To compare the sociodemographic characteristics, health status and health service use of vegetarians, semi-vegetarians and non-vegetarians.

In cross-sectional data analyses of the Australian Longitudinal Study on Women's Health in 2000, 9113 women (aged 22–27 years) were defined as non-vegetarians if they reported including red meat in their diet, as semi-vegetarians if they excluded red meat and as vegetarians if they excluded meat, poultry and fish from their diet.

The estimated prevalence was 3% and 10% for vegetarian and semi-vegetarian young women. Compared with non-vegetarians, vegetarians and semi-vegetarians were more likely to live in urban areas and to not be married. Vegetarians and semi-vegetarians had lower body mass index (mean (95% confidence interval): 22.2 (21.7–22.7) and 23.0 (22.7–23.3) kg m− 2) than non-vegetarians (23.7 (23.6–23.8) kg m− 2) and tended to exercise more. Semi-vegetarians and vegetarians had poorer mental health, with 21–22% reporting depression compared with 15% of non-vegetarians (P < 0.001). Low iron levels and menstrual symptoms were also more common in both vegetarian groups. Vegetarian and semi-vegetarian women were more likely to consult alternative health practitioners and semi-vegetarians reported taking more prescription and non-prescription medications. Compared with non-vegetarians, semi-vegetarians were less likely and vegetarians much less likely to be taking the oral contraceptive pill.

The levels of physical activity and body mass indices of the vegetarian and semi-vegetarian women suggest they are healthier than non-vegetarians. However, the greater reports of menstrual problems and the poorer mental health of these young women may be of clinical significance.

To evaluate the effects of a middle-school healthy eating promotion intervention combining environmental changes and computer-tailored feedback, with and without an explicit parent involvement component.

Clustered randomised controlled trial.

Fifteen West-Flemish (Belgian) middle schools.

A random sample of 15 schools with 2991 pupils in 7th and 8th grades was randomly assigned to an intervention group with parental support (n = 5), an intervention group without parental support (n = 5) and a control group (n = 5). In these 15 schools an intervention combining environmental changes with computer-tailored feedback was implemented. Fat and fruit intake, water and soft drinks consumption were measured with food-frequency questionnaires in the total sample of children.

In girls, fat intake and percentage of energy from fat decreased significantly more in the intervention group with parental support, compared with the intervention alone group (all F>3.9, P < 0.05) and the control group (all F>16.7, P < 0.001). In boys, there were no significant decreases in fat intake (F = 1.4, not significant (NS)) or percentage of energy from fat (F = 0.7, NS) as a result of the intervention. No intervention effects were found in boys or in girls for fruit (F = 0.5, NS), soft drinks (F = 2.6, NS) and water consumption (F = 0.3, NS).

Combining physical and social environmental changes with computer-tailored feedback in girls and their parents can induce lower fat intake in middle-school girls. However, to have an impact on the consumption of soft drinks and water, governmental laws that restrict the at-school availability of low-nutritive products may be necessary.

This study aimed to investigate the frequency of overweight and obesity among Iranian adolescent girls aged 14–17 years and its possible association with maternal education in Rasht city in 2005.

A cross-sectional survey on 1054 schoolgirls.

High schools in Rasht city, Iran.

A multistage sampling method was used and 1054 randomly selected schoolgirls were studied. Data on age and mother's years of schooling were collected by questionnaire and body weight and height were measured. Overweight and obesity were defined using age- and sex-specific body mass index (BMI) cut-off points proposed by the International Obesity Task Force (IOTF), and compared with 85th and 95th BMI percentile curves of the IOTF reference population, respectively. Data analyses included two groups based on mother's years of schooling: less educated ( < 12 years) and more educated ( ≥ 12 years).

The overall prevalence of overweight and obesity in this population was 21.9 and 5.3%, respectively. Results of logistic regression analysis showed that the risk of overweight was higher for lower age group (odds ratio = 2.0, 95% confidence interval 0.18–3.09). Overweight was more common in girls with less educated mothers than in girls with more educated mothers (26.0 vs. 19.8%, P = 0.03).

These data indicate that overweight is highly prevalent among adolescent girls, especially in lower social groups in Rasht, and the rate is exceeding those reported in other parts of the country. Preventive strategies need to be adopted to combat the epidemic of overweight and obesity in this population.

To identify dietary transition stages based on dietary patterns of adult Haitians having lived in Montreal for various lengths of time, and to assess associated dietary quality.

One hundred and eighty-one Haitians aged 25–60 years were recruited by the modified random digit dialling method.

Socio-economic, diet and lifestyle variables were documented by questionnaire. Three non-consecutive 24-hour dietary recalls were conducted over a 3-month period. Dietary patterns were studied using cluster analysis, and their association with proportion of lifetime in Canada and with socio-economic status (SES) was examined. Diet quality criteria were micronutrient adequacy and healthfulness based on dietary recommendations of the World Health Organization.

Four dietary phenotypes were identified which could roughly represent stages of dietary transition or acculturation (Traditional, Pre-Western, Western and Modern). Subjects in the ‘Traditional’ cluster were older and had lived for a significantly lower proportion of their lifetime in Canada; they also tended to be of lower SES. Diet quality was significantly higher in the ‘Traditional’ than the ‘Western’ type, particularly with respect to healthfulness. A significantly lower proportion of subjects complying with limited intake of total fat ( < 30%) and cholesterol ( < 45%) was observed in the ‘Western’ compared with other diet phenotypes. Less than 15% of all subjects consumed enough dietary fibre, irrespective of diet type.

Dietary transition stages could be identified on the basis of food patterns of Haitians according to the proportion of their lifetime in Canada. Encouraging the youth to retain the traditional food culture in its positive aspects would appear relevant.

To develop a quantitative food-frequency questionnaire (QFFQ) for the Barbados National Cancer Study (BNCS) that will permit examination of associations of diet with breast and prostate cancer.

Population intake data from the year 2000 Barbados Food Consumption and Anthropometric Surveys (BFCAS 2000) were used to derive a list of foods consumed by the population. A 192-item draft QFFQ was developed from this list.

Barbados, West Indies provides an ideal environment to understand cancer risk in African-origin populations, with high relevance to African-Americans. The BNCS is a population-based case–control study examining risk factors for breast and prostate cancer in such populations.

A total of 1600 persons, 18 years and older, completed a 24-hour recall in the BFCAS 2000. Fifty of 63 randomly selected residents (79% response rate) gave additional updated information on foods consumed.

The 50 participants provided a one-time 24-hour recall and completed the draft QFFQ. The final instrument contains 148 items: breads, cakes, cereals = 17; rice, pastas, noodles = 8; dairy = 10; meat, fish, poultry = 42; fruit = 16; vegetables = 26; soft drinks = 14; alcoholic beverages = 5; others = 10. Additional questions include supplement use and food preparation methods such as grilling.

The final instrument is concise, complete and the most up-to-date for assessing the food and nutrient intake of African-origin Barbadians and the associations with breast and prostate cancer.

To understand the periconceptional use of folic acid and its association with selected characteristics in northern China.

As part of a population-based case–control study on external structural birth defects, we analysed periconceptional use of folic acid among control mothers.

The study was conducted in four counties (Pingding, Xiyang, Taigu and Zezhou) in Shanxi Province of northern China.

The subjects in this study were the control mothers, who were interviewed between January 2003 and May 2005.

Of the 480 respondent mothers, 49 women (10.2%) reported ever using folic acid supplements, and only 16 women (3.3%) used it periconceptionally. The rates of any use and periconceptional use did not change significantly with study year. Periconceptional use of folic acid was significantly increased among women with more than high school education (odds ratio (OR) = 4.57, P < 0.10), women who were not farmers (OR = 4.72, P < 0.05), women with a history of birth-defect-affected pregnancy (OR = 32.73, P < 0.05) and women who planned their pregnancy (OR = 7.88, P < 0.10).

The rate of periconceptional folic acid use was among the lowest of those reported from other countries. More work should be done to improve preconceptional use of folic acid with special attention on less educated women and women farmers.

To evaluate the effects of a comprehensive physical activity (PA) promotion programme in elementary schools on children's total PA levels, leisure-time PA, physical fitness and psychosocial correlates of PA.

A pre-test–post-test design over two school years.

Sixteen elementary schools (764 children, mean age: 11.2 ± 0.7 years) were randomly assigned to the intervention condition (n = 8) and the control condition (n = 8). The intervention included a health-related physical education programme, an extracurricular PA promotion programme and classroom-based PA education lessons. In the total sample, leisure-time PA, psychosocial correlates of PA and physical fitness were measured using a PA questionnaire and the Eurofit test battery. In a sub-sample, total PA levels were measured using an accelerometer.

According to accelerometer data, children's moderate PA and moderate-to-vigorous PA (MVPA) levels decreased less in the intervention schools than in the control schools (P < 0.01). The average time spent on MVPA decreased by 9 min per day in the intervention schools compared with 33 min per day in the control schools. Children in the intervention schools reported significantly more moderate PA in leisure time than the controls (P < 0.05). No overall improvement of physical fitness and no effects on the psychosocial correlates of PA were found.

The comprehensive PA promotion programme was successful in preventing a decline in children's total activity levels. Furthermore, the intervention increased children's PA engagement in leisure time. Therefore, implementation needs to be encouraged.

To investigate the prevalence of obesity in affluent schoolchildren of Delhi.

This was a cross-sectional study covering over 4000 students. Anthropometric measurements and birth weights of all the students were recorded.

The study was carried out in a school catering to the affluent section of Indian society and included both boys and girls in the age range 4 to 17 years.

The heights and weights of the children were almost similar to those of the National Center for Health Statistics standards, and were much above the values reported by the Indian National Nutrition Monitoring Bureau, which largely captures rural children belonging to lower socio-economic strata in India. Of the subjects studied, 22% were overweight and 6% were obese. Only 6% of these children had low birth weight.

The prevalence of obesity is rising among children because of their change in lifestyle. Children born with a birth weight of ≥ 3 kg tended to have higher body mass index in their adolescent years and maybe consequently in their adult years. Nutrition education can play an important part in reducing the incidence of overweight/obesity and its associated complications.

To estimate the potential impact of zinc biofortification of rice and wheat on public health in India and to evaluate its cost-effectiveness compared with alternative interventions and international standards.

The burden of zinc deficiency (ZnD) in India was expressed in disability-adjusted life years (DALYs) lost. Current zinc intakes were derived from a nationally representative household food consumption survey (30-day recall) and attributed to household members based on adult equivalent weights. Using a dose–response function, projected increased zinc intakes from biofortified rice and wheat were translated into potential health improvements for pessimistic and optimistic scenarios. After estimating the costs of developing and disseminating the new varieties, the cost-effectiveness of zinc biofortification was calculated for both scenarios and compared with alternative micronutrient interventions and international reference standards.

India.

Representative household survey (n = 119 554).

The calculated annual burden of ZnD in India is 2.8 million DALYs lost. Zinc biofortification of rice and wheat may reduce this burden by 20–51% and save 0.6–1.4 million DALYs each year, depending on the scenario. The cost for saving one DALY amounts to $US 0.73–7.31, which is very cost-effective by standards of the World Bank and the World Health Organization, and is lower than that of most other micronutrient interventions.

Not only may zinc biofortification save lives and prevent morbidity among millions of people, it may also help accommodate the need to economise and to allocate resources more efficiently. Further research is needed to corroborate these findings.

To document the infant feeding practices of Maldivian mothers.

A cross-sectional survey of 251 Maldivian mothers recruited in 2004 from the ‘well baby’ or ‘well child’ clinics on the island of Male' and including 75 mothers from three other islands, Hura, Himmafushi and Thulusdhoo.

The full breast-feeding rate at hospital discharge was 93% but declined to 41% at 4 months. Any breast-feeding rates were high among Maldivian mothers: 100% at 1 month and 85% were still breast-feeding at 6 months. The median duration of breast-feeding was 24 months.

Breast-feeding rates are high and the average duration of breast-feeding is more than 2 years in the Maldives. Health promotion activities should be directed towards maintaining the already high ‘any breast-feeding’ rates and increasing the proportion of infants exclusively breast-fed to 6 months.

Contributions of fish and other foods to variance of selenium and mercury status were studied in British adults.

Plasma and red-cell selenium and whole-blood mercury concentrations were measured during the National Diet and Nutrition Survey of Adults aged 19–64 years in mainland Britain, 2000–2001 (n = 1216). Food intake was weighed for seven consecutive days, and foods were combined in groups for data analysis. Four subsidiary groups characterised fish intakes: fried white fish, ‘other’ white fish, shellfish and oily fish.

Geometric means and 5–95% ranges were: for whole-blood mercury, 5.61 (1.30–22.2) nmol l− 1; for plasma selenium, 1.09 (0.83–1.43) μmol l− 1; for red-cell selenium, 1.64 (1.14–2.40) μmol l− 1. Twenty-eight per cent had no fish intake recorded during 7 days; the remaining 72% had a median intake of 237 g over the 7-day period, 5–95% range 45–780 g. Total fish intake was strongly and directly correlated with blood mercury, and moderately with red-cell and plasma selenium. Thus, sqrt(total fish intake) was correlated with: loge(blood Hg), t = +19.7; loge(plasma Se), t = +9.8; and loge(red-cell Se), t = +9.6, all P < 0.0001. All three biochemical (mercury and selenium) indices were strongly correlated with oily fish intake, and moderately correlated with shellfish and ‘other’ ( = non-fried) white fish, but none was significantly correlated with fried white fish. Blood mercury was strongly and directly correlated with red-cell and plasma selenium, and both increased with age.

Dietary fish, especially oily fish, is a strong predictor of blood mercury and selenium in British adults.

To examine educational differences among people who consume foods containing fat in Finland and the Baltic countries.

Data were collected from cross-sectional postal Finbalt Health Monitor surveys that were carried out in 1998, 2000 and 2002.

Estonia, Finland, Latvia and Lithuania.

For each survey, nationally representative random samples of adults aged 20–64 years were drawn from population registers (Estonia, n = 3656; Finland, n = 9354, Latvia, n = 6015; Lithuania, n = 5944).

Differences were revealed between the countries in the consumption of foods that contain fat. Finnish people consumed butter on bread, high-fat milk, meat and meat products, and vegetable oil for cooking less frequently than people in the Baltic countries. Cheese was most popular in Finland. Educational differences in fat-related food habits were examined by applying logistic regression analysis. A positive association was found between level of education and consumption of vegetable oil used in food preparation. Drinking high-fat milk was associated with low education in all countries. People with higher education tended to consume cheese more often. Educational patterns in the consumption of butter on bread and in the consumption of meat and meat products differed between countries.

The consumption of foods containing fat was related to educational levels in all four countries. The diet of better-educated people was closer to recommendations for the consumption of saturated and unsaturated fats than the diet of people with lower level of education. The educational gradient was more consistent in Finland than in the Baltic countries. These existing educational differences in sources of fat consumed should be taken into account in the development of national cardiovascular disease prevention programmes.

To compare the validity of a modified Block food-frequency questionnaire (FFQ), a picture-sort administration of the FFQ (PSFFQ) and a meal pattern-based questionnaire (MPQ) in a multi-ethnic population of low socio-economic status (SES).

Participants completed six 24-hour dietary recalls (24HR) over six months; the FFQ, PSFFQ and MPQ were completed in random order in the subsequent month. Instruments were interviewer-administered. The PSFFQ and MPQ were developed in formative research concerning difficulties for older adults in responding to standard food-frequency instruments.

Rural North Carolina, USA.

One hundred and twenty-two African American, Native American and white adults aged ≥ 65 years, with approximately one-third in each ethnic group. Inclusion criteria included education ≤ 12 years and income ≤ 150% of national poverty level or Medicaid recipient.

Comparing median intakes from the average of the 24HR with the three diet assessment instruments, the MPQ tended to overestimate intakes compared with the FFQ and PSFFQ. Correlations among nutrients obtained by the 24HR and the other three instruments were generally statistically significant and positive. Across nutrients, the PSFFQ was most highly correlated with the 24HR for women, while the FFQ was most highly correlated with the 24HR for men.

Dietary assessments using 24HR and FFQ were similar to results reported elsewhere, although correlations between 24HR and FFQ were somewhat lower. Interviewer-administered dietary assessments should be used with caution to evaluate dietary intake among older adults with low SES. Gender differences and the lower correlations should be investigated more thoroughly to assist in choosing dietary assessment instruments for this population.