To analyse (i) differences in beverage pattern among Norwegian children in 2001 and 2008; (ii) beverage intake related to gender, parental education and family composition; and (iii) potential disparities in time trends among the different groups.

Within the Fruits and Vegetables Make the Marks (FVMM) project, 6th and 7th grade pupils filled in a questionnaire about frequency of beverage intake (times/week) in 2001 and 2008.

Twenty-seven elementary schools in two Norwegian counties.

In 2001 a total of 1488 and in 2008 1339 pupils participated.

Between 2001 and 2008, a decreased consumption frequency of juice (from 3·6 to 3·4 times/week, P = 0·012), lemonade (from 4·8 to 2·5 times/week, P < 0·001) and regular soft drinks (from 2·7 to 1·6 times/week, P < 0·001), but an increased consumption frequency of diet soft drinks (from 1·2 to 1·6 times/week, P < 0·001), were observed. From 2001 to 2008, boys increased their frequency of juice consumption (from 3·1 to 3·3 times/week) whereas girls decreased their frequency of juice consumption (3·8 to 3·4 times/week; interaction time × gender P = 0·02). Children with higher educated parents increased their frequency of juice consumption (3·6 to 3·8 times/week) whereas those with lower educated parents decreased their frequency of juice consumption (3·3 to 3·0 times/week; interaction time × parental education P = 0·04).

A lower frequency of consumption of sugar-sweetened beverages was observed among pupils in 2008 than in 2001. This is in accordance with the Norwegian health authority's goals and strategies for this time period, and is an important step to improve the dietary health of adolescents.

Since inadequate food consumption patterns during adolescence are not only linked with the occurrence of obesity in youth but also with the subsequent risk of developing diseases in adulthood, the establishment and maintenance of a healthy diet early in life is of great public health importance. Therefore, the aim of the present study was to describe and evaluate the food consumption of a well-characterized sample of European adolescents against food-based dietary guidelines for the first time.

The HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study is a cross-sectional study, whose main objective was to obtain comparable data on a variety of nutritional and health-related parameters in adolescents aged 12·5–17·5 years.

Ten cities in Europe.

The initial sample consisted of more than 3000 European adolescents. Among these, 1593 adolescents (54 % female) had sufficient and plausible dietary data on energy and food intakes from two 24 h recalls using the HELENA-DIAT software.

Food intake of adolescents in Europe is not optimal compared with the two food-based dietary guidelines, Optimized Mixed Diet and Food Guide Pyramid, examined in this study. Adolescents eat half of the recommended amount of fruit and vegetables and less than two-thirds of the recommended amount of milk (and milk products), but consume much more meat (and meat products), fats and sweets than recommended. However, median total energy intake may be estimated to be nearly in line with the recommendations.

The results urge the need to improve the dietary habits of adolescents in order to maintain health in later life.

To investigate whether awareness of the Japanese Food Guide (JFG) can promote changes in eating behaviour.

A longitudinal study was conducted in 2007 and 2009 by means of an Internet-based survey. Awareness status of the JFG and a sixteen-item scale for calculating eating behaviour scores were obtained.

Japan.

In total, 787 Japanese adults (20–59 years) who registered with an Internet research service organization were included in the study. The respondents were divided into three groups. The respondents who were aware of the JFG in 2007 were categorized into Group 1. Those who were not aware of the JFG in 2007 were categorized into either Group 2 or Group 3. Group 2 became aware of the JFG by 2009, and Group 3 was not aware of the JFG in 2009.

In Group 2, the eating behaviour score increased significantly by 0·8 points from 4·7 in 2007 to 5·5 in 2009 (P = 0·004). The eating behaviour score of Group 1 (6·5 points in 2007; 6·3 points in 2009) and Group 3 (3·8 points in 2007; 4·1 points in 2009) did not change significantly from 2007 to 2009.

Awareness of the JFG promoted eating behaviour change in the Japanese population. The results indicate that awareness of nutrition information from sources such as the JFG would promote healthy eating.

Previous studies focused on a limited number of determinants of food label use. We therefore tested a comprehensive model of food label use consisting of sociodemographic, health-related and motivating variables. These three predictor groups were chosen based on the previous literature and completed with new predictors not yet examined in a comprehensive study of frequency of label use.

We sent questionnaires to a random sample of households in the German-speaking part of Switzerland.

The respondents filled in the questionnaire at home and returned it by mail.

We analysed the data of 1162 filled-in questionnaires (response rate = 38 %). Of the respondents, 637 were women (55 %), and their mean age was 53·54 (sd 15·68) years.

Health-related variables were the most important group of predictors of label use, followed by motivating factors and sociodemographic variables. Placing importance on health, healthy eating and nutritional value of food, perceived vulnerability for diet-related diseases, nutrition knowledge, numeracy and gender were positively associated with frequency of food label use whereas shopping habits and seeing eating as something positive were negative predictors of frequency of label use.

People's health consciousness should be raised in order to increase the frequency of food label use. Furthermore, it should be stressed that reading labels and keeping a healthy diet do not contradict ‘good eating’, and that both of these aspects can be combined with the help of food labels.

To examine associations of education and occupation, as indicators of socio-economic position (SEP), with dietary intake and diet quality in a sample of Chinese immigrant women.

Cross-sectional. Data collection included four days of dietary recalls and information on education and current occupation for participants and their spouses.

Philadelphia, PA, USA.

Chinese immigrant women (n 423) recruited from October 2005 to April 2008.

In multivariate models, both higher education level and occupation category were significantly associated with higher energy density and intake of energy and sugar. Education was additionally associated with intake of sugar-sweetened beverages (P = 0·01) and lower dietary moderation (P = 0·01). With joint categorization based on both education and occupation, we observed significant trends indicating higher energy density (P = 0·004) and higher intake of energy (P = 0·001) and sugar (P = 0·04), but less dietary moderation (P = 0·02) with higher SEP.

In this sample of US Chinese immigrants, higher SEP as indicated by education level and occupation category was associated with differences in dietary intake and with less dietary moderation. While higher SEP is typically linked to healthier diet in higher-income nations, in these immigrants the association of SEP with diet follows the pattern of their country of origin – a lower-income country undergoing the nutrition transition.

Whereas the relationship between some components of diet, such as n-3 fatty acids and B-vitamins, and depression risk has been extensively studied, the role of fast-food or processed pastries consumption has received little attention.

Consumption of fast food (hamburgers, sausages, pizza) and processed pastries (muffins, doughnuts, croissants) was assessed at baseline through a validated semi-quantitative FFQ. Participants were classified as incident cases of depression if they reported a physician diagnosis of depression or the use of antidepressant medication in at least one of the follow-up questionnaires. Cox regression models were fit to assess the relationship between consumption of fast food and commercial baked goods and the incidence of depression.

The SUN (Seguimiento Universidad de Navarra – University of Navarra Follow-up) Project, Spain.

Participants (n 8964) from a Spanish cohort.

After a median follow-up of 6·2 years, 493 cases of depression were reported. A higher risk of depression was associated with consumption of fast food (fifth (Q5) v. first quintile (Q1): hazard ratio (HR) = 1·36; 95 % CI 1·02, 1·81; P trend = 0·003). The results did not change after adjustment for the consumption of other food items. No linear relationship was found between the consumption of commercial baked goods and depression. Participants belonging to consumption quintiles Q2–Q5 showed an increased risk of depression compared with those belonging to the lowest level of consumption (Q1; HR = 1·38; 95 % CI 1·06, 1·80).

Fast-food and commercial baked goods consumption may have a detrimental effect on depression risk.

Highly processed foods such as convenience foods usually have a high salt content and therefore might indirectly act as adipogenic due to an increasing consumption of sugar-containing beverages (SCB). We examined the association between dietary salt and body weight status.

We used data on urinary Na excretion as an indicator of dietary salt and BMI standard deviation score (BMI-SDS) and percentage body fat (%BF) of children and adolescents participating in the DONALD (Dortmund Nutritional and Anthropometric Longitudinally Designed) Study.

Dortmund, Germany.

Children and adolescents (n 364) who had at least two 24 h urine samples and two dietary records in the observational period between 2003 and 2009 were considered in our data analysis.

Repeated-measures regression models revealed that urinary Na was positively associated with BMI-SDS (+0·202 SDS/g Na excretion at baseline; P < 0·001) and %BF (+1·303 %BF/g Na excretion at baseline; P < 0·01) at baseline in boys and girls. These associations remained significant after adjustment for SCB consumption and total energy intake. Furthermore, there was a positive trend between baseline Na excretion and the individual change in %BF in the study period (+0·364 increase in %BF/g Na excretion at baseline), which was confirmed after inclusion of SCB consumption or total energy intake. There was no significant association between the change in Na excretion and the concurrent change of either BMI-SDS or %BF in any model.

Our results suggest that a high intake of processed salty foods could have a negative impact on body weight status in children and adolescents independently from their consumption of SCB.

To evaluate the cost-effectiveness of the European community-based project ‘10 000 Steps Ghent’, an intervention that resulted in a significant decrease in sedentary time and a significant increase in step counts (896 steps/d) and self-reported walking (66 min/week).

An age- and gender-dependent Markov model, with a time horizon of 20 years and a cycle length of 1 year, estimating the development of diabetes, cardiovascular events and colorectal cancer.

All individuals started in a health state free of events. The effect of the intervention was based on published risk reductions related to increased walking time. Costs and utility decrements related to events were obtained from published literature. The impact of the uncertainty of the parameters on incremental costs and quality-adjusted life years (QALY) were assessed with one-way sensitivity analyses and a Monte Carlo analysis.

Cohort representing the population reached by the intervention (266 adults aged 25–75 years with a mean age of 48·2 (sd 13·1) years, 45·6 % men, 64·6 % highly educated, 70·0 % employed).

Implementing the community-based programme increased average QALY by 0·16 and 0·11 for men and women, respectively. The total costs decreased by approximately 576€ and 427€, respectively. Hence, for both genders the intervention programme was dominant. The sensitivity analyses did not change the conclusion of dominance.

The community-based ‘10 000 Steps Ghent’ campaign is a dominant intervention. Sensitivity analyses have proved the robustness of the results; hence implementing this intervention on a population-based level could lead to improved health outcomes and reduced costs.

To investigate the effectiveness of a relatively novel concept of providing employees with healthy ready-to-heat meals to bring home to their families, here referred to as Canteen Take Away (CTA).

Employees’ dietary intake on two weekdays when they received free CTA was compared with that on weekdays when they did not receive CTA. Four non-consecutive 24 h dietary recalls were applied to assess dietary intake on a daily basis. Moreover, a digital photographic method was used to assess evening meal intake for three consecutive weeks. Data were analysed using a mixed-effects model.

A financial worksite offering CTA.

Twenty-seven employees.

Overall dietary quality as expressed by the energy density of the food (excluding beverages) was found to be significantly lower on days consuming CTA meals compared to days not consuming CTA with regard to evening meal intake (average difference: −187 (95 % CI −225, −149) kJ/100 g) and on a daily basis (average difference: −77 (95 % CI −132, −21) kJ/100 g). Other favourable differences included increased vegetable intake (average difference: 83 (95 % CI 67, 98) g/evening meal, 109 (95 % CI 62, 155) g/d).

The present study shows that providing healthy take-away dinners has potential for promoting healthy dietary habits among employees. This reinforces the importance of availability and convenience as effective tools to promote healthy eating habits.

The present analysis evaluates the overall appreciation and implementation of an intervention, Project Tomato, designed to maintain fruit and vegetable intake in children aged 8–9 years.

A random sample of fifty-four English primary schools (658 children) were randomised to either the intervention group or the control. The intervention group received a multi-component programme delivered in school by teachers and items sent home for parents/children. Dietary measurements were collected at baseline and follow-up. The intervention participants completed questionnaires on the intervention materials, to identify implementation and appreciation of the intervention, and other environmental mechanisms.

Fifty-four primary schools were randomly selected, with twenty-seven schools allocated to the intervention group.

A total of 311 children received the intervention.

Implementation of the intervention was low, 21·3 % of school items and 56·0 % of home items were implemented. The intervention materials were well received by teachers, parents and children. Other mechanisms that may affect fruit and vegetable intake were explored. Children who ate their main meal with their parents 3–7 nights/week on average consumed 37·6 (95 % CI 9·8, 65·4) g more fruit and vegetables than children who ate with their parents 0–2 times/week.

Implementation of the trial components was poor. However, the results identified the importance of parental environment and mealtime structure on children's fruit and vegetable intake.

To assess the short-term impact of a nutritional intervention aimed at reducing childhood overweight in German pre-school children.

Using a cluster-randomized study design with waiting-list controls, we tested a 6-month intervention administered once weekly by a nutrition expert consisting of joint meal preparation and activities for children and parents such as tasting and preparing nutritious, fresh foods. At baseline, 6 and 12 months, a parent-completed questionnaire assessed fruit and vegetable intakes (primary outcomes) and water and sugared drinks consumption (secondary outcomes). Direct measurement assessed BMI, skinfold thickness and waist-to-height-ratio. An intention-to-treat analysis used random-effects panel regression models to assess the intervention effect, adjusted for each child's age, gender, immigrant background and maternal education.

Eighteen pre-schools from three south German regions.

Healthy children aged 3–6 years.

Three hundred and seventy-seven (80 %) eligible pre-school children participated in the study. Of these, 348 provided sufficient data for analysis. The sample mean age was 4·26 (sd 0·78) years; the majority (53·2 %) were boys. Children's fruit and vegetable intakes increased significantly (P < 0·001 and P < 0·05, respectively); no significant changes in the consumption of water, sugared drinks or anthropometric measurements were noted.

Nutritional interventions in pre-schools have the potential to change eating behaviours in young children, which in the long term might reduce risk for developing overweight.

To study the awareness of the Heart Symbol in different age and educational groups, and changes in the awareness over a 9-year period. In addition, the reported use of products with the symbol was examined.

A series of annual cross-sectional postal surveys on Health Behaviour and Health among the Finnish Adult Population.

A random sample (n 5000 per annum) from the Finnish population aged 15–64 years, drawn from the National Population Register, received a questionnaire.

Men and women (n 29 378) participating in the surveys in 2000–2009.

At the early 2000s, 48 % of men and 73 % of women reported to be familiar with the symbol. The corresponding rates were 66 % for men and 91 % for women in 2009. The reported use of products with the symbol increased from 29 % to 52 % in men and from 40 % to 72 % in women. In men, the awareness did not vary by age, whereas older women (45–64 years) were less likely to be aware of the symbol compared with younger women (25–34 years). Men and women with the highest education were best aware of the symbol and more likely to use the products in the early 2000s. The educational differences diminished or disappeared during the study period.

The majority of Finnish adults are familiar with the Heart Symbol, and the reported use of such products increased in all age and educational groups, especially among the less educated. The symbol may work as an effective measure to diminish nutrition-related health inequalities.

To document socio-economic differences in exposure to food advertising, including advertisements for foods high in fat, salt and sugar (HFSS) as defined by the UK Food Standards Agency's Nutrient Profiling Model.

A cross-sectional survey. Information (including product advertised and viewing figures) on all advertisements broadcast in one UK region over one week (6–12 July 2009) was obtained. Food advertisements were identified and linked to nutritional information on the content of advertised foods.

UK Tyne-Tees television region.

Data were sourced from a UK-wide television viewing panel.

Eleven per cent of advertising seen was for food and 63 % of food advertising seen was for HFSS foods. The proportion of all advertising seen that was for food was smaller among viewers in the least v. most affluent social grade (OR = 0·98, 99 % CI 0·95, 1·00). There was no difference in the proportion of food advertising seen that was for HFSS food between viewers in the most and least affluent social grades. Total exposure to both all food advertising and HFSS food advertising was 2·1 times greater among the least v. the most affluent viewers.

While the least affluent viewers saw relatively fewer food advertisements, their absolute exposure to all food and HFSS food advertisements was higher than that of the most affluent viewers. Current UK restrictions prohibit advertisements for HFSS foods during programmes with a high proportion of child viewers. Extending these to all programming may reduce socio-economic inequalities in exposure to these advertisements and in diet and obesity.

Nutritionally promoted foods are now available at fast-food establishments. Little is known about their popularity, who is purchasing them, or their impact on dietary intake. Our study aimed to determine: how often nutritionally promoted fast foods were purchased; the demographic characteristics of people purchasing these foods; and if purchasing these foods resulted in reduced energy, and increased vegetable, content of lunches compared with those who purchased traditional fast foods.

A survey collecting lunchtime fast-food purchases and demographic details was administered over two months. Nutritionally promoted products included the McDonalds’ ‘Heart Foundation Tick Approved’ range and Subway's ‘Six grams of fat or less’ range. Energy and vegetable contents were estimated using information from fast-food companies’ websites. Differences in demographics, energy and vegetable contents between individuals purchasing nutritionally promoted and traditional lunches were assessed using χ2 and t tests.

Queensland, Australia.

Lunchtime diners aged over 16 years at Subway and McDonalds.

Surveys were collected from 927 respondents (58 % male, median age 25 (range 16–84) years; 73 % response rate). Only 3 % (n 24/910) of respondents who ordered a main option had purchased a nutritionally promoted item. Purchasers of nutritionally promoted foods were ∼13 years older, predominantly female (79 %), and more often reported involvement in a health-related profession (29 % v. 11 %) than purchasers of traditional foods (P < 0·05). Purchasers of nutritionally promoted foods ordered 1·5 fewer megajoules and 0·6 more vegetable servings than purchasers of traditional foods (P < 0·05).

Nutritionally promoted fast foods may reduce lunchtime energy content, however these foods were infrequently chosen.

Transnational food, beverage and restaurant companies, and their corporate foundations, may be potential collaborators to help address complex public health nutrition challenges. While UN system guidelines are available for private-sector engagement, non-governmental organizations (NGO) have limited guidelines to navigate diverse opportunities and challenges presented by partnering with these companies through public–private partnerships (PPP) to address the global double burden of malnutrition.

We conducted a search of electronic databases, UN system websites and grey literature to identify resources about partnerships used to address the global double burden of malnutrition. A narrative summary provides a synthesis of the interdisciplinary literature identified.

We describe partnership opportunities, benefits and challenges; and tools and approaches to help NGO engage with the private sector to address global public health nutrition challenges. PPP benefits include: raising the visibility of nutrition and health on policy agendas; mobilizing funds and advocating for research; strengthening food-system processes and delivery systems; facilitating technology transfer; and expanding access to medications, vaccines, healthy food and beverage products, and nutrition assistance during humanitarian crises. PPP challenges include: balancing private commercial interests with public health interests; managing conflicts of interest; ensuring that co-branded activities support healthy products and healthy eating environments; complying with ethical codes of conduct; assessing partnership compatibility; and evaluating partnership outcomes.

NGO should adopt a systematic and transparent approach using available tools and processes to maximize benefits and minimize risks of partnering with transnational food, beverage and restaurant companies to effectively target the global double burden of malnutrition.

To evaluate Ireland's food-based dietary guidelines and highlight priorities for revision.

Evaluation with stakeholder input. Energy and nutrient intake goals most appropriate for Ireland were determined. Advice from Ireland's food guide was translated into 4 d food intake patterns representing age and gender groups from 5 to 51+ years. Nutritional content of the food patterns was compared with identified goals and appropriateness of food advice was noted. Feedback from stakeholders was obtained on portion size of foods within the Bread, Cereal and Potato group and of portion descriptors for meat and cereal foods.

Government agency/community.

General population aged 5+ years, dietitians/nutritionists (n 44) and 1011 consumers.

Goals were identified for energy, macronutrients, fibre, Fe, Ca and vitamin D. Goals not achieved by the food patterns included energy, total fat, saturated fat, fibre and vitamin D. Energy content of food portions within the Bread, Cereal and Potato group varied widely, yet advice indicated they were equivalent. Dietitians/nutritionists agreed with the majority of consumers surveyed (74 %, n 745) that larger portion sizes within the Bread, Cereal and Potato group were more meaningful. ‘Palm of hand’ as a descriptor for meat portions and a ‘200 ml disposable cup’ for quantifying cereal foods were preferred.

Revision of the guidelines requires specific guidance on energy and vitamin D intakes, and comprehensive advice on how to reduce fat and saturated fat and increase fibre intakes. Advice should use portion descriptors favoured by consumers and enlarged portion sizes for breads, cereals and potatoes that are equivalent in terms of energy.

To revise the food-based dietary guidelines for Ireland and assess the affordability of healthy eating.

An iterative process was used to develop 4 d food intake patterns (n 22) until average intakes met a range of nutrient and energy goals (at moderate and sedentary activity levels) that represented the variable nutritional requirements of all in the population aged 5 years and older. Dietary guidelines were formulated describing the amounts and types of foods that made up these intake patterns. Foods required for healthy eating by typical households in Ireland were priced and affordability assessed as a proportion of relevant weekly social welfare allowances.

Government agency/community.

General population aged 5+ years.

Food patterns developed achieved energy and nutrient goals with the exception of dietary fibre (inadequate for adults with energy requirements <9·2 MJ) and vitamin D (inadequate for everyone). A new food group to guide on fats/oils intake was developed. Servings within the Bread, Cereal and Potato group were sub-categorized on the basis of energy content. Recommendations on numbers of servings from each food group were developed to guide on energy and nutrient requirements. Healthy eating is least affordable for families with children who are dependent on social welfare.

Daily supplementation with vitamin D is recommended. Wholemeal breads and cereals are recommended as the best source of energy and fibre. Low-fat dairy products and reduced-fat unsaturated spreads are prioritized to achieve saturated fat and energy goals. Interventions are required to ensure that healthy eating is affordable.