for food, were associated with chronic food deprivation.

The pervasiveness and severity of food insecurity experienced by the youths and their desperate means of food acquisition highlight the need for more effective responses to the plight of homeless youths in Canadian cities.

To examine the relationship between food insecurity and child well-being indicators.

Cross-sectional survey conducted in 2344 households with children. The main exposure measure was food insecurity status, which was categorized as food secure or food insecure based on two or more food insecurity questions answered in the affirmative. Multiple logistic regression analysis was used to model the association between food insecurity status and selected child well-being indicators.

Barbados, St. Lucia and St. Vincent and the Grenadines (hereafter St. Vincent), three Eastern Caribbean countries, 2005.

A random sample of households with children was identified by the governments of Barbados, St. Lucia and St. Vincent. In-home interviews were conducted by social workers.

One-third (33 %) of households were categorized as food insecure. Food-insecure households were more likely to include a chronically ill parent (OR = 2·48; 95 % CI 1·76, 3·49), a recently divorced parent (OR = 1·92; 95 % CI 1·21, 3·05), a child requiring multiple visits to a health-care provider for a disability (OR = 3·98; 95 % CI 1·20, 13·19) or injury (OR = 1·78; 95 % CI 1·12, 2·83), a child with a learning disability (OR = 2·08; 95 % CI 1·16, 3·74) or a child with a physical disability (OR = 2·54; 95 % CI 1·22, 5·32) after adjustment for poverty and other demographic variables.

The results indicate that food-insecure households were more likely to be burdened by child disability (learning and physical), family system disruption (recent divorce and chronic illness) and child health-care needs (for disability and injury) than food-secure households. The implementation of programmes and policies to minimize food insecurity in the Eastern Caribbean may be warranted.