To determine risk factors for anaemia in preschool children.

A cross-sectional study.

Tigray province, northern Ethiopia.

2080 of 2373 children aged 6–60 months provided blood to assess anaemia.

Anaemia was highly prevalent (42%) and constituted an important nutritional problem in the region. In a sub-sample of 230 anaemic children, 56% had a low red blood cell (RBC) count, and 43% had a serum ferritin of less than 12 μg l−1 indicating that the anaemia was largely due to iron deficiency. Unlike other regions in developing countries, hookworm (0.4%) and malaria (0.0%) were rare and contributed little to the anaemia. Even though their diet lacked variety, the amount of iron consumed through cereal-based staple foods was adequate. However, the iron in these foods was not readily available and their diets were probably high in iron absorption inhibitors and low in enhancers. Dietary factors associated with anaemia included frequent consumption of inhibitors, such as fenugreek and coffee, and poor health in the child such as diarrhoea and stunting.

Underlying causes of anaemia were lack of safe water and inadequate human waste management, maternal illiteracy and mother being ill, and having no food reserves. The root cause of these factors was poverty. The optimal control strategy for iron deficiency anaemia should have a holistic approach which includes the alleviation of poverty, the empowerment of women and the provision of a safe environment.

This report examines how sources of fat and patterns of fat-related dietary habits differed between black, Hispanic and white women participating in a randomized trial of a low-fat diet intervention.

The intervention consisted of group sessions, which met weekly for 6 weeks, biweekly for 6 weeks and monthly for 9 months, and included didactic nutrition education and activities to provide motivation for sustained dietary change. Outcomes included total fat and fat from nine food groups from a food frequency questionnaire (FFQ), and a summary scale and five subscales that measure fat-related dietary habits.

Data are from 1702 post-menopausal women, recruited from clinical centres in Atlanta, Birmingham and Miami, with dietary assessments at baseline and 6 months post-randomization.

Total fat intake was similar across race/ethnic groups at baseline, yet there were many differences in sources of fat and fat-related dietary habits. For example, blacks consumed less fat from dairy foods and more fat from meats than whites. Effects of the intervention on total fat intake or the summary fat-related dietary habits scale did not differ across race/ethnicity groups. There were, however, many differences in how the intervention affected sources of fat and fat-related dietary habits. For example, the intervention effect for added fats (e.g. butter and salad dressings) was −8.9 g for blacks and −12.0 g for whites (P < 0.05). The intervention effect for adopting low-fat meat purchasing and preparation methods was larger for blacks than whites, and the intervention effect for replacing high-fat foods with fruits and vegetables was larger for Hispanics than whites.

This study demonstrates that, if properly designed, a single nutrition intervention programme can work well even in groups with culturally diverse dietary patterns.

To evaluate the association of vegetable and fruit intake with several demographic, anthropometric, lifestyle and dietary factors.

Cross-sectional analysis. Information on habitual diet was collected by means of the diet history method. Association of vegetable and fruit intakes with other factors was assessed separately by means of multiple lineal regression and the cumulative odds model.

39 622 healthy subjects aged 29–69 years from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort in Spain.

Fruit intake increased with age, education and physical activity and decreased with intake of saturated fatty acids and cholesterol; smoking and alcohol consumption were also negatively associated with fruit, with a very low consumption for current smokers and heavy drinkers. Vegetable intake increased with education and physical activity and with intake of unsaturated fatty acids, mainly mono-unsaturated. Former smokers consumed more vegetables than never or current smokers and non-consumers of alcohol ate less vegetables than consumers, among whom no differences were observed. All these estimates were adjusted by energy and body mass index (BMI).

When assessing the association of fruit and vegetables with chronic diseases it is important to take into account confounding factors. Furthermore, it would be useful to study dietary patterns including several interrelated factors.

To evaluate the accuracy of a simplified inventory procedure for assessing nutrient intake from vitamin and mineral supplements.

Participants brought their supplements to a clinic. An interviewer conducted the supplement inventory procedure, which consisted of recording data on the type of multiple vitamin and single supplements used. For the multiple vitamins, the interviewer recorded the exact dose for a subset of nutrients (vitamin C, calcium, selenium). For other nutrients, we imputed the dose in multiple vitamins. The dose of all single supplements was recorded. Labels of the supplements were photocopied and we transcribed the exact nutrient label data for the criterion measure. Spearman correlation coefficients were used to assess precision of nutrient intakes from the simplified inventory compared to the criterion measure.

Data are from 104 adult vitamin supplement users in Washington state.

Correlation coefficients between nutrient intake estimated from the simplified inventory compared to the criterion measure were high (0.8–1.0) for those nutrients (vitamin C, calcium, selenium) for which the interviewer recorded the exact dose contained in multiple vitamins. However, for nutrients for which imputations were made regarding dose in multiple vitamins, correlation coefficients ranged from good (0.8 for vitamin E) to poor (0.3 for iron).

The simplified inventory is rapid (4–5 min) and practical for large-scale studies. The precision of nutrient estimates using this procedure was variable, although excellent for the subset of nutrients for which the dose was recorded exactly. This study illustrates many of the challenges of collecting high quality supplement data.

To assess how well supermarket sales data from a major supermarket chain can reflect on regional differences in dietary behaviour by comparing the sales data with the results provided by the annual health behaviour surveys.

Cross-sectional observational study.

The study was carried out in six Finnish cities situated in different parts of Finland. For the study supermarket sales data of milk, sour milk, fats and oils for 1 month, September 1997, were obtained from eight supermarkets. Proportional sales of different types of dairy products were calculated as well as mean salt and fat per cent and the proportion of saturated fat to total fat. The health behaviour surveys from spring 1995, 1996 and 1997 provided information about dietary habits of the adult population in the cities. The reported use of dairy products was compared with the percentage sales.

The proportional sales of dairy products varied between the cities. In Pori in western Finland the sale of milk fat was highest in all food groups. In Oulu, northern Finland, the sale of non-fat milk was high. In the capital region the sale of oil was highest. Regional differences could also be seen in the survey data. The similarity between the two different datasets was high.

The use of supermarket sales data for assessing regional differences in health behaviour is feasible. The challenge will be to get supermarket managers willing to provide sales data on a routine basis for monitoring and research.

To determine if blood levels of 25-hydroxyvitamin D (25-D) or its active metabolite, 1,25-dihydroxyvitamin D (1,25-D), are lower in women at the time of first diagnosis of breast cancer than in comparable women without breast cancer.

This was a clinic-based case–control study with controls frequency-matched to cases on race, age, clinic and month of blood drawing.

University-based breast referral clinics.

One hundred and fifty-six women with histologically documented adenocarcinoma of the breast and 184 breast clinic controls.

There were significant mean differences in 1,25-D levels (pmol ml−1) between breast cancer cases and controls; white cases had lower 1,25-D levels than white controls (mean difference ± SE: −11.08 ± 0.76), and black cases had higher 1,25-D levels than black controls (mean difference ± SE: 4.54 ± 2.14), although the number of black women in the study was small. After adjustment for age, assay batch, month of blood draw, clinic and sample storage time, the odds ratio (95% confidence interval, CI) for lowest relative to highest quartile was 5.2 (95% CI 2.1, 12.8) for white cases and controls. The association in white women was stronger in women above the median age of 54 than in younger women, 4.7 (95% CI 2.1, 10.2) vs. 1.5 (95% CI 0.7, 3.0). There were no case–control differences in 25-D levels in either group.

These data are consistent with a protective effect of 1,25-D for breast cancer in white women.

To assess the reproducibility and validity of a semiquantitative food frequency questionnaire (FFQ) to classify children and adolescents in terms of daily servings of fruits and vegetables and intake of calories, protein, fat, carbohydrate, dietary fibre, vitamin C, phosphorous, calcium and iron.

FFQs were collected in the autumn of 1993 and 1994. Four 24-hour diet recalls were collected during the same 1-year period and their mean was compared to the FFQ diet estimates.

Low income, inner-city state schools.

A sample of 109 inner-city fourth to seventh grade students.

The 1-year reproducibility of the FFQ, assessed with Spearman correlations, was lower among the fourth and fifth (range: r = −0.26 to 0.40) than the sixth and seventh grade students (range: r = 0.18–0.47). After adjusting for day-to-day variation in dietary intake, for most nutrients and foods the correlations between the FFQ and the 24-hour recalls remained greater among the junior high school students (fourth to fifth grade range: r = 0.0–0.42; sixth to seventh grade range: = 0.07–0.76).

Inner-city sixth and seventh grade students demonstrated the ability to provide valid estimates of intake of calories, carbohydrate, calcium, phosphorous, iron and vitamin C over the past year. However, children in the fourth and fifth grades experienced some difficulty in completing the FFQ. Our results suggest that, before using this instrument with fourth and fifth grade children, investigators should assess whether study participants can think abstractly and are familiar with the concept of ‘average intake’.

Diet validation research was conducted to compare the respondents' reporting of dietary intake in a food frequency questionnaire (FFQ) with intake reported in food recalls. Because the population received annual salary increments that could modify food intake, diet validation studies (DVSs) were conducted during two time intervals.

A 99-item FFQ was administered by an interviewer twice in a 1-year interval, and responses to each FFQ item were compared with 28 days of interviewer-administered food recalls that were collected in four 1-week intervals during each season of 1992/93. The second validation study in 1995/96 had a similar design to the earlier one.

A prospective cohort study of lung cancer among tin miners in China was initiated in 1992, with dietary and other risk factors updated annually.

Among a cohort of high risk tin miners for lung cancer, two different samples (n = 141 in 1992/93, and n = 113 in 1995/96) for each diet validation study were randomly selected from four mine units, that were representative of all worker units.

Miners reported a significantly higher average frequency of intake of foods in the food recalls than the FFQ, with few exceptions. Deattenuated Pearson correlation coefficients of the frequency of food intake between the FFQ and food recalls were in the range of –0.40 to 0.72 in both studies, with higher positive correlations for beverages and cereal staples than for animal protein sources, vegetables, fruits and legumes. The percentage of individuals with exact agreement in the extreme quartiles of intake in the food recalls and FFQ ranged from 0 to 100% in both studies.

Among Chinese miners, the range in correlations between the food recalls and the FFQ were due to: (i) market availability of foods during the food recall weeks compared to their annual reported intake in the FFQ; (ii) cultural perception of time; and (iii) differences in how the intake of mixed dishes and their multi-ingredient foods were reported in the recalls vs. the FFQ. The range in the percentage of agreement in the same quartiles and the changes in food intake over time may have implications for the analysis of the diet-disease relationship in this cohort.