To characterise plasma and red-blood-cell (RBC) folate status among pregnant women in an area with an extremely high prevalence of neural tube defects, and to compare them with those of women from a low prevalence area.

A cross-sectional survey conducted in 2003.

One county and one city from each of the high prevalence area and the low prevalence area in China.

Five hundred and sixty-two women in their first trimester of pregnancy in the high prevalence area and 695 pregnant women in the low prevalence area.

Women in the high prevalence area had less than half the plasma and RBC folate concentrations (12.2 and 440.0 nmol l− 1, respectively) of women in the low prevalence area (33.5 and 910.4 nmol l− 1, respectively). In the high prevalence area, 40% of rural women were deficient in RBC folate and 50% were deficient in plasma folate; 20% of urban women were deficient in RBC folate and 30% deficient in plasma folate. In contrast, only 4% (RBC folate) and 6% (plasma folate) of rural women, and 2% (RBC folate) and 1% (plasma folate) of urban women, were folate-deficient in the low prevalence area. Less than 10% of rural and about 26% of urban women in the high prevalence area took folic acid periconceptionally, compared with 70% and 60% of women in the low prevalence area.

Blood folate deficiency is highly prevalent among pregnant women in an area of China with a very high prevalence of neural tube defects.

Valid dietary data are essential when trying to identify whether or not one or more dietary exposures are responsible for disease. We examined diet composition in women who reported dietary change in the past compared with non-changers, and how the associations between dietary factors and postmenopausal breast cancer are influenced by dietary change, obesity status and misreporting of energy.

A population-based prospective cohort study. Data were obtained by a diet history method, anthropometrical measurements and an extensive lifestyle questionnaire including items on past food habit change.

The Malmö Diet and Cancer (MDC) study, conducted in Malmö, Sweden.

A subsample of 12 781 women from the MDC cohort recruited from 1991 to 1996. A total of 428 postmenopausal women were diagnosed with incident breast cancer, during 9.2 years of follow-up.

Past food habit changers reported healthier food habits and lower energy intake compared with non-changers, a finding that raises issues regarding possible reporting biases. When excluding diet changers, the trend of increased breast cancer risk across omega-6 fatty acid quintiles was stronger, and a tendency of decreased risk emerged for ‘fruit, berries and vegetables’. When excluding individuals with non-adequate reports of energy intake, risk estimates were similar to that of the whole sample. In women with body mass index < 27 kg m− 2, significant trends of increased breast cancer risk were seen for total fat and omega-6 fatty acids, and of decreased risk for ‘fruit, berries and vegetables’.

This study indicates that both obesity and self-reported past food habit change may be important confounders of diet–breast cancer relationships. The study demonstrates that sensitivity analysis, through stratification, may facilitate interpretation of risk relationships and study results.

To describe patterns of dietary behaviours specific to low quality snacking, fruit and vegetable, and fast food consumption during the transition from childhood to adolescence and to examine how these behaviours are associated with tendencies towards dietary restraint and the occurrence of overweight and obesity in mid-adolescence.

A 5-year follow-up of self-reported eating. Hierarchical linear modelling was utilised to explore the relationship between dietary changes and body mass index (BMI) and dietary restraint while controlling for physical activity and smoking.

The sample was derived from students participating in the Quebec Heart Health Demonstration Project, and represents rural, suburban and inner city youths.

A sample of 561 girls and 627 boys in the fourth, sixth, seventh and ninth grades.

Overall the sample was characterised by a decrease in fruit and vegetable consumption and increase in low quality snacking, and a decrease in fast food consumption over the 5-year follow-up. Dietary restraint and BMI were found to be associated with dietary behaviour. Lower than average dietary restraint was associated with a lower frequency of fast food consumption and greater increase in low quality snacking over the 5-year period. Higher than average dietary restraint was associated with lesser frequency of low quality snacking at baseline. Having a BMI in the obese range was associated with more frequent fast food consumption in the fourth grade and a more rapid drop in fast food consumption across the 5-year period.

Dietary behaviours are associated with the psychological construct dietary restraint and with weight status in this population of adolescents.

The aim of this study was to explore the prevalence of and differences in self-reported occasions of overeating (such as at celebrations and other parties), compensatory behaviours and specific weight gain prevention strategies among young Dutch adults according to sociodemographics and overweight status.

Cross-sectional data were analysed from Dutch adults aged 20–40 years, recruited from an Internet research panel (n = 857, response rate = 76.6%). Using electronic questionnaires, self-report data were collected on sociodemographics, body mass index (BMI), occasions of overeating, compensatory behaviours, and diet and physical activity used as weight gain prevention strategies. Associations were tested using multiple linear and logistic regression analyses.

Of the participants, 48.6% reported occasions of overeating at least once a week during the 4-week period, 44.6% reported compensating for these occasions and 72.9% reported engaging in dietary and physical activities specifically for weight gain prevention purposes. Only 32.1% of the respondents reported using the recommended combination of diet and physical activity as a weight gain prevention strategy. In addition, results showed that overweight people (BMI ≥ 25 kg m-2) and women were more likely to report overeating than people with healthy body weights (odds ratio (OR) = 1.79; 95% confidence interval (CI) 1.32–2.42) and men (OR = 1.50; 95% CI 1.14–1.97). Overweight people, women and people who regularly reported overeating were also significantly more likely to report compensatory behaviours by eating less and to report specific weight gain prevention strategies using diet and physical activity.

The present study suggests that people experience frequent occasions of overeating and try to compensate for such occasions in different ways. However, the combination of dietary changes and physical activity recommended by experts was seldom reported.

To assess the prevalence of hyperthyroidism just after implementation of iodine prophylaxis among adults from an area with iodine deficiency.

A total of 1648 adults (age 16 years and older) were sampled from an area of southern Poland during two nationwide epidemiological surveys. Of these, 1424 adults with negative medical history for thyroid disorders qualified for final analysis. The authors compared thyroid dysfunction in participants prior to (1989–1990) and after implementation of iodine prophylaxis (1997–1999).

The southern part of Poland.

We found an increase in the serum concentration of anti-thyroid microsomal antibodies from 4.9% in the years 1989–1990 to 12.1% after introduction of iodised household salt (P < 0.0001). The prevalence of hyperthyroidism (defined as thyroid-stimulating hormone < 0.4 μU ml− 1) significantly increased in the equivalent period from 4.8 to 6.5% (P = 0.009).

We concluded that a sudden rise in iodine intake after implementation of iodine prophylaxis among adults from the area with iodine deficiency may lead to an increase in thyroid autoimmunity and prevalence of hyperthyroidism. Those possible early side-effects appear to be only temporary and are acceptable when compared with the evident benefits of adequate iodine intake.

To examine the associations of adiposity, dietary restraint and other personal characteristics with energy reporting quality.

Secondary analysis of 230 women and 158 men from the 1997/98 Ontario Food Survey.

Energy reporting quality was estimated by ratios of energy intake (EI) to both basal metabolic rate (BMR) and total energy expenditure (TEE). Multivariate regression analyses were conducted to examine energy reporting quality between two dietary recalls and in relation to body mass index (BMI) with adjustment for potential confounders. Energy reporting quality was explored across categories of age, BMI, income, education, dieting status and food insecurity through analysis of variance (ANOVA).

From the ANOVA, energy reporting quality was associated with BMI group, age category and weight loss for men and women, as well as with education among women (P < 0.05). The multivariate regression analyses indicated that energy reporting quality was positively associated with education and inversely associated with obesity and dieting. No associations were observed in relation to food insecurity or income (P>0.05). EI:BMR and EI:TEE on the first and second 24-hour recalls were positively related (P < 0.0001 for men and women). A higher proportion of variance in energy reporting quality was explained for women than for men (R2 = 0.19 and 0.14, respectively).

Studies of diet and adiposity are probably hindered to some extent by BMI-related variation in energy reporting quality. Methods to address this issue are urgently needed if population surveys will continue to serve as the primary source of dietary intake data.

Throughout the world, the proportion of the male population aged 65 years and older is increasing. Yet, we have limited information regarding diet quality and predictors of diet quality in this segment of the population. The objectives of the current analyses are to describe the diet quality of a cohort of men >65 years of age, and identify lifestyle factors associated with poor diet quality.

We present a cross-sectional analysis of the diet quality of 5928 men, aged 65–100 years, who are participants in the Osteoporotic Fractures in Men (MrOS) cohort study. Dietary intake was determined using a modified Block 98 food-frequency questionnaire. Diet quality was calculated using the previously validated Diet Quality Index-Revised (DQI-R). Univariate and multivariate modelling was used to estimate the variance in diet quality predicted by a number of sociodemographic factors, including age, race/ethnicity, body mass index (BMI), marital status, education, smoking status, physical activity, self-perceived health and nutritional supplement use.

Overall, we found that in this geographically diverse group of older men, diet quality was low, with a mean modified DQI-R for the entire study population of 62.5 (standard deviation 13.1) out of an ideal of 100. Further, younger age, very low total calorie intake ( ≤ 1187 kcal day− 1), higher BMI, residence in a North or Southeast community, being of African-American or Hispanic race, being less educated, not using dietary supplements and smoking were each significant independent predictors of a poorer diet.

These data may prove useful in both understanding the dietary intake of older US men as it relates to published dietary guidelines, and for targeting future dietary intervention programmes.

To evaluate the effectiveness of a school nutrition programme on the weight gain and growth of Vietnamese schoolchildren.

A proximate cluster evaluation of children in seven schools, in which fortified milk and biscuits supplying 300 kcal of energy were being given on school days, compared with children in 14 nearby schools with no feeding. All children were dewormed.

Twenty-one primary schools in Dong Thap Province, Vietnam.

A cohort of 1080 children in grade 1 of 21 primary schools, and a cross-sectional interview of 400 children in grade 3.

The programme gave children the equivalent of 90 kcal day− 1 over 17 months. t-Tests showed a small but statistically significant difference between groups in their average gain in weight and height: 3.19 versus 2.95 kg (P < 0.001) and 8.15 versus 7.88 cm (P = 0.008). A multiple-level model showed that the programme was statistically significant after controlling for clustering of children in schools, sex, age and initial underweight (P = 0.024). A significant impact on height was also seen in a regression model, but not when controlling for school. The most undernourished children tended to gain the least weight. There was no evidence of substitution.

The programme had a small but significant effect on weight gain, but the most undernourished children benefited the least. Methods need to be developed to target them. This design may offer a means of estimating the impact of school feeding on growth in other programme settings.

To identify regimen, individual, community and cultural factors that affect adoption and adherence to weekly vitamin A supplementation in Ghana.

Fifty semi-structured interviews were conducted with women who would be eligible for vitamin A supplementation, 30 with husbands, and 13 with drug sellers, birth attendants and health workers. Six focus group discussions were also conducted with women. These interviews were followed by a 4-month capsule trial with 60 women. Data from a previously conducted communication channel survey of 332 women were also reviewed.

The study was conducted in Kintampo District in central Ghana.

Participants for the semi-structured interviews and focus groups were selected from four villages and the district capital, and women in the capsule trial were selected at random from two villages.

Knowledge of vitamins was low and taking ‘medicines’ for long periods and when healthy is a new concept. In spite of this, long-term supplementation will be accepted if motives are explained, specific questions answered and clear instructions are given. Potential barriers included the idea of ‘doctor’ medicines as curative, false expectations of the supplement, forgetting to take the supplement, losing the supplement, travelling, lack of motivation, perceived side-effects, concerns that the supplement is really family planning or will make delivery difficult, and concerns about taking the supplement with other ‘doctor’ or herbal medicine, or when pregnant or breast-feeding, or if childless.

Successful supplementation programmes require appropriately designed information, education and communication strategies. Designing such strategies requires pre-programme formative research to uncover barriers and facilitators for supplementation.

The primary objective was to evaluate the rate at which non-English dietary supplement advertisements distributed in a sampled ethnic minority community are in compliance with the federal advertising regulations. The secondary objective was to assess the availability of supporting evidence to substantiate the advertised health claims.

Cross-sectional study.

The contents of dietary supplement advertisements from the Los Angeles Korea Times and the Los Angeles Korea Daily were evaluated during the month of July 2005. After removing duplicate advertisements, the percentage of advertisements making prohibited disease claims and DSHEA (Dietary Supplement Health and Education Act) disclaimer statements was determined. The presence of data substantiating advertised claims was determined by requesting data from the manufacturers and browsing the manufacturers' websites. An observational technique was utilised for content analysis, and data analysis was conducted using quantitative descriptive statistics.

Disease claims were present in 84.5%, while DHSEA disclaimer statements were present in only 18.4% of the advertisements. Data to substantiate the claims were provided by 53.4% of the manufacturers. The majority of the additional information consisted of repetition of the advertised claims and consumer testimonies. Experimental data were available for only 13.6% of the products.

The high rate of non-compliance with federal regulations suggests a need for better oversight of non-English promotions of dietary supplements.

To validate a new food-frequency questionnaire (FFQ) for measuring the intake of fruit, vegetables and tea reported by women participating in the Norwegian Mother and Child Cohort Study (MoBa).

Intake of fruits, vegetables and tea estimated by the FFQ was compared with urinary flavonoid excretion, plasma carotenoid concentration and intake measured by a 4-day weighed food diary (FD). The triangular method was applied to calculate FFQ validity coefficients using two independent biomarkers.

One hundred and nineteen women participating in MoBa.

The FFQ estimate of fruit intake was significantly correlated with urine phloretin (r = 0.33), citrus fruit/juice with urine hesperetin (r = 0.44), cooked vegetables with plasma α-carotene (r = 0.37), and tea with urine kaempferol (r = 0.41) (P < 0.01 for all). On average, 60% of the participants fell into the same or adjacent quintiles when classified by FFQ and biomarkers. Significant correlations between the FFQ and FD were found for fruit (r = 0.39), vegetables (r = 0.34), juices (r = 0.50) and tea (r = 0.53). The FFQ validity coefficient was 0.65 for citrus fruit/juice and 0.59 for cooked vegetables as calculated by the triangular method.

The validation study shows that the MoBa FFQ can be used to estimate fruit, juice, vegetable and tea intake in pregnant Norwegian women, and to rank individuals within the distribution.

To assess the intake inadequacy and food sources of zinc of people in China.

Diets of 68 962 subjects aged 2–101 years (urban 21 103, rural 47 859) in the 2002 China National Nutrition and Health Survey were analysed. Dietary intake was assessed using 24-hour recall for three consecutive days. Zinc intake inadequacy was calculated based on values suggested by the World Health Organization.

The median zinc intake ranged from 4.9 mg day− 1 (urban girls, 2–3 years) to 11.9 mg day− 1 (rural males, 19+ years). The zinc density of urban residents (2–3 to 19+ years) was 5.0–5.3 mg day− 1 (1000 kcal)− 1, significantly higher than that of their rural counterparts (4.7–4.8 mg day− 1 (1000 kcal)− 1). Differences in food sources of zinc from cereal grains (27.4–45.1 vs. 51.6–63.2%) and animal foods (28.4–54.8 vs. 16.8–30.6%) were found between urban and rural residents. Zinc from vegetables and fruits (8.2–13.8 vs. 9.7–12.4%) and legumes (1.3–3.3 vs. 2.5–3.4%) was comparable between urban and rural residents. The proportion of zinc intake inadequacy ranged between 2.8% (urban females, 19+ years) and 29.4% (rural lactating women). Rural residents had higher proportions of zinc intake inadequacy than their urban counterparts. Significantly higher proportions of zinc inadequacy were found in the category of phytate/zinc molar ratio >15 for both rural and urban residents.

About 20% of rural children are at risk of inadequate zinc intake, with phytate as a potential important inhibitor. Moreover, lactating women are also considered a vulnerable group.

To assess the validity of the adapted Radimer/Cornell questionnaire to measure food insecurity in low-income urban households in Tehran, the capital of Iran.

The Radimer/Cornell questionnaire was modified and used to assess the applicability, validity and reliability of such a measure in a culturally different context of urban households in Tehran. Factor analysis and Cronbach's α were used to assess validity and reliability, respectively. Socio-economic characteristics and food consumption frequency of the household were used to assess the criterion validity of the questionnaire.

District 20 of Tehran.

A sample of 250 Iranian nuclear households with at least one child aged 1–18 years and a non-pregnant, non-lactating woman of reproductive age, selected through a multistage random sampling method.

Three scales, labelled as household, individual and child hunger, were extracted through factor analysis using varimax rotation. Internal consistency of the scales was 0.897, 0.820 and 0.796, respectively. Individual insecurity and child hunger were inversely correlated with monthly per capita income, father's education, mother's education and father's occupational status, and positively correlated with household size, as expected. However, household insecurity did not follow the same pattern. Consumption frequency of fruits, vegetables, dairy, red meat and rice declined as food insecurity status worsened, while bread and potato consumption increased.

The results show that a modified version of the Radimer/Cornell questionnaire is a valid and reliable instrument to measure household food insecurity in a culturally different context. However, further modifications seem necessary to measure food insecurity at household level. Results lend support to the utility and applicability of experience-based measures in varying cultural communities.