To determine the prevalences of overweight and obesity in children aged 4 to 12 years, using the standard definitions proposed by the International Obesity Taskforce.

Population prevalence cross-sectional survey involving measurement of height and weight. Data collection took place in 1998.

Schools in Gibraltar.

In total 2994 children, aged 4–12 years, attending these schools (1540 boys, 1454 girls).

Prevalence of overweight in boys was 19.7%, while obesity prevalence was 10.8%. For the girls, overweight prevalence was 21.4%, while obesity prevalence was 10.6%. There were no significant differences in the proportions of overweight or obesity between boys and girls.

This was the first time that the prevalences of overweight and obesity have been estimated in children from Gibraltar. These data provide further information on prevalence rates of overweight and obesity, using defined cut-offs for comparison with data from other countries.

This study aims to analyse the differences, with regard to socio-cultural characteristics and dietary habits, between low and high consumers of yoghurt and other fermented dairy product desserts, and the nutritional significance of these differences.

We analysed the diet of a healthy population (4–65 years), using the 24-hour recall method, on three non-consecutive days. The participants were grouped by age and sex and were also divided into tertiles on the basis of yoghurt consumption. We compared energy and nutrient intakes, educational level and socio-economic status in the low consumption (LC) group and the high consumption (HC) group.

In general there were no significant differences in energy intake or nutritional profile between LC and HC groups. The only significant difference was in the percentage of energy provided by lipids, which was significantly lower in HC women, possibly due to the high number of women in this group who consumed low-fat yoghurt. There were significant differences in the distribution of HC and LC subjects according to the three educational levels (P < 0.05) but n according to socio-economic status.

The fact of being a high consumer of fermented dairy products took place in the framework of other dietary changes that compensated for this high consumption, resulting in the absence of significant differences in energy intake and nutritional profile between HC and LC subjects. The only exception was found in women who consumed low-fat dairy products. There was a relationship between high consumption of fermented dairy products and educational level.

To examine the association between consumption of red and processed meat (RPM) and iron intakes and status in adults.

Further analysis of the Dietary and Nutritional Survey of British Adults, a cross-sectional study of 2197 adults aged 16–64 years carried out in 1986/7.

Adults (836 men and 838 women) with serum ferritin measurements, who were not taking iron supplements, were classified into four groups according to RPM consumption (from 7-day weighed records). Iron absorbed was estimated from equations based on haem and non-haem iron and the influence of iron stores.

Women who ate least meat (<90gday-1) had three times the risk of a low iron intake (below the Lower Reference Nutrient Intake) compared with high consumers of RPM (>140gday-1). Men who ate no RPM also had a higher risk of low iron intake. Using an estimate of minimal values for iron losses, there was a twofold difference in the potential risk of negative iron balance between women non-RPM consumers and high RPM consumers. Status measurements indicated that, among women, anaemia was least prevalent (6%) among high consumers compared with 12–14% among average RPM consumers. Inverse trends were also observed for serum ferritin in both sexes.

Low consumption of RPM has implications for iron intakes and iron status in men and women, since the risk of negative iron balance and its consequences are increased. Dietary messages must consider these implications and provide appropriate advice.

To describe the consumption of ready-to-eat-breakfast cereals (RTEBCs) in Irish adults and its impact on adequacy and safety of micronutrient intakes and compliance with dietary recommendations.

Analysis for this paper used data from the North/South Ireland Food Consumption Survey that estimated habitual food intake using a 7-day food diary in a representative sample of adults aged 18–64 years (n=1379; 662 men, 717 women).

Despite the small quantity consumed (mean 28.6gday-1 or 4.7% of total energy intake), RTEBCs made an important contribution to the mean daily intake of carbohydrate (8.1%), starch (10.8%), dietary fibre (9.8%) and non-starch polysaccharides (NSP) (10.8%) in consumers. Increased consumption was associated with a more fibre-dense diet and with greater compliance with dietary recommendations for fat, carbohydrate and NSP. Fortified RTEBCs contributed significantly to mean daily intakes of iron (18%), thiamin (14%), riboflavin (17%), niacin (15%), vitamin B6 (13%), total folate (18%) and vitamin D (10%) and most of the contribution was from micronutrients added to RTEBCs. Increased consumption of fortified RTEBCs was associated with an increased nutrient density for a number of micronutrients and with a lower prevalence of dietary inadequacy of calcium, iron, riboflavin and folate, particularly in women. However, it was not associated with intakes in excess of the Tolerable Upper Intake Level for any micronutrient.

The consumption of RTEBCs is associated with improved compliance with dietary recommendations for fat, carbohydrate and fibre, with a more micronutrient-dense diet and a reduced risk of dietary inadequacy for calcium, iron, riboflavin and folate, without increasing the risk of excessive intakes of micronutrients.

To describe the meal patterns and food use on weekdays among 10- to 11-year-old Finnish children and to analyse these in relation to family's socio-economic status and the child's behaviour.

Cross-sectional study on a cohort of 404 children aged 10–11 years in the rural town of Ylivieska, mid-western Finland.

A food-frequency questionnaire including questions on meal patterns and food use and the Child Behaviour Checklist (CBCL) completed by the parents and the child together.

Practically all children (99%) ate breakfast regularly, 94% had a daily school lunch and 80% had dinner at home daily. Vegetables were consumed daily at home by 26% and fruits or berries by 21%, while 46% of the children had salad daily at school. Twenty-four per cent ate sweets daily or nearly so on weekdays. The children from families of high socio-economic status ate vegetables more often, and fewer of them used butter or high-fat milk. The children with no regular family dinner ate sweets and fast foods more often, and had higher total CBCL problem scores than those with a regular family dinner.

Skipping meals appears not to be common among Finnish children aged 10–11 years, but a considerable proportion consume sweets frequently and vegetables infrequently. High family socio-economic status and a tendency to eat together are associated with healthy food choices among schoolchildren.

The European Physical Activity Surveillance System (EUPASS) research project compared several physical activity (PA) measures (including the International Physical Activity Questionnaire (IPAQ)) in a time series survey in eight countries of the European Union. The present paper describes first results provided by the different instruments regarding PA participation, frequency and duration, both at the European and national levels. The purpose of the present study is to explore and compare the specific quality and usefulness of different indicators rather than to provide valid and reliable prevalence data. Thus, the main focus is on discussion of the methodological implications of the results presented.

A time series survey based on computer-aided telephone interviewing (CATI) was carried out in eight European countries over a six-month period. The study provided for about 100 realised interviews per month in each country (i.e. ~600 per country). Descriptive statistical analysis was used to: (1) report IPAQ results on vigorous, moderate and light PA and sitting, as well as on the overall measure of calories expenditure (MET min−1), in the different countries; (2) compare these results with national PA indicators tested in EUPASS; and (3) compare IPAQ results with other European studies.

First, the scores for the different PA categories as well as for the overall measure of calories expenditure provided by the IPAQ appeared rather high compared with previous studies and public health recommendations. Second, the different PA measurements used in EUPASS provided completely different results. For example, national indicators used in Germany and The Netherlands to date neither corresponded in absolute values (e.g. means of PA or sitting) nor correlated with the IPAQ in any significant way. Third, comparing EU countries, the ranking for vigorous, moderate and light activities by use of the IPAQ differed from that of other European studies. For example, in the present analysis, German respondents generally showed higher scores for PA than the Finns and the Dutch, while, in contrast, findings from other studies ranked Finland before The Netherlands and Germany.

The present analysis highlights some methodological implications of the IPAQ instrument. Among other things, differences in overall scores for PA as well as in the ranking of nations between the present results using IPAQ and other measures and studies may partly be due to the concepts of PA behind the measurements. Further analysis should investigate if the range of PA-related categories provided by the IPAQ is fully appropriate to measure all relevant daily activities; it may also consider the public health implications of mixing up different contexts of PA (e.g. work, leisure-time, transportation) in the IPAQ short version.

The main objective of this paper is to describe the approach and specific findings of the European Physical Activity Surveillance System (EUPASS) research project. In particular, the analysis presented aims at testing the reliability, comparability and predictive power of different sets of physical activity (PA) indicators.

First, a panel study based on computer-aided telephone interview (CATI) was designed to report PA data of a representative, selected group of about 100 persons per country at three points in time. Second, a CATI time series survey was carried out with the goal of realising about 100 interviews per month over six consecutive months.

The project was carried out in eight European countries to support the development of the European Union's (EU) Health Monitoring Programme.

Random population samples (subjects aged 18 years and older) were drawn from each participating country.

While many PA indicators used in EU countries to date as well as the psychosocial and environmental measures tested in the present study had acceptable to good reliability coefficients, the test–retest reliability scores of the International Physical Activity Questionnaire (IPAQ) version tested (the short (last 7 days) telephone interview IPAQ; IPAQ-S7T) were rather low. The comparability between extant national PA items and the IPAQ-S7T was low for all countries. The strongest predictors of perceived health were the psychosocial and environmental PA indicators.

According to the results of the present study, more research is needed to further investigate and improve the quality of the IPAQ. In addition, the specific predictive power of the tested psychosocial and environmental PA indicators on perceived health should be of particular interest for designing health surveillance activities in the future.

We examine (1) the extent to which seasonal diet assessments correctly classify individuals with respect to their usual nutrient intake, and (2) whether the magnitude of true variation in intake between individuals is seasonal. These effects could lead, respectively, to bias in estimates of relative risk for associations between usual nutrient exposure and disease, and to an increase in required sample size.

One hundred and twenty-seven families in four regions of the Japan Public Health Center (JPHC) Cohort Study.

On average, 48 weighed daily food records were collected per family over six seasons of 1994 and 1995.

A random slopes regression model was used to predict the correlation between seasonal and annual average intakes, and to estimate true between-person variation in intakes by season. Mean vitamin C intake was greatest in summer and autumn, and seasonal variation was attributable to the consumption of fruit and vegetables. Predicted correlations between seasonal and annual average vitamin C intake ranged from 0.62 to 0.87, with greatest correlations in summer and autumn. True between-person variation in vitamin C intake was also strongly seasonal, ranging from 45 to 78% of total variance, and was again greatest in summer and autumn. These effects were less seasonal among energy and 13 other nutrients.

It may be possible substantially to reduce both seasonal misclassification of individuals with respect to their usual vitamin C intake, and required sample size, by asking subjects to report high-season intake of fruit and vegetables in the JPHC Study.

Dietary assessment has been used for certification to receive food supplements or other nutrition services and to provide feedback for educational purposes. The proportion of individuals correctly certified as eligible is a function of the amount of error that exists in the dietary measures and the level of dietary intake used to establish eligibility. Whether individuals are correctly counselled to increase or decrease the consumption of selected foods or nutrients is a function of the same factors. It is not clear, however, what percentage of individuals would be correctly classified under what circumstances. The objective of this study is to demonstrate the extent to which measurement error and eligibility criteria affect the accuracy of classification.

Hypothetical distributions of dietary intake were generated with varying degrees of measurement error. Different eligibility criteria were applied and the expected classification rates were determined using numerical methods.

Simulation study.

Cut points of dietary intake at decreasing levels below the 50th percentile of true intake were associated with lower sensitivity and predictive value positive rates, but higher specificity and predictive value negative rates. The correct classification rates were lower when two cut points of dietary intake were used. Using a single cut point that was higher than the targeted true consumption resulted in higher sensitivity but lower predictive value positive, and lower specificity but higher predictive value negative.

Current methods of dietary assessment may not be reliable enough to attain acceptable levels of correct classification. Policy-makers and educators must consider how much misclassification error they are willing to accept and determine whether more intensive methods are necessary.

To develop a nutritional dietary intake database based on available reliable international nutritional databases adapted to the local needs of a specific population.

The Negev Nutritional Study (NNS) is a survey of a random sample of the Negev population regarding their dietary intake using 24-hour dietary recalls. A nutritional database for the Israeli population was developed based on adaptation and modification of the US Department of Agriculture's database. A data-entry system was developed based on the logic of the US Food Information Analysis System. The system was designed as bilingual (English and Hebrew). Local foods and recipes were collected during the NNS, which included 1465 24-hour diet interviews.

During the course of the NNS, 383 basic Israeli recipes were constructed. In total 1362 Israeli products were added to the database, and each was given a code, specific gravity and portion size. Most of the added products were cereals and grains and dairy products. The added recipes were collected from the interviewees in the NNS and from the most popular cookbooks.

This paper describes the process undertaken to develop an Israeli food composition database as well as the data-entry system. This knowledge may aid other research groups in developing a computerised, nation-specific nutritional database and data-entry system adapted to their own specific local needs.

To assess the validity and repeatability of a simple index designed to rank participants according to their energy expenditure estimated by self-report, by comparison with objectively measured energy expenditure assessed by heart-rate monitoring with individual calibration.

Energy expenditure was assessed over one year by four separate episodes of 4-day heart-rate monitoring, a method previously validated against whole-body calorimetry and doubly labelled water. Cardio-respiratory fitness was assessed by four repeated measures of sub-maximum oxygen uptake. At the end of the 12-month period, participants completed a physical activity questionnaire that assessed past-year activity. A simple four-level physical activity index was derived by combining occupational physical activity together with time participating in cycling and other physical exercise (such as keep fit, aerobics, swimming and jogging).

One hundred and seventy-three randomly selected men and women aged 40 to 65 years.

The repeatability of the physical activity index was high (weighted kappa = 0.6, P < 0.0001). There were positive associations between the physical activity index from the questionnaire and the objective measures of the ratio of daytime energy expenditure to resting metabolic rate (P = 0.003) and cardio-respiratory fitness (P = 0.001). As an indirect test of validity, there was a positive association between the physical activity index and the ratio of energy intake, assessed by 7-day food diaries, to predicted basal metabolic rate.

The summary index of physical activity derived from the questions used in the European Prospective Investigation into Cancer and Nutrition (EPIC) study suggest it is useful for ranking participants in terms of their physical activity in large epidemiological studies. The index is simple and easy to comprehend, which may make it suitable for situations that require a concise, global index of activity.

To compare a widely used Australian food-frequency questionnaire (FFQ) with diet records and consider the results in relation to its use in nutrition surveillance.

Inter-method reliability study.

A randomised trial in subjects with past asbestos exposure.

Seventy-two adults living in Western Australia.

A semi-quantitative FFQ developed by the Commonwealth Scientific Industrial Research Organisation in South Australia was administered after the completion of four 7-day diet records (DRs).

Mean agreement between methods was not significantly different from 100% for many nutrients, but the limits of agreement indicated that, at the individual level, the FFQ over- or underestimated the DR by at least 50%. Mean agreement between methods decreased significantly with increasing intakes for the majority of nutrients. Pearson's correlation coefficients were less informative indicators of agreement compared with the limits of agreement.

These results indicate poor agreement between the FFQ and DR when estimating absolute intakes. Therefore, comparing intakes collected using this FFQ with specific cut-off points such as Recommended Dietary Intakes for nutrition surveillance may lead to seriously flawed conclusions about population intakes.