To assess socio-economic indicators, nutritional status and living conditions of farm workers and their families, with the purpose to develop research and intervention programmes aimed at enhancing nutritional status and quality of life.

Three farm schools in two districts of the North-West Province and farming communities were selected. Anthropometrical measurements, structured face-to-face questionnaires and focus group discussions were carried out in 2002 and 2003 by a multidisciplinary research team.

Access to electricity, water and sanitation, as well as monthly food rations or subsidies, vary and depend on farm owners. The majority of adults have education below or up to grade four, farm schools provide only up to grade seven. Distance to farm schools and intra-household issues hamper children's attendance and performance at school. Household food security is compromised due to a lack of financial resources, infrastructure and also household resource allocation. This impacts negatively especially on children, with half of them being underweight, stunted or wasted. Employment is usually linked to men, while most women have access to casual jobs only. Insecurity of residence and the perceived disempowered position towards farm owners add to feelings of hopelessness and stress.

This study highlights destitute living conditions of farm worker families. Apart from structural and financial constraints, paternalistic structures of the past might also hamper development. Based on these findings, follow-up research projects and in-depth investigations into underlying social issues with regard to nutrition insecurity and livelihoods of farm workers were initiated.

The purpose of the present study was to characterise the food landscape of an inner city African American neighbourhood and its mixed-race suburban neighbour. Detailed analysis focuses on the relationship between community store mix and price, availability and produce quality.

A market basket study was completed by members of the Chicago Food Systems Collaborative. The US Department of Agriculture's standard market basket survey and methodology were used. Additional items and analyses were added in consultation with community members.

Austin is a lower-middle-class African American community of 117 500 on the western edge of Chicago. Oak Park, which borders Austin, is an upper-middle-income suburb of 52 500 with a mixed racial profile.

A market basket survey of every retail food store in Austin and Oak Park was completed. A total of 134 were included.

Results indicate that Austin has many grocery stores and few supermarkets. Many Austin groceries stores carry produce that is usually competitively priced, but often of unacceptable quality. Supermarkets had the best selection. Prices were lowest at discount supermarkets. Prices of packaged items were higher at independent stores than at chain supermarkets, but fresh items were cheaper.

Food access is related more to store type than number. In this study, item availability and produce quality varied greatly between store types. Price differences were complicated and varied by store type and food category. This has consequences in terms of food purchasing decisions and dietary quality that public health professionals should acknowledge.

The present study aimed to investigate whether organic conversion in catering has positive effects on the nutritional quality of menus offered.

The methodology was based on a self-administered questionnaire. The self-declared priority given to the use of organic foods was measured as the basis for assigning catering managers to one of two groups: ‘green’ or ‘non-green’ caterers. These groups were then compared with regard to the relative nutritional quality of the menu options offered to customers.

The study was carried out among randomly selected Danish worksite catering outlets.

The subjects participating in the study comprised 526 Danish worksite catering managers.

The results showed a strong correlation between caterers' ‘green-ness’ and the nutritional quality of the menu options offered. Green caters had more healthy options in their menus than non-green caters, which is likely to result in improved nutritional quality of the diets of end consumers. The reason for this may partly be the increased service training efforts that green caterers practise in order to be able to implement organic foods successfully. It may also be associated with the fact that the price premiums and availability of the organic products forces caterers to serve menus with higher amounts of root and non-green leafy vegetables, pulses and seasonal vegetables.

The present findings suggest that organic conversion of public canteens may be a good opportunity to promote healthier eating in public catering.

The aim of the present study was to examine the relationships between genetic susceptibility to obesity, physical activity (PA), dietary fibre, sugar and fat intakes and 4-year changes in body mass index (BMI) and attained waist circumference (WC) in a cohort of 287 monozygotic and 189 dizygotic young adult male twin pairs. Increased knowledge about interactions between genes and environment may provide insight into why some individuals are more prone to obesity than others.

Information about PA, BMI, dietary habits, WC and potential confounders was collected by questionnaire in 1998 and 2002. The cohort data were analysed by mixed linear models.

Twins with low PA attained larger WC than twins with high PA (difference 2.5 cm; 95% confidence interval (CI) 1.3, 3.6). The twins with the lowest fibre intake were found to have attained the highest WC and to have increased most in BMI (difference between highest and lowest fibre intakes: 1.6 cm, 95% CI 0.4, 2.9 and 0.45 kg m−2, 95% CI 0.15, 0.76, respectively). Furthermore, our results suggested the presence of interactions so that twins with genetic susceptibility to obesity were more prone to have larger WC if sedentary than twins without genetic susceptibility.

PA and a diet rich in fibre may be protective against weight gain among younger adult men. An interaction between PA, genes and attained WC is a novel finding which needs confirmation by other studies.

To compare serum lipids and their changes during a family-based health education in children aged 6–17 years with or without the ɛ4 allele of the gene encoding apolipoprotein E (apoE).

An intervention study.

A family-based prevention of risk factors of coronary heart disease in Eastern Finland. The programme consisted of two counselling meetings at children's schools and three at children's homes.

Four hundred and thirty-nine children with a family history of cardiovascular diseases (CVD) participated in a family-based health education. The children were divided into two groups according to apoE genotype. The risk group consisted of 143 children having apoE ɛ4 allele (genotype ɛ3/4 or ɛ4/4) and the non-risk group of 296 children without apoE ɛ4 allele (ɛ2/3 or ɛ3/3). The final sample of the follow-up study included 354 (81%) children (114 and 240, respectively).

Baseline differences were found in low-density lipoprotein cholesterol (LDL-C) (P = 0.007) and LDL-C/high-density lipoprotein cholesterol (HDL-C) ratio (P = 0.030) among boys and in total cholesterol (TC)/HDL-C (P = 0.008) and LDL-C/HDL-C ratios (P = 0.006) among girls. Differences between groups in changes during the follow-up were observed only for TC/HDL-C ratio (P-value adjusted for age = 0.049) among boys.

At baseline, children with apoE ɛ4 allele had on average a more unfavourable lipid profile than those without apoE ɛ4 allele. However, the effect of about 33 months' family-based health education on plasma lipids did not depend on apoE genotype in children with a family history of CVD.

To determine if participants would be interested in consuming soy foods to lower cholesterol in primary and secondary prevention of heart disease, and to identify the role physicians and registered dietitians have in providing dietary advice, about soy foods or other foods, for participants with elevated cholesterol.

Qualitative data from 12 focus groups were gathered from a convenience sample of 74 adults, aged 18–91 years, with and without high cholesterol (total cholesterol >200 mg dl−1). Participants were recruited from Minneapolis/St. Paul mainstream and natural foods grocery stores. Focus group interviews were taped and transcribed verbatim. Common themes were identified, coded and compared using NVivo computer software.

Participants believed diet, lifestyle and genetics were the cause of high cholesterol and cardiovascular disease (CVD). Few participants were aware of the Food and Drug Administration health claim for soy protein, yet many were willing to consume soy as part of lifestyle modification to prevent CVD. They reported preferring food and exercise over medication to treat high cholesterol. Few participants had ever received dietary advice from physicians on treating high cholesterol or CVD, and most doubted the accuracy of such advice. They believed registered dietitians were the most credible source of nutrition counselling and expressed an interest in physician referrals to dietitians.

A collaboration and referral system between physicians and registered dietitians could increase CVD patients' consumption of soy foods as a means potentially leading to a reduced risk of heart disease in participants.

The association of alcohol and fibre intake with breast cancer may be mediated by circulating sex hormone levels, which are predictors of breast cancer risk.

To evaluate the relationship of alcohol and dietary fibre intake with circulating sex hormone levels among premenopausal women.

A total of 205 premenopausal women completed a validated food-frequency questionnaire at baseline and after 2 years; blood samples taken at the same time were analysed for circulating sex hormone concentrations, including oestrone (E1), oestradiol (E2), free E2, progesterone, androstenedione and sex hormone-binding globulin, by radioimmunoassay. We used mixed models to estimate least-square means of sex hormone concentrations for alcohol intake categories and quartiles of dietary intake.

After adjustment for covariates, alcohol consumption was moderately associated with higher circulating oestrogen levels; those who consumed more than one drink per day had 20% higher E2 (Ptrend = 0.07) levels than non-drinkers. In contrast, higher dietary fibre intake was associated with lower serum levels of androstenedione (−8% between the lowest and highest quartiles of intake, Ptrend = 0.06), but not oestrogens. Similarly, consumption of fruits (−12%, Ptrend = 0.03), vegetables (−9%, Ptrend = 0.15) and whole grains (−7%, Ptrend = 0.07) showed inverse associations with androstenedione levels.

The consistency of the observed differences in sex hormone levels associated with alcohol and fibre-rich foods indicates that these nutritional factors may affect sex hormone concentrations and play a role in breast cancer aetiology and prevention.

To examine the association between fish consumption and stroke risk.

Prospective population cohort study.

Norfolk, UK cohort of the European Prospective Investigation into Cancer (EPIC–Norfolk).

Subjects were 24 312 men and women aged 40–79 years who had no previous history of stroke at baseline.

Fish consumption was assessed using a food-frequency questionnaire at baseline in 1993–1997 and stroke incidence ascertained to 2004.

A total of 421 incident strokes were identified (mean follow-up=8.5 years, total person-years=209 238). There were no significant relationships between total fish, shellfish or fish roe consumption and risk of stroke in men and women after adjusting for age, systolic blood pressure, body mass index, smoking, cholesterol, diabetes, physical activity, alcohol consumption, fish oil supplement use and total energy intake using Cox regression analyses. Oily fish consumption was significantly lower in women who subsequently had a stroke (odds ratio (OR) for consumers vs. non-consumers=0.69, 95% confidence interval (CI) 0.51–0.94, P=0.02). The trend in men was similar but not significant (OR for consumers vs. non-consumers=0.88, 95% CI 0.65–1.19, P=0.41).

There was no consistent relationship between fish consumption and stroke in this British population. Inconsistencies in the observed health effects of fish consumption in different populations may reflect different patterns and type of fish consumed and preparation methods.

To describe parental concerns about their child's weight, to determine the proportion of parents taking preventive action to avoid obesity in their children and the predictors of taking preventive action, and to describe the strategies adopted by parents.

A cross-sectional survey was conducted. Children's heights and weights were measured, and parents completed a questionnaire that included measures of their own weight status, perceptions of their child's weight, concerns about their child's current weight and future weight as an adolescent and adult, and the strategies used to prevent obesity.

The study was conducted in Melbourne, Australia.

A total of 291 families of children aged 5–6 years and 919 families of children aged 10–12 years participated.

Eighty-nine per cent of parents of overweight 5–6-year-olds and 63% of parents of overweight 10–12-year-olds were unaware their child was overweight. Seventy-one per cent of parents of overweight 5–6-year-olds and 43% of parents of overweight 10–12-year-olds were not concerned about their child's current weight. Although 31% of parents of 5–6-year-olds and 43% of parents of 10–12-year-olds were taking action to prevent unhealthy weight gain in their children, less-educated parents were less likely to do so.

Public health programmes are required to raise parental recognition of childhood overweight and of related risk behaviours, and to provide parents with practical strategies to prevent unhealthy weight gain in their children.

To assess the consequences on body composition of increasing birth weight in Indian babies in relation to reported values in Western babies, and to assess the relationship between maternal and neonatal anthropometry and body composition.

Prospective observational study.

Bangalore City, India.

A total of 712 women were recruited at 12.5±3.1 weeks of gestation (mean±standard deviation, SD) and followed up until delivery; 14.5% were lost to follow-up. Maternal body weight, height, mid upper-arm circumference and skinfold thicknesses were measured at recruitment. Weight and body composition of the baby (skinfold thicknesses, mid upper-arm circumference, derived arm fat index and arm muscle index; AFI and AMI, respectively) were measured at birth in hospital.

The mean±SD birth weight of all newborns was 2.80±0.44 kg. Birth weight was significantly related to the triceps and subscapular skinfold thickness of the baby. In a small number of babies with large birth weight for gestational age, there was a relatively higher normalised AFI relative to AMI than for babies with lower or appropriate birth weight for gestational age. Maternal height and fat-free mass were significantly associated with the baby's length at birth.

Skinfold thicknesses in Indian babies were similar to those reported in a Western population with comparable birth weights, and the relationship of AFI to birth weight appeared to be steeper in Indian babies. Thus, measures to increase birth weight in Indian babies should take into account possible adverse consequences on body composition. There were no significant relationships between maternal anthropometry and body composition at birth on multivariate analysis, except for sum of the baby's skinfold thicknesses and maternal fat-free mass (P<0.02).

To evaluate the effect of iron supplementation on physical growth in children through a systematic review of randomised controlled trials (RCTs).

Electronic databases, personal files, and hand search of reviews, bibliographies of books, abstracts and proceedings of international conferences.

RCTs evaluating change in anthropometry with interventions that included oral or parenteral iron supplementation, or iron-fortified formula milk or cereals, were analysed.

Twenty-five trials (26 cohorts) had relevant information. There was no evidence of publication bias. The pooled estimates (random effects model) did not document a statistically significant (P<0.05) positive effect of iron supplementation on any anthropometric variable (weight-for-age, weight-for-height, height-for-age, mid upper-arm circumference, skinfold thickness, head circumference). Significant heterogeneity was evident, and its predictors included greater weight-for-age in supplemented children in malaria hyperendemic regions and greater weight-for-height for children above 5 years of age, but a negative effect on linear growth in developed countries and with supplementation for 6 months or longer.

This review did not document a positive effect of iron supplementation on the physical growth of children. The identified predictors of heterogeneity should be considered as exploratory and requiring confirmation, not conclusive

The objective of this study was to identify the determinants of anaemia in Lebanese women of childbearing age attending health centres in Lebanon.

Cross-sectional study carried out between May and December 2003. Anthropometric measurements as well as sociodemographic, health and dietary intake data were collected using a questionnaire. Haemoglobin (Hb), plasma ferritin, plasma folate and vitamin B12 were assessed using standard laboratory methods.

Governmental health centres in Lebanon.

Four hundred and seventy non-pregnant Lebanese women aged 15–45 years.

Anaemia (Hb <12 g dl−1) and iron deficiency (ferritin <15 μg l−1) were prevalent in 16.0 and 27.2% of the study sample, respectively. Of the total sample, 7.7% had iron-deficiency anaemia. The percentage of women with either Hb or ferritin deficiency or both was 35.6%. Plasma folate and vitamin B12 deficiency was reported in 25.1 and 39.4%, respectively, and 12.6% of the women had both folate and vitamin B12 deficiencies. Of the anaemic group, 48.0% of the women had iron deficiency. The intake of iron was lower in iron-deficient than in non-deficient women and a positive relationship was shown between folate intake and its corresponding serum levels. Regression analysis showed that ferritin, plasma folate and family history of anaemia were significant determinants of the anaemia in the sample of women.

Anaemia not related to iron deficiency was partly explained by plasma folate deficiency. Measures to control folate and iron deficiency should be considered.

To investigate the internal validity of a food-frequency questionnaire (FFQ) developed for a case–control study of prostate cancer in southeast China.

A comprehensive questionnaire comprising a quantitative FFQ and a short food habit questionnaire (SFHQ) was developed and modified from previous cancer and nutritional studies. The Goldberg formula (ratio of energy intake (EI) to basal metabolic rate (BMR), EI/BMR) was used to assess the validity of the FFQ by making comparisons with physical activity levels. Physical activity levels were measured by the estimated total metabolic equivalents (MET) and the ratio of energy expenditure (EE) to BMR (EE/BMR). Correlation analyses were undertaken to compare the SFHQ variables with those of the quantitative FFQ.

Hangzhou, Zhejiang Province, China.

A total of 404 men over 45 years old with or without prostate cancer were recruited from eight hospitals.

The partial correlation coefficients, controlling for age and family history of prostate cancer, were moderate to high (P < 0.05) for preserved foods intake, fat consumption and tea drinking variables between the SFHQ and the quantitative FFQ. The average EI/BMR was 1.72, with 76% of subjects exceeding the Goldberg cut-off value of 1.35. Apart from weight, BMI, EE/BMR and MET, there were no significant differences in characteristics between low (< 1.35) and normal EI/BMR groups.

The FFQ is demonstrated to be a valid instrument to measure energy and food intake for elderly men in southeast China.

To validate an estimated food record (EFR), using a weighed food record (WFR) as the reference method, for the determination of food consumption and nutrient intakes in a group of Costa Rican adults.

For the WFR, all foods consumed by subjects during seven consecutive days were weighed and recorded by nutrition students. Two EFRs (a 4-day and a 3-day record) were recorded by subjects with the use of home measures and photographs to estimate amounts.

Costa Rica.

Sixty adults: 30 men and 30 women; 30 living in urban and 30 in rural areas.

The EFR gave statistically significant lower average intake estimates for energy and 12 of the 22 nutrients examined. The correlation coefficients ranged from 0.68 (polyunsaturated fats) to 0.87 (calcium). The percentage of subjects classified into the same quartile ranged from 45.0% (polyunsaturated fats) to 68.3% (vitamin B12). For all nutrients except vitamin C, 0 or 1.7% were misclassified into extreme quartiles. For food group consumption, the EFR gave statistically significant lower estimates for six of the 17 groups and correlation coefficients ranged from 0.22 (fish) to 0.93 (beverages). Greater differences in estimates of mean energy and nutrient intakes were detected among subjects from rural areas, caused in part by a tendency to underestimate the amounts of rice and beans consumed.

Validation of the EFR using a WFR as the reference method gave results that compare favourably with those reported by other authors, and support the use of the EFR for dietary surveys among Costa Rican adults.

To compare growth patterns and estimates of malnutrition based on the World Health Organization (WHO) Child Growth Standards (‘the WHO standards’) and the National Center for Health Statistics (NCHS)/WHO international growth reference (‘the NCHS reference’), and discuss implications for child health programmes.

Secondary analysis of longitudinal data to compare growth patterns (birth to 12 months) and data from two cross-sectional surveys to compare estimates of malnutrition among under-fives.

Bangladesh, Dominican Republic and a pooled sample of infants from North America and Northern Europe.

Respectively 4787, 10 381 and 226 infants and children.

Healthy breast-fed infants tracked along the WHO standard's weight-for-age mean Z-score while appearing to falter on the NCHS reference from 2 months onwards. Underweight rates increased during the first six months and thereafter decreased when based on the WHO standards. For all age groups stunting rates were higher according to the WHO standards. Wasting and severe wasting were substantially higher during the first half of infancy. Thereafter, the prevalence of severe wasting continued to be 1.5 to 2.5 times that of the NCHS reference. The increase in overweight rates based on the WHO standards varied by age group, with an overall relative increase of 34%.

The WHO standards provide a better tool to monitor the rapid and changing rate of growth in early infancy. Their adoption will have important implications for child health with respect to the assessment of lactation performance and the adequacy of infant feeding. Population estimates of malnutrition will vary by age, growth indicator and the nutritional status of index populations.