To stress the importance of social and environment (nutritional) factors in determining the growth spurt during puberty and the risk of excessive adiposity, two contrasting adolescent populations, one from a rural area of Senegal (West Africa) and the other from Martinique (French West Indies), were compared.

Cross-cultural comparison of contrasting populations. Adolescents from Senegal belonged to a cohort followed up since 1995. Adolescents from Martinique participated in a cross-sectional nutritional survey that covered the entire island.

A total of 507 adolescents (mean age: 14.3 ± 0.7 years) from Senegal (319 girls and 188 boys) and 703 adolescents from Martinique (351 boys and 352 girls) were surveyed.

Differences in growth and maturation were striking: boys in Martinique were 22.7 kg heavier and 20.1 cm taller than boys in Senegal. Differences were less important for girls but still evident: 12.6 kg in weight and 10.5 cm in stature. In Senegal, there were virtually no overweight adolescents, but 18% of girls and 50% of boys could be considered as malnourished. In Martinique, 19% of girls and 23% of boys were overweight or obese. Adolescent girls from Martinique were also sexually more mature than adolescent girls from Senegal. When comparisons were repeated after Senegalese girls reached menarche, differences in weight and body mass index disappeared, but Senegalese girls were still shorter than girls from Martinique.

Adolescents are extremely susceptible to nutritional changes and their particular situation needs to be incorporated into nutritional prevention programmes.

To examine the adoption of feeding recommendations among caregivers of children recuperating from malnutrition and assess the determinants of growth of children attending a nutrition rehabilitation centre (NRC) in Accra, Ghana.

Longitudinal study in which attendance and maternal programme participation were recorded daily and children's anthropometry and dietary intake were measured at four time points (admission, interim, exit, post-exit) at the NRC and participants' homes.

NRCs at four polyclinics and participants' homes in Accra, Ghana.

One hundred and eight caregivers and their 116 children referred to an NRC between November 1999 and July 2000.

Most caregivers attended the NRC sporadically (effective length of stay was 1.4 ± 0.1 months). Use of NRC-promoted foods in the home after discharge was low due to inaccessibility of the food items, lack of preparation knowledge or money, child preferences and the common practice of purchasing ready-to-eat foods. Although there were significant increases in children's weight-for-age (P = 0.048) and weight-for-height (P = 0.002) Z-scores between enrolment and discharge, most children discontinued programme participation before adequate recuperation.

The NRC education did not address the use of street foods for child feeding and was unsuccessful in changing in-home feeding behaviour. The prominence of street foods in children's diets warrants re-evaluation of the NRC's educational approaches to enhance their responsiveness to caregivers' needs and effectiveness for the continued recuperation of malnourished children at home. NRC feeding strategies need improvement to ensure adequate provision of energy and nutrients to support catch-up growth in children.

To analyse factors associated with breast-feeding and use of sweetened drinks at 12 months, and to compare dietary habits among breast-fed and non-breast-fed infants.

Data were collected by a semi-quantitative food-frequency questionnaire filled in by the parents.

National dietary survey in Norway.

In total, 1932 12-month-old infants were included.

At 12 months, 36% of the infants were breast-fed. The odds of breast-feeding at this age were more than doubled both for mothers ≥35 years compared with mothers <25 years and for mothers in the highest educational group compared with mothers in the lowest. A negative association was found for maternal smoking, and the odds of breast-feeding were 40% lower for mothers who smoked than for non-smokers. Some dietary differences were observed between breast-fed and non-breast-fed infants apart from intake of milk. In particular, breast-fed infants had a significantly lower daily intake of sweetened drinks than non-breast-fed infants and a 16% lower mean daily intake of added sugars (P < 0.001). Furthermore, breast-fed infants had 30% higher odds of not receiving sweetened drinks daily, compared with non-breast-fed infants.

Maternal age, education and smoking status were important factors for breast-feeding at 12 months. Breast-fed infants had lower intakes of sweetened drinks and added sugars than non-breast-fed infants. From a public health perspective, continued promotion of breast-feeding is needed to reduce inequalities in breast-feeding. Moreover, prevention of high intakes of sweetened drinks and added sugars should start in infancy.

To examine the relationship between child-feeding strategies and the stage of change for fruit and vegetable consumption of low-income African American women.

Mothers were asked to think aloud as they shopped for groceries and prepared a meal for their family. Verbalisations were audio-taped and transcribed. Transcripts were coded. Coded segments were sorted according to stage of change of the women who made the verbalisation. Themes were identified and analysed for differences across the stages of change. Child-feeding strategies and factors influencing provision of fruits and vegetables to children were identified through content analysis procedures.

Seventy women, aged 18 to 45 years, were classified by stage of change (10 to 18 per stage) based on self-reported intakes of fruits and vegetables and intention to increase intake. Women on average had two to three children less than 12 years of age and tended to be single heads of households, with about half having some college or technical training.

According to the women's comments, food preferences of children were important considerations for women in all stages regarding their food choice behaviours. Women in the later stages reported using more positive child-feeding strategies to promote the intake of fruit and vegetables, including positive role-modelling and methods related to food purchasing, preparation and meal planning.

Promoting mothers' movement to more advanced stages of change for fruit and vegetable intake may result in the use of more positive child-feeding strategies and therefore contribute to increased fruit and vegetable intake by children.

To investigate the socio-economic and dietary factors associated with overweight and obesity, respectively, in southern France.

Cross-sectional analysis of socio-economic, lifestyle and nutritional characteristics of a representative population sample. A questionnaire elicited information on anthropometric measurements, socio-economic factors, physical activity, tobacco use, and alcohol and food intakes. Non-parametric tests, multiple linear regression models and correspondence factorial analysis (CFA) were used to estimate the association of the various factors with overweight and obesity.

French Southwest and Mediterranean areas.

In total, 1169 subjects (578 women and 552 men), aged 30–77 years, were recruited at random.

Overweight and obesity were associated with age and education in both genders, reproductive factors in women and tobacco use in men. A few dietary factors were identified (high energy intake and low intake of carbohydrates), but all these variables explained little of the variation (18.5% in women and 14.6% in men). The CFA further investigated the association of lifestyle and nutritional factors, giving more weight to nutritional behaviour for overweight men and women. Factors for obesity differed from those for overweight by being different in men and women, possibly related to psychological behaviour, and there were fewer of them, suggesting an insufficient coverage by the usual questionnaires.

Overweight and obesity appear as two different entities. Energy imbalance induced by various lifestyle factors plays a major role in the development of overweight, whereas obesity represents a more complex entity where psychological and genetic factors that are difficult to assess may be more important. General nutritional guidelines appear more adapted to the prevention of overweight than to that of obesity, and individual counselling to the prevention of obesity.

To determine the prevalence of obesity and body fat distribution of Moroccan women of childbearing age, using a panel of anthropometric measurements.

A cross-sectional survey conducted in 1995 in an agricultural community, El Jadida province of Morocco. Weight, height, waist and hip circumferences and triceps, biceps, subscapular and supra-iliac skinfold thicknesses were measured. Body mass index (BMI), waist/hip ratio (WHR), sum of all and sum of trunk skinfold thicknesses were determined.

In total, 1269 women aged 15–49 years from urban and rural areas were surveyed.

The means of all anthropometric measurements including body fat were higher in urban than in rural women and increased with age. Trunk fat contributed 50% of total fat. Globally, 4.7% of women were underweight (BMI < 18.5 kg m−2), 35.2% were overweight or obese (BMI ≥ 25 kg m−2), 10.1% were obese (BMI ≥ 30 kg m−2) and 16.8% had central obesity (WHR > 0.85). The prevalence of overweight and obesity was higher in the urban than in the rural area. Underweight prevalence decreased with age, whereas that of overweight and obesity increased. All anthropometric parameters adjusted for age increased with the increase of BMI and WHR.

Although undernutrition is still prevalent, there is an alarming prevalence of overweight and obesity in Moroccan women of childbearing age. The results indicate a shift in this country from the problem of dietary deficiency to the problem of dietary excess, and alert one to the necessity of establishing an intervention to prevent obesity-related diseases. It is necessary to address which of the anthropometric variables studied here is the best predictor of obesity-related diseases in this population.

To report the rationale, recruitment, design, dietary intervention and baseline characteristics of participants in the Medi-RIVAGE study (Mediterranean Diet, Cardiovascular Risks and Gene Polymorphisms).

A randomised, parallel trial comparing a new nutritional programme with a conventional programme.

Centre for Detection and Prevention of Arteriosclerosis, Timone University Hospital, Marseille, France, and collaborating teams.

Two hundred and twelve male and female volunteers with at least one cardiovascular risk factor.

A Mediterranean-type diet characterised mainly by the quality of fatty acids, amount of fish, vegetable foodstuffs and fibre was proposed and compared with a usually prescribed, low-fat/cholesterol diet. Body mass index, fasting lipids and lipoproteins, apolipoproteins, glucose, insulin and homocysteine were the main outcome measures. Gene polymorphisms of interest were determined.

Characteristics of men in the two arms were comparable with regard to sociodemographic variables, and clinical and biological cardiovascular risk factors. There were few differences between the groups of women (cholesterol-related parameters, P < 0.05). There was no difference between arms in allelic distribution of the gene polymorphisms studied. Saturated fat and protein intakes were high while carbohydrate and fibre intakes were low, but with no difference between arms. Overall, the nutritional markers were comparable in both arms with few exceptions. Correlations between nutritional intakes and plasma nutrient levels ranged from 0.19 (β-carotene) to 0.47 (folate).

The comparability of the two arms is notable and warrants a low risk of biases. Current diet departs from the traditional Mediterranean one. The assessment of nutritional intake is validated by correlations obtained between dietary intake and relevant biomarkers. This will be important to estimate participant compliance and to analyse intervention data.

Many public health campaigns encourage increased fibre consumption, but short-term studies suggest that various components of dietary fibre inhibit the absorption of certain micronutrients including carotenoids. These do not take into account long-term adaptation to nutrient intake levels. We aimed to investigate the effect of non-starch polysaccharide (NSP) fibre on plasma micronutrient concentrations in a large free-living population consuming their usual diet.

Prospective cohort study. Semi-weighed 4-day food diaries were analysed for micronutrient and NSP fibre intakes. Blood samples were taken and analysed for carotenoids, vitamin A, vitamin E, thiamine, riboflavin, vitamin B6, vitamin B12, folic acid, vitamin C and trace metals.

Participants in a large national cohort study who lived within 30 miles of Leeds.

Two hundred and eighty-three middle-aged women.

The association between NSP intake and plasma nutrient concentrations was assessed taking into account nutrient intakes and other dietary and lifestyle factors. Higher levels of NSP were not associated with lower plasma concentrations of the micronutrients measured, even allowing for the higher nutrient levels generally found in high-fibre foods.

Amongst middle-aged women we have shown that current guidelines for increasing the population's NSP consumption can be safely applied. Such guidelines are unlikely to reduce serum micronutrient concentrations, although other, more vulnerable population groups may benefit from further investigation.

This paper provides the rationale for the Guideline Daily Amounts (GDAs) for fat, saturated fat and other nutrients that appear on food labels in the UK. These GDAs are provided voluntarily by manufacturers and retailers and were developed to help people make better use of nutrition labelling – the format of which is prescribed by the European Union's nutrition labelling directive. The paper also describes the basis to some Rules of Thumb for what counts as ‘a lot’ or ‘a little’ of fat, saturated fat and other nutrients, in an individual food.

The paper gives the background to, and purpose of, the GDAs and Rules of Thumb and explains how they were calculated. It briefly describes their subsequent usage by food producers and others.

Both GDAs and the Rules of Thumb first appeared in a leaflet developed by the authors and published in 1996 by the Ministry of Agriculture, Fisheries and Food. GDAs for fat, saturated fat and energy were adopted subsequently by the Institute of Grocery Distribution and then by many retailers and some manufacturers. The Rules of Thumb for fat, saturated fat, sugar and sodium have recently been republished in some leaflets published by the Food Standards Agency in the UK.

GDAs and Rules of Thumb may provide useful ways of helping consumers make sense of nutrition labelling. The current GDAs and the Rules of Thumb could usefully be updated in the light of recent developments.

As epidemiological studies have become more complex, demands for short, easily administered measures of risk factors have increased. This study investigates whether such a measure of physical activity is associated with the risk of death from all causes and death from specific causes.

A prospective follow-up study of 11 090 men and women, aged 35–64 years, recruited from five UK general practices who responded to a postal questionnaire in 1989. Self-reported frequency of vigorous-intensity physical activity and data on confounding factors were collected at baseline survey. Death notifications up to 31 December 2001 were provided by the Office for National Statistics. The relative risk (and 95% confidence interval) of dying associated with each level of exposure to physical activity was estimated by the hazard ratio in a series of Cox regression models.

After > 10 years' follow-up there were 825 deaths among the 10 522 subjects with no previous history of angina or myocardial infarction. Participation in vigorous exercise was associated with a significantly lower risk of all-cause mortality. Similar associations were found for ischaemic heart disease and cancer mortality, although the relationships were not significant at the 5% level.

Simple measures of self-reported vigorous physical activity are associated with the risk of future mortality, at least all-cause mortality in a somewhat selected group. Interpretation of the finding should be treated with caution due to the reliance on self-report and the possibility that residual confounding may underlie the associations. Because moderate-intensity physical activity is also beneficial to health, short physical activity questionnaires should include measures of such physical activity in the future.

To test the hypothesis that many foods with reduced-fat (RF) claims are relatively energy-dense and that high-fat (HF) vegetable-based dishes are relatively energy-dilute.

Nutrient data were collected from available foods in Melbourne supermarkets that had an RF claim and a full-fat (FF) equivalent. Nutrient analyses were also conducted on recipes for HF vegetable-based dishes that had more than 30% energy from fat but less than 10% from saturated fat. The dietary intake data (beverages removed) from the 1995 National Nutrition Survey were used for the reference relationships between energy density (ED) and percentage energy as fat and carbohydrate and percentage of water by weight.

Linear regression modelled relationships of macronutrients and ED. Paired t-tests compared observed and predicted reductions in the ED of RF foods compared with FF equivalents.

Both FF and RF foods were more energy-dense than the Australian diet and the HF vegetable-based dishes were less energy-dense. The Australian diet showed significant relationships with ED, which were positive for percentage energy as fat and negative for percentage energy as carbohydrate. There were no such relationships for the products with RF claims or for the HF vegetable-based dishes.

While, overall, a reduced-fat diet is relatively energy-dilute and is likely to protect against weight gain, there appear to be two important exceptions. A high intake of products with RF claims could lead to a relatively energy-dense diet and thus promote weight gain. Alternatively, a high intake of vegetable-based foods, even with substantial added fat, could reduce ED and protect against weight gain.

To examine dietary iodine sources and to estimate the dietary iodine intake of the Norwegian population.

Food iodine analyses carried out in Norway during the last 10 years were compiled, and iodine intake calculated on the basis of food intake data from nation-wide dietary surveys among children and adults. The food intake of adults was measured by a self-administrated food-frequency questionnaire, which covered habitual diet during the past year. The food intake of children was measured by dietary record during four consecutive days.

Neither household nor industrial iodisation of salt is mandatory in Norway, but some brands of table salt have 5 μg of iodine added per gram of NaCl. In spite of this, the population has been considered iodine-replete for decades, i.e. having an iodine intake well above the Recommended Dietary Allowance of 150 μg day−1. This assumption has not been substantiated by dietary surveys.

The adults included 1374 females and 1298 males aged 16–79 years. The children included 185 girls and 206 boys aged 4 years, 411 girls and 404 boys aged 9 years, and 517 girls and 492 boys aged 13 years.

The calculated iodine intake was in the range of 100–250 μg day−1 in the majority of the adult population. The mean iodine intake was 136 μg day−1 (170 μg I/10 MJ) among women and 176 μg day−1 (161 μg I/10 MJ) among men. For children the iodine intake was in the range of 100–120 μg day−1. Milk and dairy products contributed approximately 55% and 70% of the dietary iodine intake in adults and children, respectively. Fish contributed more than 20% of the iodine intake in adults and about 10% in children. The iodine contribution of drinking water was negligible.

While fish has the highest natural concentration of iodine and as such is an excellent iodine source, milk and diary products are the main determinants of iodine intake in the Norwegian population. Iodisation of cow fodder has been mandatory in Norway since 1950 and provides an efficient alternative to universal salt iodisation. Our results show that the dietary iodine intake of adults is in the range considered to be sufficient. The dietary intake of iodine was at recommended levels among the youngest children; however, it decreased among adolescents, especially among girls.

To determine the level of agreement between the American (Chilean) and British food composition tables in estimating intakes of macronutrients and antioxidants.

Design, setting and subjects: Information based on a food-frequency questionnaire with emphasis on antioxidants was collected from 95 Chileans aged 24–28 years. Nutritional composition was analysed using the British table of food composition and the American table of food composition modified by Chilean food items. Mean differences and limits of agreement (LOAs) of estimated intake were assessed.

Mean differences between the two tables of food composition ranged from 5.3% to 8.9% higher estimates when using the American (Chilean) table for macronutrients. For micronutrients, a bias towards a higher mean was observed for vitamin E, iron and magnesium when the American (Chilean) table was used, but the opposite was observed for vitamin A and selenium. The intra-class correlation coefficient (ICC) ranged from 0.86 (95% confidence interval (CI) 0.81–0.91) to 0.998 (95% CI 0.995–1.00), indicating high to excellent agreement. LOAs for macronutrients and vitamins A and C were satisfactory, as they were sufficiently narrow. There was more uncertainty for other micronutrients.

The American table gives relative overestimates of macronutrients in comparison to the British table, but the relative biases for micronutrients are inconsistent. Estimates of agreement between the two food composition tables provide reassurance that results are interchangeable for the majority of nutrients.