To elicit predictors of variation in likelihood to purchase foods rich inlong-chain omega-3 fatty acids.

Responses from a community sample (n =220) were elicited using a computer-administered questionnaire based on anadaptation of Protection Motivation Theory including measures of perceivedrisk and vulnerability to coronary heart disease (CHD). Other measuresincluded health status, body mass index (BMI), perceived risk/benefits ofnovel technologies and sociodemographics. Descriptions of model productswere presented, including farmed fish fed fishmeal (FFFF); farmed fish fedgenetically modified (GM) oilseed (FFFGM); bread, milk and supplementscontaining fish oil (SFO) or GM oilseed. It was hypothesised that perceivedvulnerability to CHD would enhance acceptance of GM products (H1).Furthermore, information describing the benefits of LCO3FA, limitations tofish supply and potential alternatives was given to a treatment group (50%)and hypothesised to have a positive effect on the acceptance of GM products(H2).

No evidence was found to support H1 or H2. FFFF was most likely to bepurchased (P < 0.01), followedby SFO and FFFGM. Multivariate regression analysis identified significant(P < 0.05) predictors(standardised β) forlikelihood to purchase FFFF: self-efficacy 0.56; behaviour (product)efficacy 0.19; belief that fishmeal is unnatural −0.14 (R2 = 0.44) and for FFFGM:self-efficacy 0.65; perceived severity of CHD 0.15; BMI −0.13;significant other has/had arthritis 0.11; belief that GM oilseed isunnatural 0.11 (R2 =0.49).

Self-efficacy (confidence to consume) was the most important predictor oflikelihood to purchase all products.

Recent research indicates that n–3 fatty acids can inhibit cognitive decline,perhaps differentially by hypertensive status.

We tested these hypotheses in a prospective cohort study (the AtherosclerosisRisk in Communities). Dietary assessment using a food-frequencyquestionnaire and plasma fatty acid exposure by gas chromatography werecompleted in 1987–1989 (visit 1), while cognitive assessment withthree screening tools – the Delayed Word Recall Test, the DigitSymbol Substitution Test of the Wechsler Adult IntelligenceScale–Revised and the Word Fluency Test (WFT) – wascompleted in 1990–1992 (visit 2) and 1996–1998 (visit4). Regression calibration and simulation extrapolation were used to controlfor measurement error in dietary exposures.

Four US communities – Forsyth County (North Carolina), Jackson(Mississippi), suburbs of Minneapolis (Minnesota) and Washington County(Maryland).

Men and women aged 50–65 years at visit 1 with complete dietarydata (n = 7814); white men and women insame age group in the Minnesota field centre with complete plasma fatty aciddata (n = 2251).

Findings indicated that an increase of one standard deviation in dietarylong-chain n–3 fatty acids (%of energy intake) and balancing long-chain n−3/n–6 decreased the risk of 6-year cognitive decline inverbal fluency with an odds ratio (95% confidence interval) of 0.79(0.66–0.95) and 0.81 (0.68–0.96), respectively, amonghypertensives. An interaction with hypertensive status was found for dietarylong-chain n–3 fatty acids (gday−1) and WFT decline (likelihood ratio test,P = 0.06). This exposure in plasmacholesteryl esters was also protective against WFT decline, particularlyamong hypertensives (OR = 0.51, P< 0.05).

One implication from our study is that diets rich in fatty acids of marineorigin should be considered for middle-aged hypertensive subjects. To thisend, randomised clinical trials are needed.

To test the hypothesis that maternal food fortification with omega-3 fattyacids and multiple micronutrients increases birth weight and gestationduration, as primary outcomes.

Non-blinded, randomised controlled study.

Pregnant women received powdered milk during their health check-ups at 19antenatal clinics and delivered at two maternity hospitals in Santiago,Chile.

Pregnant women were assigned to receive regular powdered milk (n = 477) or a milk product fortified withmultiple micronutrients and omega-3 fatty acids (n = 495).

Intention-to-treat analysis showed that mean birth weight was higher in theintervention group than in controls (65.4 g difference, 95% confidenceinterval (CI) 5–126 g; P =0.03) and the incidence of very preterm birth (<34 weeks) waslower (0.4% vs. 2.1%; P = 0.03).On-treatment analysis showed a mean birth weight difference of 118 g (95% CI47–190 g; P = 0.001) and arelative fall in both the proportion of birth weight ≤3000 g(P = 0.015) and the incidence ofpre-eclampsia (P = 0.015). Compliancewith the experimental product was apparent from a haematological study ofred-blood-cell folate at the end of pregnancy, which was performed in asub-sample. In both types of analyses, positive differences were alsopresent for mean gestation duration, birth length and head circumference.Nevertheless, the relatively small sample sizes allowed a statistical powerof >0.80 just for mean birth weight and birth length in theon-treatment analysis; birth length in that analysis had a difference of0.57 cm (95% CI 0.19–0.96 cm; P = 0.003).

The new intervention resulted in increased mean birth weight. Associationswith gestation duration and most secondary outcomes need a larger samplesize for confirmation.

To describe (1) the prevalence of overweight and obesity and theirassociation with physical activity; (2) the effect of different cut-offpoints for body mass index (BMI) on weight status categorisation; and (3)associations of weight status with perceptions of body size, health and dietquality.

A cross-sectional study.

Secondary schools in Barbados.

A cohort of 400 schoolchildren, 11–16 years old, selected to studyphysical education practices.

Prevalence of overweight (15% boys; 17% girls) and obesity (7% boys; 12%girls) was high. Maternal obesity, as defined by the International ObesityTask Force (IOTF) BMI cut-off points, predicted weight status such thatreporting an obese mother increased the odds of being overweight by 5.25(95% confidence interval: 2.44, 11.31). Physical activity was inverselyassociated with weight status; however levels were low. Recreationalphysical activity was not associated with weight status in either category.Overweight subjects tended to misclassify themselves as normal weight andthose who misclassified perceived themselves to be of similar health statusto normal-weight subjects. The National Center for Health Statistics andIOTF BMI cut-off points produced different estimates of overweight andobesity.

Our findings suggest that inadequate physical activity and ignorance relatedto food and appropriate body size are promoting high levels of adipositywith a strong contribution from maternal obesity, which may be explained byperinatal and other intergenerational effects acting on both sexes.Prevalence studies and local proxy tools for adiposity assessment areneeded.

To identify determinants of adolescents’ consumption of carbonatedsoft drinks (regular and diet), both of total consumption and of consumptionat school.

Regular and diet soft drink consumption was measured by food frequencyquestions that were dichotomised. Several potential environmental andpersonal determinants of consumption were measured. A total of 2870(participation rate: 85%) 9th and 10th graders, within 33 Norwegian schools,participated in the study. Multilevel logistic regression analyses werepreformed for total soft drink consumption (twice a week or more vs. less)and for consumption at school (once a week or more vs. less).

A total of 63% and 27% of the participants reported to drink respectivelyregular and diet soft drinks twice a week or more, and 24% and 8%,respectively, reported to drink soft drinks once a week or more at school.Preferences, accessibility, modelling and attitudes were the strongestdeterminants of both regular and diet soft drink consumption. In addition,gender, educational plans and dieting were related to both total soft drinkconsumption and consumption at school. Pupils with longer distance fromschool to shop and those in schools with rules concerning soft drinkconsumption tended to have lower odds of drinking both regular and diet softdrinks at school.

This study shows that gender, educational plans, dieting, accessibility,modelling, attitudes and preferences all seem to be strong determinants ofadolescents’ soft drink consumption. Parents and the homeenvironment appear as great potential intervention targets.

To create, validate and assess the reliability of a checklist to measurecalcium intake in children.

Calcium intakes from a checklist and parent-assisted 24-h dietary recall werecompared. Checklist reliability was assessed separately.

After-school programmes in the United States.

Forty-two children (18 males, 24 females, age = 8.0 ± 0.9 years)participated in the validation analysis and 49 children (28 males, 21females, age = 7.5 ± 0.9 years) in the reliability analysis.

No differences in mean calcium intakes were found by method or gender. Thechecklist correlated well with recall among girls (r = 0.65, P = 0.01) but notboys (r = −0.33, P = 0.19). Agreement over time was above 80%for most foods.

The calcium checklist is useful for assessing calcium intake among groups of6–10-year-old children in settings that preclude parentalassistance. More research is needed to improve accuracy among boys.

To validate a diet history questionnaire (DHQ) using a weighed food record(WFR) as the standard method in the estimation of food consumption andnutrient intake in a group of adults.

WFR: all foods consumed by subjects during 7 consecutive days were weighedand recorded by nutrition students. Two DHQ interviews were carried out ondays 1 (first diet history questionnaire, DHQ1) and 28 (second diet historyquestionnaire, DHQ2).

Costa Rica.

Sixty adults: 30 men and 30 women; 30 living in urban and 30 in ruralareas.

In comparison to the WFR, the DHQ1 gave statistically significant higherestimates of the mean intake of 19 nutrients for men and of three nutrientsfor women. The uncorrected correlation coefficients for nutrient intakeaccording to both methods ranged from 0.40 to 0.83 for males and from 0.22to 0.62 for females. Percentage of subjects classified in the same quartilesof nutrient intake according to each method ranged from 33.3% to 63.3% formales and from 23.3% to 53.3% for females. Misclassification in extremequartiles ranged from 0% to 13.3% for both sexes. The mean food groupconsumption, according to the DHQ1, when compared with the WFR, gavestatistically significant differences for three of the 18 food groups formen and for two groups in the case of women. The two applications of the DHQgave similar results.

Validation of a DHQ using a WFR as the standard method gave results thatcompare favourably with those reported by other authors. This study foundimportant differences in the response of men and women to the DHQ: amongmen, the estimates of mean nutrient intake from DHQ1 were significantlygreater than those of the WFR, while in the case of women, the mean nutrientintake estimates from both methods were not significantly different. Therewas a higher degree of correlation between the DHQ1 and the WFR meannutrient intakes among men than among women. The DHQ showed goodreproducibility.

To quantify factors influencing iron supplementation compliance andhaemoglobin (Hb) concentrations among pregnant women participating in aniron supplementation programme under routine field conditions.

Cross-sectional interviews and Hb measurements.

Albay and Sorsogon provinces, Bicol, Philippines.

Three hundred and forty-six pregnant women receiving iron supplements via thePhilippine iron supplementation programme.

Women had a mean Hb concentration of 10.75 ± 1.43 gdl−1, and 56.4% were anaemic (Hb < 11.0g dl−1). On average, the first prenatal visit occurredat nearly 4 months (3.80 ± 1.56). The ratio of visits to numberof months pregnant was 0.51 ± 0.24. Self-reported consumption ofpills received was 85% (0.85 ± 0.23), although pill countssuggested that consumption was 70% (0.70 ± 0.35). Using multipleregression, an earlier first prenatal visit and greater self-reportedcompliance were positively associated with Hb concentrations. Additionally,perceived health benefits from taking the supplements and higher healthprogramme knowledge were positively associated with pill consumption, whileexperiencing side-effects and disliking the taste of the supplements wereassociated with lower pill consumption. A greater number of living childrenwas negatively associated with the frequency of prenatal visits. The numberof children was also directly negatively associated with Hbconcentrations.

Compliance was positively related to Hb concentrations. Several factorsassociated with greater compliance were identified, including maritalstatus, number of children, health programme knowledge, side-effects,perceived health benefits, and dislike of taste. Some of these factors mayserve as avenues for interventions to increase compliance, and ultimately Hbconcentrations.

To develop and validate a short food-frequency questionnaire to assesshabitual dietary salt intake in South Africans and to allow classificationof individuals according to intakes above or below the maximum recommendedintake of 6 g salt day−1.

Cross-sectional validation study in 324 conveniently sampled men andwomen.

Repeated 24-hour urinary Na values and 24-hour dietary recalls were obtainedon three occasions. Food items consumed by >5% of the sample andwhich contributed ≥50 mg Na serving−1 wereincluded in the questionnaire in 42 categories. A scoring system wasdevised, based on Na content of one index food per category and frequency ofconsumption.

Positive correlations were found between Na content of 35 of the 42 foodcategories in the questionnaire and total Na intake, calculated from 24-hourrecall data. Total Na content of the questionnaire was associated with Naestimations from 24-hour recall data (r =0.750; P < 0.0001; n = 328) and urinary Na (r = 0.152; P= 0.0105; n = 284). Urinary Na was higherfor subjects in tertile 3 than tertile 1 of questionnaire Na content(P < 0.05). QuestionnaireNa content of <2400 and ≥2400 mgday−1 equated to a reference cut-off score of 48 andcorresponded to mean (standard deviation) urinary Na values of 145 (68) and176 (99) mmol day−1, respectively (P < 0.05). Sensitivity andspecificity against urinary Na ≥100 and <100 mmolday−1 was 12.4% and 93.9%, respectively.

A 42-item food-frequency questionnaire has been shown to have content-,construct- and criterion-related validity, as well as internal consistency,with regard to categorising individuals according to their habitual saltintake; however, the devised scoring system needs to show improvedsensitivity.

A nationwide study was performed in Cuba to assess vitamin A status and theintake of vitamin-A-providing foods in children aged 6–11years.

The sample comprised 1191 schoolchildren from first to sixth grade, bothsexes, from municipalities randomly selected from the five eastern provincesof Cuba in 2002 (first semester) and from the four western and four centralprovinces in 2003 (first semester). A food-frequency questionnaire wascompleted by 2038 mother-and-child pairs.

Mean (±standard deviation) plasma retinol concentrations were 1.77± 0.48 μmol l−1 in the western,2.01 ± 0.56 μmol l−1 in thecentral and 1.40 ± 0.41 μmol l−1in the eastern region. No child had plasma retinol concentration below 0.35μmol l−1, indicative of a high risk ofclinical deficiency. Subclinical deficiency, plasma retinol concentration of0.35–0.7 μmol l−1, was seen in<2% of subjects in all three regions and was <5% evenin the two provinces with the worst vitamin A status (Guantánamo,4.6%; Las Tunas, 3.0%). Adequate status (>1.05 μmoll−1) was present in >90% of subjects inall western and central provinces, and in one of the eastern provinces(Holguín), whereas in the four remaining eastern provinces,adequate status was present in >75%. Only nine fruits andvegetables were consumed frequently (>3 times per week) by>50% of children. Thirty-seven per cent regularly consumed asupplement containing vitamin A.

Most Cuban children aged 6–11 years had adequate vitamin A status.Consumption of foods rich in vitamin and provitamin A, especiallyvegetables, was frequent but limited to a small variety of foods.

There are no data on optimal cut-off points to classify obesity among OmaniArabs. The existing cut-off points were obtained from studies of Europeanpopulations.

To determine gender-specific optimal cut-off points for body mass index(BMI), waist circumference (WC) and waist-to-hip ratio (WHR) associated withelevated prevalent cardiovascular disease (CVD) risk among Omani Arabs.

A community-based cross-sectional study.

The survey was conducted in the city of Nizwa in Oman in 2001.

The study contained a probabilistic random sample of 1421 adults aged≥20 years. Prevalent CVD risk was defined as the presence of atleast two of the following three risk factors: hyperglycaemia, hypertensionand dyslipidaemia. Logistic regression and receiver-operating characteristic(ROC) curve analyses were used to determine optimal cut-off points for BMI,WC and WHR in relation to the area under the curve (AUC), sensitivity andspecificity.

Over 87% of Omanis had at least one CVD risk factor (38% had hyperglycaemia,19% hypertension and 34.5% had high total cholesterol). All three indicesincluding BMI (AUC = 0.766), WC (AUC = 0.772) and WHR (AUC = 0.767)predicted prevalent CVD risk factors equally well. The optimal cut-offpoints for men and women respectively were 23.2 and 26.8 kgm−2 for BMI, 80.0 and 84.5 cm for WC, and 0.91 and0.91 for WHR.

To identify Omani subjects of Arab ethnicity at high risk of CVD, cut-offpoints lower than currently recommended for BMI, WC and WHR are needed formen while higher cut-off points are suggested for women.