To describe the proportion of women reporting time is a barrier to healthy eating and physical activity, the characteristics of these women and the perceived causes of time pressure, and to examine associations between perceptions of time as a barrier and consumption of fruit, vegetables and fast food, and physical activity.

A cross-sectional survey of food intake, physical activity and perceived causes of time pressure.

A randomly selected community sample.

A sample of 1580 women self-reported their food intake and their perceptions of the causes of time pressure in relation to healthy eating. An additional 1521 women self-reported their leisure-time physical activity and their perceptions of the causes of time pressure in relation to physical activity.

Time pressure was reported as a barrier to healthy eating by 41 % of the women and as a barrier to physical activity by 73 %. Those who reported time pressure as a barrier to healthy eating were significantly less likely to meet fruit, vegetable and physical activity recommendations, and more likely to eat fast food more frequently.

Women reporting time pressure as a barrier to healthy eating and physical activity are less likely to meet recommendations than are women who do not see time pressure as a barrier. Further research is required to understand the perception of time pressure issues among women and devise strategies to improve women’s food and physical activity behaviours.

To explore policy options that public health specialists (PHS) consider appropriate for combating obesity in Europe, and compare their preferences with those of other stakeholders (non-PHS).

Structured interviews using multicriteria mapping, a computer-based, decision-support tool.

Nine European countries.

A total of 189 stakeholders. Twenty-seven interviewees were PHS and non-PHS included food, sports and health sectors.

A four-step approach was taken, i.e. selecting options, defining criteria, scoring options quantitatively and weighting the criteria to provide overall rankings of options. Interviews were recorded and transcribed to yield qualitative data.

The PHS concur with other stakeholders interviewed, as all emphasised the importance of educational initiatives in combating obesity, followed by policies to improve community sports facilities, introduce mandatory food labelling and controlling food and drink advertising. Further analyses revealed several significant differences. The non-PHS from the private sector ranked institutional reforms favourably; the PHS from non-Mediterranean countries supported the option of medicines to prevent obesity; and those PHS from Mediterranean countries endorsed the use of activity monitoring devices such as pedometers. As far as appraisal criteria were concerned, PHS considered efficacy and the economic impact on the public sector to be the most important.

There is clear consensus among PHS and other stakeholders concerning the need for a package of policy options, which suggests that European-wide implementation could be successful. However, it would be advisable to avoid more contentious policy options such as taxation until future changes in public opinion.

To investigate differences in overweight and obesity between first-generation Dutch-Ghanaian migrants in The Netherlands and their rural and urban counterparts in Ghana.

Cross-sectional study.

A total of 1471 Ghanaians (rural Ghanaians, n 532; urban Ghanaians, n 787; Dutch-Ghanaians, n 152) aged ≥17 years.

Overweight (BMI ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2).

Dutch-Ghanaians had a significantly higher prevalence of overweight and obesity (men 69·1 %, women 79·5 %) than urban Ghanaians (men 22·0 %, women 50·0 %) and rural Ghanaians (men 10·3 %, women 19·0 %). Urban Ghanaian men and women also had a significantly higher prevalence of overweight and obesity than their rural Ghanaian counterparts. In a logistic regression analysis adjusting for age and education, the odds ratios for being overweight or obese were 3·10 (95 % CI 1·75, 5·48) for urban Ghanaian men and 19·06 (95 % CI 8·98, 40·43) for Dutch-Ghanaian men compared with rural Ghanaian men. Among women, the odds ratios for being overweight and obese were 3·84 (95 % CI 2·66, 5·53) for urban Ghanaians and 11·4 (95 % CI 5·97, 22·07) for Dutch-Ghanaians compared with their rural Ghanaian counterparts.

Our current findings give credence to earlier reports of an increase in the prevalence of overweight/obesity with urbanization within Africa and migration to industrialized countries. These findings indicate an urgent need to further assess migration-related factors that lead to these increases in overweight and obesity among migrants with non-Western background, and their impact on overweight- and obesity-related illnesses such as diabetes among these populations.

The first aim was to evaluate BMI cross-sectionally over a period of 14 years (1992 to 2005) in 43 343 army men and the second was to compare BMI using the paired data of 1497 army men. The data were analysed as a function of the military ranking system, used as an indicator for socio-economic position.

Multiple cross-sectional and longitudinal design.

A significant increase of BMI between age categories was detected over the 14-year period; BMI remained stable in each age category. In the paired cohort, median BMI increased during the same period from 23·9 (interquartile range 3·3) kg/m2 to 24·7 (interquartile range 3·5) kg/m2 (P < 0·0001). This age-dependent evolution was present in all military rankings. From age 40 years or more, BMI indicated a significant increase in the prevalence of overweight and obesity.

For the total cohort, BMI remained stable in each age category. For the paired cohort, BMI increased over time. The military leadership should emphasize prevention in order to reduce the health-care costs and disease burden in this cohort. This emphasis on prevention should target those aged less than 40 years.

To assess maternal diet and nutritional adequacy prior to conception and during pregnancy.

Follow-up of a cohort of pregnant women with collection of questionnaire data throughout pregnancy and after delivery.

Antenatal clinics at two public hospitals in Porto, Portugal.

Two hundred and forty-nine pregnant women who reported a gestational age below 13 weeks at the time they attended their first antenatal visit.

Intakes of energy and macronutrients were within recommended levels for most women. Pregnancy was accompanied by increases in the dietary intake of vitamins A and E, riboflavin, folate, Ca and Mg, but declines in the intake of alcohol and caffeine. The micronutrients with higher inadequacy prevalences prior to pregnancy were vitamin E (83 %), folate (58 %) and Mg (19 %). These three micronutrients, together with Fe, were also those with the highest inadequacy prevalences during pregnancy (91 %, 88 %, 73 % and 21 %, respectively, for folate, Fe, vitamin E and Mg). Ninety-seven per cent of the women reported taking supplements of folic acid during the first trimester, but the median gestational age at initiation was 6·5 (interquartile range 5, 9) weeks. Self-reported prevalences of Fe and Mg supplementation were high, and increased throughout pregnancy.

The study identified low dietary intakes of vitamin E, folate and Mg both in the preconceptional period and during pregnancy, and low intake of Fe during pregnancy only. The low dietary intake of folate and the late initiation of supplementation indicate that current national guidelines are unlikely to be effective in preventing neural tube defects.

To determine the effectiveness of a redesigned Fe supplementation delivery system (ISDS) in improving Hb concentrations and compliance among pregnant women.

A controlled before and after study design was used. Interviews and Hb measurements of randomly selected pregnant women in both treatment areas were conducted at baseline and after 6 months. The redesigned ISDS, reached by consensus based on the surveys and focus group discussions, involved the health workers in spot mapping and clustering; Fe tablets’ distribution, monitoring and promotion; and counselling of pregnant women.

Negros Occidental and Negros Oriental, Philippines.

In total, 1180 pregnant women given Fe/folic acid tablets daily through the redesigned ISDS in the experimental areas and the existing ISDS in the control areas.

There were significantly more anaemic pregnant women in the experimental than in the control area at baseline (50·7 v. 37·3 %; P = 0·001). However, at endline, the anaemia prevalence rate in the experimental area was comparable to that of the control (35·6 v. 33·1 %; P = 0·530). Also, the mean Hb concentration increased significantly in the experimental area by 0·5 g/dl (P = 0·002). An increase in the actual number of prenatal visits/trimester in the experimental area was observed (from 0·99 to 1·66; P < 0·0001). Pregnant women in the experimental area were four times more likely to take Fe tablets (OR = 3·79; P < 0·001) and sixteen times more likely to being monitored for Fe intake (OR = 16·86; P < 0·001) compared to the control.

The redesigned ISDS was effective in improving the Hb concentration and health-related behaviour of pregnant women.

To assess the folate and vitamin B12 status of a group of Vietnamese women of reproductive age and to estimate the rate of neural tube defects (NTD) based on red blood cell (RBC) folate concentrations.

A representative sample of non-pregnant women (15–49 years) living in Hanoi City (n 244) and Hai Duong Province (n 245).

RBC folate, plasma vitamin B12 and plasma holo-transcobalamin (holoTC), a sensitive indicator of vitamin B12 status.

Mean (95 % CI) concentrations of RBC folate, plasma B12 and plasma holoTC were 856 (837, 876) nmol/l, 494 (475, 513) pmol/l and 78 (74, 82) pmol/l, respectively. Only 3 % and 4 % of women had plasma B12 and holoTC concentrations indicative of deficiency. No woman had an RBC folate concentration indicative of deficiency (<317 nmol/l). Only 47 % of women had an RBC folate concentration ≥905 nmol/l. Accordingly, we predict the NTD rate in these regions of Vietnam to be 14·7 (14·2, 15·1) per 10 000 pregnancies.

There was no evidence of folate and vitamin B12 deficiency among this population of Vietnamese women. However, suboptimal folate status may be placing three out of five women at increased risk of NTD. Reductions in NTD rates are still possible and women would benefit from additional folic acid during the periconceptional period from either supplements or fortified foods.

To determine the prevalence of metabolic syndrome (MetS) in schoolchildren from 6 to 16 years old, while considering their socio-economic status and other potential risk factors.

A cross-sectional study was conducted between April and November of 2005 in a semi-rural city with a total population of 13 000 inhabitants.

The study was conducted in Maracai city, located in the Brazilian state of Sao Paulo.

Schoolchildren (n 2170) of both genders, corresponding to approximately 82 % of all Maracai schoolchildren, were evaluated for components of MetS, as defined by the National Cholesterol Education Program; reference values for children and adolescents were adjusted for age and sex.

Overall, MetS prevalence was 3·6 % (95 % CI 2·9, 4·5) and did not differ statistically between genders, skin colour, between children and adolescents. However, when we analysed groups of subjects by weight, MetS prevalence progressively increased from 0·3 % (95 % CI 0·1, 0·8) in normal-weight subjects to 10·7 % (95 % CI 7·4, 14·8) and 34·5 % (95 % CI 25·9, 43·9) in overweight and obese subjects, respectively (both P < 0·001 compared to normal-weight controls). When socio-economic classes were considered, 4·7 % high-income students (95 % CI 3·5, 6·2) had MetS, which was significantly greater than low-income students (2·7 %; 95 % CI 1·9, 3·9; P = 0·023).

MetS prevalence was high in overweight and obese schoolchildren and these risk factors were present during childhood and adolescence. Changes in lifestyle and alimentary safety should be encouraged to avoid future cardiovascular morbidity and type 2 diabetes mellitus.

To estimate the prevalence of underweight between 1998 and 2006 in Liverpool schoolchildren aged 9–10 years using recently published underweight cut-off points.

Stature and body mass data collected at the Liverpool SportsLinx project’s fitness testing sessions were used to calculate BMI.

Data were available on 26 782 (n 13 637 boys, 13 145 girls) participants.

Overall underweight declined in boys from 10·3 % in 1998–1999 to 6·9 % in 2005–2006, and all sub-classifications of underweight declined, in particular grade 3 underweight, with the most recent prevalence being 0·1 %. In girls, the prevalence of underweight declined from 10·8 % in 1998–1999 to 7·5 % in 2005–2006. The prevalence of all grades of underweight was higher in girls than in boys. Underweight showed a fluctuating pattern across all grades over time for boys and girls, and overall prevalence in 2005–2006 represents over 200 children across the city.

Underweight may have reduced slightly from baseline, but remains a substantial problem in Liverpool, with the prevalence of overall underweight being relatively similar to the prevalence of obesity. The present study highlights the requirement for policy makers and funders to consider both ends of the body mass spectrum when fixing priorities in child health.

Using a nationally representative sample, to identify groups among British children aged 1½; – 4½; years who report similar patterns of diet.

Nationally representative dietary survey, using 4 d weighed dietary records, of girls and boys aged 1½; – 4½; years living in private households in Great Britain in 1992–1993. Cluster analysis was used to aggregate individuals into diet groups.

Great Britain.

Eight hundred and forty-eight boys and 827 girls.

Three clusters were identified for girls and three for boys. Among boys the most prevalent cluster was ‘Healthy Diet’ (52·3 %), the second was ‘Convenience Diet’ (38·3 %) and the third was ‘Traditional Diet’ (9·3 %). Among girls, the most prevalent dietary cluster was ‘Healthy Diet’ (58·7 %), followed by a ‘Convenience Diet’ (36·6 %) and ‘Traditional Diet’ (4·3 %). There were important differences in nutrient profile, sociodemographic and behavioural characteristics between clusters.

Cluster analysis identified three groups among both girls and boys which differed not only in terms of reported dietary intake, but also with respect to nutrient intake, social and behavioural characteristics. The groups identified could provide a useful basis for the development, monitoring and targeting of public health nutrition policy for pre-school children in the UK. Further research is needed on the consequences for chronic disease in the future for these children.

To evaluate the relative validity of an FFQ for assessing nutrient intakes in 12-month-old infants.

The FFQ was developed to assess the diets of infants born to women in the Southampton Women’s Survey (SWS), a population-based survey of young women and their offspring. The energy and nutrient intakes obtained from an interviewer-administered FFQ were compared with those obtained from 4d weighed diaries (WD).

A sub-sample of fifty infants (aged 1 year) from the SWS had their diets assessed by both methods. The FFQ recorded the frequencies and amounts of foods and drinks consumed by the infants over the previous 28 d; milk consumption was recorded separately. The WD recorded the weights of all foods and drinks consumed by the infants on 4 d following the FFQ completion.

The Spearman rank correlation coefficients for intakes of energy, macronutrients and eighteen micronutrients, determined by the two methods, ranged from r = 0·25 to 0·66. Bland–Altman statistics showed that mean differences between methods were in the range +5 % to +60 % except for vitamin D (+106 %). Differences in micronutrient intake were partly explained by changes in patterns of milk consumption between the two assessments.

Although there were differences in absolute energy and nutrient intakes between methods, there was reasonable agreement in the ranking of intakes. The FFQ is a useful tool for assessing energy and nutrient intakes of healthy infants aged around 12 months.

Childhood obesity has become a major public health problem in many countries. To explore the risk factors of overweight in infants and young children might be helpful in developing an early overweight intervention strategy.

To assess the prevalence of overweight and the relationship of parental characteristics and feeding practices to overweight in infants and young children in Beijing, China.

Data on weight and length/height were collected on 4654 children aged 1–35 months in twelve communities in Beijing from a cross-sectional study. Overweight was defined as weight-for-length/height ≥2sd above the median of the WHO reference. Two hundred and fifteen families with overweight children and 215 families with normal-weight children were interviewed using a questionnaire to obtain feeding practices.

The overall prevalence of overweight was 4·7 %. Both parental overweight and low parental education were significantly higher among overweight than normal-weight children. The total energy intake was significantly higher in overweight than in normal-weight children at 12–35 months of age. Compared with normal-weight children, significantly fewer overweight children were breast-fed for at least 4 months. Overweight children were also more likely to have been introduced to infant formula and semi-solid foods during the first 4 months.

Early prevention strategies should include feeding practices identified as putting children at risk of obesity. These include early cessation of breast-feeding and premature introduction of other foods.

The aim of this qualitative study was to test the comprehensibility of the preliminary food-based dietary guidelines (FBDG) for healthy South African children aged 1–7 years. Objectives included assessing exposure to FBDG, comprehension of the proposed paediatric FBDG (PFBDG) and whether the guidelines can be used in meal planning.

Focus group discussions were used to collect data. Discussions were facilitated by the investigator in either English or Afrikaans, according to a predetermined discussion schedule. Focus groups were formed on the basis of language and socio-economic status (SES).

Areas within the City of Cape Town representing lower, middle and upper SES groups.

A total of seventy-six English- and Afrikaans-speaking mothers were contacted via randomly selected consenting preschool groups to participate voluntarily.

Most mothers reported that they do not use guidelines. They had a good grasp of the concepts of and need for PFBDG. They suggested slight alterations to wording/phrasing of the guidelines. The most problematic guidelines were those regarding starch, milk and sweet treats/drinks. No substantial differences were found between English and Afrikaans data. Differences were found between SES groups, with the upper SES groups comprehending the guidelines better.

The proposed PFBDG were well received. The target population that would benefit the most from these guidelines would be the less educated, lower SES groups. The present study shows that once the guidelines have been modified, they may be used as a comprehensive guide for nutritional education.

The prevalence of child overweight in the Czech Republic is substantially lower than that in the USA. The objective of the present pilot study was to explore dietary intakes, frequency of dining in fast-food establishments, and the amount and intensity of physical activity between a sample of American and Czech children.

A cross-sectional correlational pilot study.

Four public schools in the USA and four public schools in the Czech Republic.

Ninety-five Czech and forty-four American 4–6th graders from urban public schools participated in the study. Dietary intake and number of fast-food visits were evaluated using two multiple-pass 24 h recalls. Physical activity was measured using the modified Self-Administered Physical Activity Checklist.

American children (mean age 10·8 (se 0·2) years) consumed more energy and fat, less fruits and vegetables, more soft drinks, and visited fast-food establishments more often than Czech children (mean age 11·0 (se 0·1) years). Although no differences were found in vigorous activity by nationality, Czech children spent significantly more time in moderate physical activities than American children.

Despite the influx of some negative Western dietary trends into the country, Czech children had a healthier diet and were more physically active than American children. Further research is warranted to determine whether the same differences in dietary intakes, physical activity and fast-food visits exist between nationally representative samples of American and Czech children.

The Mediterranean diet (MD) prototype is widely used as an educational tool in public health programmes; few studies, however, have been conducted on the adherence of children to this diet.

To evaluate the quality of Cypriot children’s diet by assessing the degree of adherence to the MD.

A national cross-sectional study among 1140 children (mean age = 10·7 (sd 0·98) years), using stratified multistage sampling design, was conducted in primary schools of Cyprus. Dietary assessment was based on a 154-item semi-quantitative FFQ and the two supplementary questionnaires (a Food Groups Frequency Questionnaire and a Short Eating Habits Questionnaire). Adherence to the MD was assessed by the KIDMED index. The association between the frequencies of consumption of various food groups and the level of adherence to the MD (poor v. average v. good KIDMED score) was also evaluated. Multiple logistic regression analyses were used to adjust for potential confounders.

Only 6·7 % of the sample was classified as high adherers of MD, whereas 37 % had a poor KIDMED score. Multiple logistic regression analysis has shown that children with at least an average KIDMED score were more likely to eat frequently seafood and fish, legumes, nuts, bread, fruits, leafy vegetables, olives, low glycaemic index foods and unrefined foods. Effect size of associations was from medium to high.

Higher adherence to MD is associated with better diet quality in children. The MD prototype may thus represent a useful educational tool for promotion of healthy eating habits in children.

Poor nutrition and limited sunlight exposure (season) can be related to reduced serum 25-hydroxyvitamin D (25(OH)D) concentrations. Thus, elderly people in the Nordic countries might be at high risk for vitamin D deficiency. The aims of the study were to describe the prevalence of vitamin D deficiency in elderly hospitalized patients in Reykjavik, Iceland, and to investigate the effects of nutritional status and season on serum 25(OH)D.

Cross-sectional study. Nutritional status was assessed and fasting blood was drawn and analysed for serum 25(OH)D and other clinical routine measurements.

Departments of Geriatrics, Landspitali-University Hospital, Reykjavik, Iceland.

Sixty hospitalized patients (mean age 83·0 (sd 7·9) years) were randomly assigned.

Of the patients, 12·3 % suffered from vitamin D deficiency (serum 25(OH)D < 25 nmol/l) and 71·9 % suffered from hypovitaminosis D (serum 25(OH)D = 25–75 nmol/l). There were no significant effects of gender or nutritional status on serum 25(OH)D. Anthropometric variables correlated significantly with serum 25(OH)D, but on stepwise linear regression modelling for the prediction of serum 25(OH)D, BMI remained the only predictor variable (B = −1·454, 95 % CI −2·535, −0·373, P = 0·009).

BMI was significantly negatively associated with serum 25(OH)D in hospitalized elderly patients. Neither nutritional status nor season significantly affected serum 25(OH)D in our patient group. Higher levels of serum 25(OH)D in elderly subjects with lower BMI are most likely explained by volume of distribution rather than by mobilization of vitamin D from its storage in adipose tissue due to age and disease-related catabolism.

There is strong evidence that what we eat and how it is produced affects climate change.

The present paper examines coverage of food system contributions to climate change in top US newspapers.

Using a sample of sixteen leading US newspapers from September 2005 to January 2008, two coders identified ‘food and climate change’ and ‘climate change’ articles based on specified criteria. Analyses examined variation across time and newspaper, the level of content relevant to food systems’ contributions to climate change, and how such content was framed.

There were 4582 ‘climate change’ articles in these newspapers during this period. Of these, 2·4 % mentioned food or agriculture contributions, with 0·4 % coded as substantially focused on the issue and 0·5 % mentioning food animal contributions. The level of content on food contributions to climate change increased across time. Articles initially addressed the issue primarily in individual terms, expanding to address business and government responsibility more in later articles.

US newspaper coverage of food systems’ effects on climate change during the study period increased, but still did not reflect the increasingly solid evidence of the importance of these effects. Increased coverage may lead to responses by individuals, industry and government. Based on co-benefits with nutritional public health messages and climate change’s food security threats, the public health nutrition community has an important role to play in elaborating and disseminating information about food and climate change for the US media.

In developed countries, there is abundant information on the epidemic of childhood obesity, but only a few studies on trends in the dual burden of body weight (overweight and thinness).

To examine trends in overweight and thinness among 9–10-year-old Spanish children in the last decade.

Data were taken from cross-sectional studies on schoolchildren in Cuenca (Spain), conducted in 1992, 1996, 1998 and 2004 with similar methods. Weight and height were measured by trained personnel with standardized procedures. Overweight (including obesity) and thinness were defined according with the International Obesity Taskforce BMI cut-offs.

The overall prevalence of overweight increased from 24·4 % in 1992 to 30·9 % in 2004 (P = 0·07), rising from 21·2 % in 1992 to 32·0 % in 2004 (P = 0·03) among boys and from 27·7 % to 29·8 % (P = 0·67) among girls. The overall prevalence of thinness was 2·7 % in 1992 and 9·2 % in 2004 (P < 0·001); in the same period, thinness prevalence rose from 1·9 % to 9·0 % (P = 0·10) among boys and from 3·7 % to 9·5 % (P < 0·01) among girls.

The dual burden of body weight has increased among children in Cuenca in the last decade. Population-based policies addressing childhood obesity, which is the most frequent problem, should not increase the risk of thinness.