Research in industrialised countries has documented a high prevalence of underreported energy intakes associated with characteristics such as obesity. This paper examines the prevalence, patterns and impact of energy under- and overreporting on diet–obesity relationships in a middle-income developing country.

A 70-item food-frequency questionnaire was used. Underreporters had reported energy intakes < 1.35 × basal metabolic rate (BMR), overreporters > 2.4 × BMR. Multinomial models were used to identify characteristics associated with implausible reporting. Intakes were compared across reporting groups to assess evidence of bias. Associations between diet and obesity were compared with and without adjustment for implausible reporting.

Spanish Town, neighbouring the capital city of Kingston, Jamaica.

Eight hundred and ninety-one Jamaican adults, aged 25–75 years, were randomly recruited.

More women than men (38.6% vs. 22.5%) underreported, but more men overreported energy (23.7% vs. 16.0%). Underreporting was positively associated with obesity, special diets, smoking and age; age was inversely associated with overreporting. Underreporters estimated lower energy from potentially socially undesirable food groups (e.g. snacks) and higher intakes of ‘healthy’ foods (e.g. fruit) than did plausible reporters. For some of these food groups, significant differences in intakes among normal-weight versus obese subjects observed among plausible reporters were absent when implausible reporters were included. In models of food group–obesity associations, adjusting for implausible energy yielded more credible results that more closely resembled findings in plausible reporters.

Energy under- and overreporting are highly prevalent in Jamaica. Adjusting for implausible reporting may help to reduce bias in diet–health outcome associations.

High consumption of energy-dense foods has been linked to high energy intakes and excess weight gain. This study tested the hypothesis that high energy density of the total diet is associated with lower diet costs.

Dietary intakes of 837 French adults, aged 18–76 years, were assessed using a dietary history method. Dietary energy density (MJ kg−1) was calculated by dividing total energy by the edible weight of foods consumed. Daily diet cost (€day−1) was estimated using mean national food prices for 57 food items. The relationship between dietary energy density and diet cost at each level of energy intake was examined in a regression model, adjusted for gender and age.

The more energy-dense refined grains, sweets and fats provided energy at a lower cost than did lean meats, vegetables and fruit. Within each quintile of energy intake, diets of lower energy density (MJ kg−1) were associated with higher diet costs (€day−1).

In this observational study, energy-dense diets cost less whereas energy-dilute diets cost more, adjusting for energy intakes. The finding that energy-dilute diets are associated with higher diet costs has implications for dietary guidelines and current strategies for dietary change.

An unbalanced diet is a main risk factor for several chronic diseases. This paper identifies groups of individuals with an unbalanced diet based on the consumption of nutrients. A characterisation of the groups may help to focus efforts aimed at improving the dietary behaviour of the population.

Using nutritional data of 1763 men and 2267 women participating in the German Nutrition Survey of 1998, we constructed two indices for diet quality that each combines a large amount of nutrients into a single indicator. The impact of sociodemographic and lifestyle characteristics on the diet quality indices was analysed using multiple regression analyses.

The results show a considerable variation of diet quality between different groups of individuals. High diet quality in terms of the consumption of vitamins, minerals and trace elements is positively associated with income, education level, age, energy intake, food diversity, sport activity and vegetarianism. On the other hand, a low diet quality as indicated by high intakes of e.g. fat, sugar, alcohol and sodium can be expected when energy intake is high, for individuals of middle age and for pregnant and breast-feeding women.

The results of this study help to identify groups of individuals with preferable and non-preferable diet quality. For developing public health strategies, in particular the impact of age on diet quality seems to be interesting. The rising diet quality with increasing age could reflect a changing health consciousness. It could thus be a challenge for health policy to promote a healthy way of living focused especially on young individuals.

To determine the selenium intake of adults residing in high and low selenium areas of rural Punjab.

All food samples consumed by the subjects were collected and analysed for selenium content. Based on food intake data and selenium content of foods, the selenium intake of the subjects was calculated. Hair, fingernails and urine samples from a sub-sample of subjects were collected and analysed for selenium.

Three villages from the selenium-endemic area of Nawan Shahr District and two villages from the non-endemic area of Ludhiana District, Punjab, India, were covered.

Forty families from each of the two areas, with one adult male and one adult female in the age range of 20–40 years, were surveyed. Thus a total of 80 men and 80 women constituted the study sample.

In the selenium-endemic area, the average selenium intake of both men and women was more than nine times that in the non-endemic area and exceeded the maximum tolerable limit in more than 60% of men. Mean selenium content of the hair, nails and urine of both men and women was tens of times higher than in the non-endemic area.

High selenium intake in the endemic area resulted in high selenium content in the hair, nails and urine of men and women. In addition, clinical symptoms of selenium toxicity were also observed in some of the subjects. Selenium intake in the non-endemic area was marginally below the suggested value. Based on the study results, steps need to be taken to educate the public in the endemic area to avoid selenium toxicity.

To analyse the dietary behaviour of persons engaging in different levels of sport activity.

A cross-sectional survey analysis.

A population-based sample of German adults.

A total of 1756 men and 2254 women participating in the German National Health Interview and Examination Survey and the integrated German Nutrition Survey 1998.

Among both genders, the median micronutrient intakes of active persons were more preferable than those of sedentary persons when German current reference values were used as a criterion. The median nutrient densities were also higher in the diet of active persons, especially those of vitamin E, calcium, magnesium, and among women also those of folate and vitamin C. On average, active persons consumed higher amounts of fruit/vegetable juice, drinking water, milk products (including cheese) and fruits. Active men additionally consumed higher amounts of vegetables and vegetable fat. The contribution of dietary supplements to the total nutrient intake was 3%, on average, for active men and women. Compared with sedentary persons, this contribution was significantly higher for vitamins, and among men also for calcium and magnesium.

There was no indication of an impaired micronutrient intake of active and moderately active persons compared with sedentary persons.

To describe the characteristics of employees having lunch at staff canteens and to examine the association between workplace lunch and recommended food habits.

A mailed questionnaire including data on lunch pattern, food habits, sociodemographic background, work-related factors and body weight. Logistic regression models including food habits as dependent variables and lunch pattern, sociodemographic factors, work-related factors and body mass index as independent variables.

Helsinki Health Study survey data, collected in spring 2001.

Employees from the City of Helsinki reaching 40, 45, 50, 55 and 60 years. The data included 2474 women and 591 men; the response rate was 68%.

About half of those with a staff canteen at work had lunch there. Those with higher educational level were more likely to have lunch at the staff canteen, as also were women with pre-school children and normal-weight men. Those having lunch at staff canteens were more likely to follow recommended food habits, compared with other subjects. Having lunch at the staff canteen seemed to increase the consumption frequency of vegetables and fish.

Having lunch at staff canteens is associated with the quality of the diet. To serve a cooked meal including vegetables during working time may be an efficient way to improve diet among adult employees. More emphasis should be put on increasing the possibility for employees to have lunch at staff canteens.

The aims of this study were to investigate the consistency of use of plant stanol ester margarine and to characterise consistent and inconsistent users.

A cohort of plant stanol ester margarine users was established based on 14 national surveys conducted by the National Public Health Institute in Finland between 1996 and 1999. A follow-up study questionnaire was developed and sent to 1294 users in 2000.

Subjects who reported using plant stanol ester margarine in both the original survey and the follow-up study were classified as consistent users, and the rest as inconsistent users.

The study population consisted of 1094 subjects aged 18–87 years, 590 men and 504 women.

There were 357 (33%) consistent and 737 (67%) inconsistent users of plant stanol ester margarine in the study population. Consistent users were more likely to be men and to have a higher household income than inconsistent users. Both consistent and inconsistent users were predominantly middle-aged persons with a healthy lifestyle and diet as well as a history of cardiovascular disease. Healthfulness was the main factor affecting bread spread choice among 94% of the consistent users and 59% of the inconsistent users.

The use of plant stanol ester margarine is more often inconsistent than consistent. There is nevertheless a relatively large subgroup of long-term users of plant stanol ester margarine. It is important to examine the health effects especially among these regular users.

The study was conducted to gain an understanding of the status of potential nutrition risks in > 53-year-old men and women in Taiwan.

The study employed a validated nutrition-risk screening questionnaire, the Mini Nutritional Assessment, to assess the potential risk of undernutrition in the elderly population in Taiwan. The questionnaire was translated into the local language, Chinese, and was modified slightly based on cultural considerations. It was administered to 4440 randomly selected subjects by means of face-to-face interviews. The questionnaire included questions on subjective self-evaluations, global parameters, simple dietary assessment and some anthropometric measurements.

Results show that the questionnaire can be used effectively as a tool to screen for individuals who are at risk of undernutrition. It showed that the proportion of the elderly population at risk of nutritional inadequacy is relatively low, but does increase with advanced ageing. The proportion of the elderly considered at high risk of undernutrition was found to increase with age, ranging from 0.88% for 53–60-year-old subjects to 1.86% for subjects aged 60–70 years, 3.6% for 70–80-year-olds and 5.3% for >80-year-old subjects.

The study showed that a simple questionnaire adopted from the Mini Nutritional Assessment can be employed to provide a preliminary screening and to identify individuals who are potentially at increased risk of nutritional inadequacy in the elderly population in Taiwan.

To investigate the relationships between nutritional and lifestyle factors and bowel movement frequency.

Cross-sectional analysis using data from a prospective study. Mean numbers of bowel movements were calculated in relation to a range of factors. In addition, individuals were categorised according to frequency of bowel movements: fewer than 7 per week (‘less than daily’) versus 7 or more per week (‘daily’), and odds ratios were calculated from logistic regression models. Results for each factor were adjusted for the other factors under consideration.

The European Prospective Investigation into Cancer and Nutrition, Oxford cohort (EPIC–Oxford), UK.

In total, 20,630 men and women aged 22–97 years at recruitment. Thirty per cent of the subjects were vegetarians or vegans.

Women had fewer bowel movements on average than men, and were less likely to have daily bowel movements. Mean bowel movement frequency was higher in vegetarians (10.5 in men, 9.1 in women) and especially in vegans (11.6 in men, 10.5 in women) compared with participants who ate meat (9.5 in men, 8.2 in women). There were also significant positive associations between bowel movement frequency and body mass index (BMI), intakes of dietary fibre and non-alcoholic fluids, for both men and women. Vigorous exercise was positively associated with bowel movement frequency in women although results for men were less clear. Alcohol intake was positively associated with bowel movement frequency in men but not in women.

Being vegetarian and especially vegan is strongly associated with a higher frequency of bowel movements. Moreover, having a high intake of dietary fibre and fluids and a high BMI are associated with an increase in frequency of bowel movements.

To determine whether parentally reported habitual intake of specific foods differed between children with diagnosed Campylobacter jejuni infection and children of a comparison group without diagnosed infection.

Information was collected from the parents or primary caregivers of South Australian children aged 1–5 years with diagnosed C. jejuni (cases, n=172) and an age- and gender-matched group of uninfected children (controls, n=173). Frequency of consumption of 106 food and drink items was determined for the preceding two months by food-frequency questionnaire. Four children in the control group had recorded diarrhoeal episodes during the assessment period and were excluded, so 169 responses were evaluated for this group. Information was gathered on possible confounders including socio-economic status. Response frequencies were classified into three levels of consumption (rarely, weekly or daily) and statistical comparison was made by frequency of consumption of foods versus the ‘rarely’ classification for cases and controls, respectively.

Frequency of consumption of most foods, including starchy foods and fruits and vegetables, did not differ between cases and controls. However, reported consumption of eight food items (block and processed cheese (slices and spread), salami/fritz (a form of processed sausage), chicken nuggets, pasteurised milk, fish (canned or fresh) and hot French fries) was significantly higher by controls.

The hypothesis that reported consumption of starchy foods was lower by cases than by controls was not supported by the data. However, consumption of some processed and unprocessed foods was higher by controls. Some of these foods have established bactericidal actions in vitro that may indicate a possible mechanism for this apparent protection.

(1) To determine the reliability and validity of a food-frequency questionnaire (FFQ) for use in epidemiological research in postmenopausal women; and (2) to compare the volume estimation (VE) and weight estimation (WE) method of administration of this questionnaire.

An initial list of foods was derived and modified after pre-testing in 22 subjects. Test-retest reliability was assessed in 21 subjects who had repeat administrations of the questionnaire 14 days apart (FFQ1, FFQ2). The validity of the FFQ was assessed by comparing nutrient intakes with those from a 4-day food record.

Chengdu, People's Republic of China.

Twenty-two postmenopausal women (50–70 years) were recruited from The Second University Hospital, West China University of Medical Sciences, Chengdu and participated in the pre-test. Another 21 women (50–70 years) were randomly selected from the general population of all five districts of Chengdu and participated in the reliability and validity sub-studies.

Energy, protein, carbohydrate, magnesium and sodium intakes in this sample were less than the Recommended Dietary Allowances (RDAs) for 45–70-year-old women in China. Intake of non-cooking fat was higher than the Chinese RDA. Pearson correlation coefficients and intra-class correlation coefficients (ICCs) for reliability of the VE FFQ ranged from 0.51 to 0.85 and from 0.51 to 0.81, respectively; for the WE FFQ, they ranged from 0.22 to 0.86 and from 0.21 to 0.81. Correlation coefficients and ICCs for validity of the WE FFQ ranged from 0.36 to 0.69 and from 0.34 to 0.57, respectively; corresponding values for the VE FFQ were −0.30 to 0.65 and −0.14 to 0.65.

Both the VE and WE FFQs were reliable and valid except for sodium intake. The VE FFQ provided more valid estimates of nutrient intakes than did the WE FFQ.