To study pregnant women's diet at food and nutrient levels and how these match recommendations; to describe how factors such as education level, economy and folk dietetics influence the women's food choice; and to give suggestions for the improvement of nutrition education in the existing antenatal care systems.

Thirty pregnant women in the last trimester were interviewed three times using a 24-hour dietary recall with weighing of foods and recipes of dishes. Interviews regarding health, nutrition and socio-economic status, and measurements of weight and height of the women, were conducted.

Rural parts of Salem District, Tamil Nadu, South India.

The women's diet (without supplements) was insufficient in energy and all nutrients except fat, compared with the Indian recommendations. Aggravating low intakes of micronutrients were found which were reflected in low intakes of foods other than rice. Eating customs and economy appeared to influence the women's food choice negatively in relation to recommendations while factors such as education level, family type, pregnancy number and folk dietetics did not seem to have a negative effect. The amounts of foods recommended, especially green leafy vegetables, must be shown to the women. The nutrition advice given by all levels of health providers must be the same and based on cheap, local, commonly consumed foods.

To investigate the relationship between different types and levels of physical activity and cardiovascular disease risk factors, including oxidative stress, blood lipids and insulin resistance, in a healthy female population in China.

Healthy women (n = 761) aged 35 to 65 years participated in this study. The habitual physical activity was evaluated by self-administered questionnaire (MOSPA). The dietary intakes of nutrients were calculated from 3-day recall records. Anthropometric data of each subject were measured, fasting blood samples were taken, and erythrocytes and serum were prepared for the measurement of erythrocyte superoxide dismutase activity, serum malondialdehyde, total antioxidant capacity, insulin, glucose and lipids (total cholesterol, triglycerides, apolipoprotein AI (apo A) and apolipoprotein B (apo B)) concentrations.

Low level of physical activity was related to a lower concentration of serum apo B, and higher energy expenditure from household physical activity had a reverse relationship with serum apo B and triglyceride levels. In the group with moderate occupational energy expenditure, the concentration of serum triglycerides was lower, but that of high-density lipoprotein was higher. Moderate energy expenditure (less than 1700 kcal day−1) from leisure-time physical activity was positively related to total antioxidant capacity and insulin sensitivity. However, heavy occupational physical activity may be not beneficial for the cardiovascular system.

This study indicates that leisure-time, moderate occupational and household physical activity levels decreased risk factors for cardiovascular disease.

To examine the validity and reproducibility of a self-administered food-frequency questionnaire (FFQ) used for two cohort studies in Japan.

Cross-sectional study.

Two rural towns in the Miyagi Prefecture, in north-eastern Japan.

Fifty-five men and 58 women.

A 40-item FFQ was administered twice, 1 year apart. In the mean time, four 3-day diet records (DRs) were collected in four seasons within the year. We calculated daily consumption of total energy and 15 nutrients, 40 food items and nine food groups from the FFQs and the DRs. We computed Spearman correlation coefficients between the FFQs and the DRs. With adjustment for age, total energy and deattenuation for measurement error with the DRs, the correlation coefficients for nutrient intakes ranged from 0.25 to 0.58 in men and from 0.30 to 0.69 in women, with median of 0.43 and 0.43, respectively. Median (range) of the correlation coefficients was 0.35 (−0.30 to 0.72) in men and 0.34 (−0.06 to 0.75) in women for food items and 0.60 (−0.10 to 0.76) and 0.51 (0.28–0.70) for food groups, respectively. Median (range) of the correlation coefficients for the two FFQs administered 1 year apart was 0.49 (0.31–0.71) in men and 0.50 (0.40–0.64) in women for nutrients, 0.43 (0.14–0.76) and 0.45 (0.06–0.74) respectively for food items, and 0.50 (0.30–0.70) and 0.57 (0.39–0.66) respectively for food groups. Relatively higher agreement percentages for intakes of nutrients and food groups with high validity were obtained together with lower complete disagreement percentages.

The FFQ has a high reproducibility and a reasonably good validity, and is useful in assessing the usual intakes of nutrients, foods and food groups among a rural Japanese population.

To determine low-income consumers' attitudes and behaviour towards fruit and vegetables, in particular issues of access to, affordability of and motivation to eat fruit and vegetables.

Questionnaire survey mailed to homes owned by a large UK housing association.

Participants were 680 low-income men and women, aged 17–100 years.

Age, employment, gender, smoking and marital status all affected attitudes towards access, affordability and motivation to eat fruit and vegetables. Few (7%) participants experienced difficulty in visiting a supermarket at least once a week, despite nearly half having no access to a car for shopping. Fruit and vegetables were affordable to this low-income group in the amounts they habitually bought; purchasing additional fruits and vegetables was seen as prohibitively expensive. Less than 5% felt they had a problem with eating healthily and yet only 18% claimed to eat the recommended 5 or more portions of fruit and vegetables every day.

Supported by research, current UK Government policy is driven by the belief that low-income groups have difficulties in access to and affordability of fruit and vegetables. Findings from this particular group suggest that, of the three potential barriers, access and affordability were only a small part of the ‘problem’ surrounding low fruit and vegetable consumption. Thus, other possible determinants of greater consequence need to be identified. We suggest focusing attention on motivation to eat fruit and vegetables, since no dietary improvement can be achieved if people do not recognise there is a problem.

The objective of the present review is to assess the impact of universal salt iodisation in Nigeria during the last five years, with reference to some of the sentinel sites studied previously during a 1995 multi-centre study.

The method of goitre classification by palpation was employed using the new internationally accepted method in which the classification is simply graded as 0, 1 or 2. The multistage random sampling method was used and states and local government areas were already selected by virtue of their known status for iodine deficiency disorders (IDD). Schools were randomly chosen in each local government area and children aged 8–12 years in each school were determined. A percentage of the children was then included in the study to give a sample size greater than the minimum number allotted to the school. A total of 2372 schoolchildren (1420 males and 952 females) in 11 local government areas were examined; urine samples were collected from 537 children and analysed for urinary excretion of iodine. The method known as the Sandell–Kolthoff reaction was adopted, in which the iodide in the urine samples catalyses the reduction of ceric ammonium sulphate (yellow colour) to the cerous form (colourless) in the presence of arsenious acid. The degree of reduction in colour intensity of the yellow ceric ammonium sulphate is proportional to the iodine content in the urine sample.

The results from this study show that the median urinary iodine excretion for this sampled population in Nigeria, drawn mostly from IDD-endemic areas, is 14.65 μg dl−1 with a mean value of 13.39 μg dl−1.

This finding would suggest that Nigeria, in general terms, has achieved the goal of universal salt iodisation and should now focus its attention on constant monitoring in order to sustain this iodisation level.

The insulin-like growth factor (IGF) system has been implicated in the aetiopathogenesis of cancer, cardiovascular disease and diabetes. Since dietary factors and ethnicity are considered contributory to the development of these diseases, we examined the IGF system in relation to nutritional intake by ethnic group.

Dietary intake in 257 subjects of White European, African-Caribbean and Pakistani ethnic origin living in Manchester, UK was assessed using ethnic-group-specific food-frequency questionnaires to assess habitual nutrient intake over the previous 12 months. Fasting IGF-I, IGF-II and IGF-binding protein-1 (IGFBP-1) concentrations were determined and their relationship to specific dietary constituents was analysed.

Analysis by quintiles of nutrient intake showed a significant increase in circulating IGF-I concentration with increasing dietary fat intake (F for trend = 3.9, P < 0.01), saturated fat intake (F = 3.3, P = 0.01) and for protein intake (F = 4.2, P < 0.01). There was also a significant increase in IGF-II by quintiles of dietary protein intake (F = 2.7, P < 0.05). There was a trend for increasing IGF-I with increasing energy intake. The relationships between circulating concentration of IGFBP-1, an acute regulator of IGF action, and fat/protein intake were opposite to those for IGF-I and IGF-II. Multiple linear regression modelling showed that people of Pakistani origin and older subjects had lower levels of IGF-I (Pakistani origin vs. others, P < 0.001) (age, P < 0.001 for both). There was an independent inverse relationship between IGF-I and dietary carbohydrate intake (P = 0.036).

This study provides evidence for a dietary contribution to regulation of the IGF system, although the effects of ethnicity on circulating IGF levels remain dominant. We propose that the IGF system's influences on cancer risk in specific ethnic groups are potentially modifiable by dietary intervention.

To undertake an assessment of survey participation and non-response error in a population-based study that examined the relationship between socio-economic position and food purchasing behaviour.

The study was conducted in Brisbane City (Australia) in 2000. The sample was selected using a stratified two-stage cluster design. Respondents were recruited using a range of strategies that attempted to maximise the involvement of persons from disadvantaged backgrounds: respondents were contacted by personal visit and data were collected using home-based face-to-face interviews; multiple call-backs on different days and at different times were used; and a financial gratuity was provided.

Non-institutionalised residents of private dwellings (n = 1003), located in 50 small areas that differed in their socio-economic characteristics.

Rates of survey participation – measured by non-contacts, exclusions, dropped cases, response rates and completions – were similar across areas, suggesting that residents of socio-economically advantaged and disadvantaged areas were equally likely to be recruited. Individual-level analysis, however, showed that respondents and non-respondents differed significantly in their sociodemographic and food purchasing characteristics: non-respondents were older, less educated and exhibited different purchasing behaviours. Misclassification bias probably accounted for the inconsistent pattern of association between the area- and individual-level results. Estimates of bias due to non-response indicated that although respondents and non-respondents were qualitatively different, the magnitude of error associated with this differential was minimal.

Socio-economic position measured at the individual level is a strong and consistent predictor of survey non-participation. Future studies that set out to examine the relationship between socio-economic position and diet need to adopt sampling strategies and data collection methods that maximise the likelihood of recruiting participants from all points on the socio-economic spectrum, and particularly persons from disadvantaged backgrounds. Study designs that are not sensitive to the difficulties associated with recruiting a socio-economically representative sample are likely to produce biased estimates (underestimates) of socio-economic differences in the dietary outcome being investigated.

To examine the association between socio-economic position (SEP) and diet, by assessing the unadjusted and simultaneously adjusted (independent) contributions of education, occupation and household income to food purchasing behaviour

The sample was randomly selected using a stratified two-stage cluster design, and the response rate was 66.4%. Data were collected by face-to-face interview. Food purchasing was examined on the basis of three composite indices that reflected a household's choice of grocery items (including meat and chicken), fruit and vegetables

Brisbane City, Australia, 2000

Non-institutionalised residents of private dwellings (n = 1003), located in 50 small areas (Census Collectors Districts)

When shopping, respondents in lower socio-economic groups were less likely to purchase grocery foods that were high in fibre and low in fat, salt and sugar. Disadvantaged groups purchased fewer types of fresh fruits and vegetables, and less often, than their counterparts from more advantaged backgrounds. When the relationship between SEP and food purchasing was examined using each indicator separately, education and household income made an unadjusted contribution to purchasing behaviour for all three food indices; however, occupation was significantly related only with the purchase of grocery foods. When education and occupation were simultaneously adjusted for each other, the socio-economic patterning with food purchase remained largely unchanged, although the strength of the associations was attenuated. When household income was introduced into the analysis, the association between education, occupation and food purchasing behaviour was diminished or became non-significant; income, however, showed a strong, graded association with food choice

The food purchasing behaviours of socio-economically disadvantaged groups were least in accord with dietary guideline recommendations, and hence are more consistent with greater risk for the development of diet-related disease. The use of separate indicators for education, occupation and household income each adds something unique to our understanding of how socio-economic position is related to diet: each indicator reflects a different underlying social process and hence they are not interchangeable, and do not serve as adequate proxies for one another

To identify consumer perceptions of whole milk, reduced-fat milk and soy milk, and to investigate demographic influences on perceptions and types of milk consumption.

Questionnaires covering nutritional and sensory perceptions of three types of milk.

Three hundred and sixty-one randomly selected shoppers in Melbourne, Australia.

Generally, respondents held positive perceptions about milk. Milk was considered as having good sensory properties, providing a good source of nutrients, and being a convenient and safe product. However, despite these findings, misperceptions and unawareness about the nutrient content of milk were prevalent. Negative perceptions were most common for whole milk and were mostly related to its perceived high fat, cholesterol and energy contents. Soy milk received lower ratings on sensory quality and convenience than dairy milk. There were few sociodemographic differences in consumers' perceptions. Although reduced-fat milk consumption was more frequent among elderly people and type of milk consumption was related to parenthood, no other significant effects of demographic variables were found on the consumption of specific milk types.

Although positive perceptions were common, negative perceptions and misperceptions appear to be prevalent, presenting a challenge for nutrition education. Sociodemographic factors were not shown to be important predictors of perceptions and type of milk consumption.

The aim of this study was to evaluate the effectiveness of a widespread vitamin A supplementation programme and to describe indicators of compliance with the programme in Indonesia.

Prospective cohort study. Children's anthropometric data were gathered at baseline (June 2000) and 4 months later (2 months after supplementation in August 2000). Serum retinol, haemoglobin, ferritin, α1-acid glycoprotein and C-reactive protein were measured at baseline and at follow-up. Caregivers of the children were interviewed using a questionnaire.

Semi-urban and rural areas of Semarang district, Central Java, Indonesia.

Children (n = 400) aged 1–5 years.

After the supplementation, the proportion of children with a low concentration of retinol decreased in recipients from 18.8 to 14.5%. However, in non-recipients, the prevalence of vitamin A deficiency increased from 31.9 to 37.5%, this prevalence being significantly higher than in recipients. A significant decrease occurred in the proportion of recipients with low ferritin (26.5 to 16.2%) and haemoglobin (25.7 to 15.3%), whereas the proportions did not show a significant change after supplementation for non-recipients. Modest linear growth was detected in recipients after supplementation but there was no effect on ponderal growth. The coverage rate of the supplementation in the study areas was 60%. There was an association between compliance of the caregivers and their knowledge about the potential benefit of vitamin A supplementation, the place where sick children were taken and age of the children.

The vitamin A supplementation programme marginally decreased the proportion of vitamin A deficiency and had a marginal effect on the nutritional status of recipients. More than one micronutrient intervention is needed to increase the effectiveness of the supplementation programme. To increase compliance and coverage in the supplementation programme, nutrition communication and private healthcare practices need to be included in the programme.

An exploratory qualitative investigation was done to determine the feeding and weaning practices, knowledge and attitudes towards nutrition of mothers/caregivers of children up to 3 years old attending baby clinics in the Moretele district (South Africa).

Qualitative data collection on six relevant nutrition topics was done using focus group interviews. Trained moderators, using a pre-tested, structured interview schedule, interviewed participants in six age groups. Focus group interviews were taped, transcribed and translated. Content analysis produced systematic data descriptions and ethnography provided descriptive data.

Breast-feeding was the choice feed and bottle-feeding was only given when breast-feeding was impossible. Solid food was introduced early (at 2–3 months) and a mixed family diet at 7–9 months. Milk feeds were stopped completely from 18–24 months. Weaning diets were compromised due to poor food choices, preparation practices and limited variety. The participant's nutrition knowledge regarding specific foods, their functions and recommended quantities was poor. The women adhered to their cultural beliefs regarding food choices and preparation practices.

The data analysis revealed that inadequate nutrition knowledge and adherence to cultural practices lead to poor-quality feeding practices. Cultural factors and taboos have a powerful influence on feeding practices and eating patterns. Young mothers often find it impossible to ignore their ill-informed elders or peer group. Nutrition knowledge needs to be changed in a first step towards implementing improved feeding practices. Facilitated group discussions could focus on possible solutions for the identified nutrition-related problems.