Fe is an essential micronutrient required for optimal cognitive and physical performance. Cross-sectional studies indicate that training degrades Fe status in female military personnel; however, longitudinal studies to measure the direct impact of military training on Fe status and performance have not been conducted. As such, the objective of the present study was to determine the longitudinal effects of military training on Fe status in female soldiers. Fe status was assessed in ninety-four female soldiers immediately before and following a 9-week basic combat training (BCT) course. Fe status indicators included Hb, erythrocyte distribution width (RDW), serum ferritin, transferrin saturation and soluble transferrin receptor (sTfR). A 2-mile (3·2 km) run test was performed at the end of BCT to assess aerobic performance. Fe status was affected by BCT, as all Fe status indicators, excluding Hb, were diminished (P ≤ 0·01) at the end of BCT. Fe status indicators at the end of BCT (Hb and RDW) were associated (P ≤ 0·05) with running performance, as was the change in sTfR over the training period (r 0·320; P ≤ 0·05). In conclusion, Fe status in female soldiers is degraded during BCT, and degraded Fe status is associated with diminished aerobic performance. Female athletes and military personnel should strive to maintain Fe status to optimise physical performance.

Large food portions may be facilitating excess energy intake (EI) and adiposity among adults. The present study aimed to assess the extent to which EI and amounts of foods consumed are influenced by the availability of different-sized food portions. A randomised within-subject cross-over, fully residential design was used, where forty-three (twenty-one men and twenty-two women) normal-weight and overweight adults were randomly allocated to two separate 4 d periods where they were presented with either ‘standard’ or ‘large’ food portions of the same foods and beverages. The main outcome measures were the amount of food (g) and EI (MJ) consumed throughout each study period. Mean EI over 4 d was significantly higher on the large portion condition compared with the standard condition in the total group (59·1 (sd 6·6) v. 52·2 (sd 14·3) MJ; P = 0·020); men and women increased their EI by 17 % (10 (sd 6·5) MJ; P < 0·001) and 10 % (4 (sd 6·5) MJ; P = 0·005) respectively when served the large food portions relative to the standard food portions. The increased intakes were sustained over the 4 d in the large portion condition with little evidence of down-regulation of EI and food intake being made by subjects. Increased food portion size resulted in significant and sustained increases in EI in men and women over 4 d under fully residential conditions. The availability and consumption of larger portions of food may be a significant factor contributing to excess EI and adiposity.

Worldwide dietary data for nutrition monitoring and surveillance are commonly derived from food balance sheets (FBS) and household budget surveys (HBS). We have compared food supply from FBS and food availability data from HBS among eighteen European countries and have estimated the extent to which they correlate, focusing on food groups which are comparably captured by FBS and HBS and for which there is epidemiological evidence that they can have a noticeable impact on population mortality. Spearman's correlation coefficient was +0·78 (P < 10− 3) for vegetables (including legumes),+0·76 (P < 10− 3) for fruits, +0·69 (P < 10− 3) for fish and seafood and +0·93 (P < 10− 3) for olive oil. With respect to meat and meat products, the coefficient was lower at +0·39 (P = 0·08). Moreover, we have examined whether the supply (FBS) or the availability (HBS) of food groups known or presumed to have beneficial effect on the occurrence of CHD and total cancer can predict overall, coronary and cancer mortality in ecological analyses. After controlling for purchasing power parity-adjusted gross domestic product and tobacco smoking we found that for vegetables, fruits, fish and seafood, as well as for olive oil, both the FBS and the HBS estimates were inversely associated with all three indicators of mortality, although the number of countries with complete information on all study variables hindered formal statistical documentation (P>0·05 in some instances). FBS and HBS have their own strengths and weaknesses, but they may complement each other in dietary assessments at the population level.

The BMI cut-score used to define overweight and obesity was derived primarily using data from Caucasian men and women. The present study evaluated the racial/ethnic bias of BMI to estimate the adiposity of young men and women (aged 17–35 years) using dual-energy X-ray absorptiometry (DXA) determination of percentage body fat (DXA-BF%) as the referent standard. The samples were 806 women and 509 men who were tested from one to three times over 9 months providing 1300 observations for women and 820 observations for men. Linear mixed models (LMM) regression showed that with age and BMI controlled, DXA-BF% of African-American (AA) men and women, Asian-Indian men and women, Hispanic women and Asian women significantly differed from non-Hispanic white (NHW) men and women. For the same BMI of NHW women, the DXA-BF% of AA women was 1·76 % lower, but higher for Hispanic (1·65 %), Asian (2·65 %) and Asian-Indian (5·98 %) women. For the same BMI of NHW men, DXA-BF% of AA men was 4·59 % lower and 4·29 % higher for Asian-Indian men. Using the recommended BMI cut-scores to define overweight and obesity systematically overestimated overweight and obesity prevalence for AA men and women, and underestimated prevalence for Asian-Indian men and women, Asian women and Hispanic women. The present study extends the generalisability of research documenting the racial/ethnic bias of the universal overweight and obesity BMI cut-scores.

The objective was to compare ethnic differences in anthropometry, including size, proportions and fat distribution, and body composition in a cohort of seventy Caucasian (forty-four boys, twenty-six girls) and seventy-four urban Indigenous (thirty-six boys, thirty-eight girls) children (aged 9–15 years). Anthropometric measures (stature, body mass, eight skinfolds, thirteen girths, six bone lengths and five bone breadths) and body composition assessment using dual-energy X-ray absorptiometry were conducted. Body composition variables including total body fat percentage and percentage abdominal fat were determined and together with anthropometric indices, including BMI (kg/m2), abdominal:height ratio (AHtR) and sum of skinfolds, ethnic differences were compared for each sex. After adjustment for age, Indigenous girls showed significantly (P < 0·05) greater trunk circumferences and proportion of overweight and obesity than their Caucasian counterparts. In addition, Indigenous children had a significantly greater proportion (P < 0·05) of trunk fat. The best model for total and android fat prediction included sum of skinfolds and age in both sexes (>93 % of variation). Ethnicity was only important in girls where abdominal circumference and AHtR were included and Indigenous girls showed significantly (P < 0·05) smaller total/android fat deposition than Caucasian girls at the given abdominal circumference or AHtR values. Differences in anthropometric and fat distribution patterns in Caucasian and Indigenous children may justify the need for more appropriate screening criteria for obesity in Australian children relevant to ethnic origin.

Sensory-specific satiation (SSS) drives food selection and contributes to meal termination. We hypothesised that smaller sips would increase SSS due to increased oro-sensory exposure, irrespective of energy content. The objective was to determine the effects of sip size and energy content on ad libitum intake of orangeade and subjective SSS for orangeade. Orangeade intake and ratings of wanting and liking were measured before and after ad libitum orangeade consumption in a 2 × 2 cross-over design (n 53). Conditions differed in energy content (no-energy v. regular-energy orangeade) and in sip size (large, 20 g/sip v. small, 5 g/sip). The mean intake of both orangeades was lower when consumed with small sips than when consumed with large sips (regular-energy, 352 v. 493 g; no-energy, 338 v. 405 g; both P < 0·001). When consumed with large sips, the mean intake of no-energy orangeade was lower than that of regular-energy orangeade (P = 0·02). When consumed with small sips, subjective SSS (based on the desire to drink) was higher for no-energy orangeade than for regular-energy orangeade (P = 0·01), while mean intake was comparable. We concluded that smaller sip size, i.e. increased oro-sensory exposure per unit of consumption, can lower intake of sweet drinks. Only with low oro-sensory exposure (large sip size) was intake higher for an energy-containing sweet drink than for a no-energy sweet drink. This suggests that intake of sweet drinks is stimulated by (metabolic) reward value and inhibited by sensory satiation. This underpins the importance of SSS for meal termination.

For many epidemiological questions an overall indicator of healthy nutrition can be useful. Based on the data from the FFQ of the German Health Interview and Examination Study for children and adolescents (KiGGS) we developed a healthy nutrition score based on a comparison with current recommendations for children and adolescents. We observed independent and statistically significant relationships between the nutrition score and age, sex, socio-economic status, immigration background, level of urbanisation and residence in former East v. former West Germany. Furthermore, the nutrition score was statistically significantly related to serum concentrations of homocysteine (inverse association) and folate (positive associations). The construction of a healthy nutrition score appears to be useful for several reasons. For instance, our score can be used to summarise an abundance of dietary information to a single measure, to get an overall impression of diets of individuals or groups, which can be useful to detect certain risk groups.

This simulation study aimed to assess the change in saturated fat intake achieved by replacing one to three of the products contributing most to individual saturated fat intake by alternative products low in saturated fat. Food consumption data of 750 participants (aged 19–30 years) from a recent Dutch food consumption survey were used. For each participant, the three products (from different product groups) that contributed most to their saturated fat intake were ranked in order of diminishing contribution. These products were sequentially replaced by lower saturated fat alternatives that were available in Dutch supermarkets. Mean percentage energy (en%) from saturated fat and energy intake in kJ per d were calculated before and after each of the three replacements. Dutch cheese, meat (for dinner) and milk were the main contributors to saturated fat intake for most participants. Starting at a mean en% from saturated fat of 12·4, the three replacements together resulted in a mean reduction of 4·9 en% from saturated fat. The percentage of participants meeting the recommendation for saturated fat ( < 10 en%) increased from 23·3 % to 86·0 %. We conclude that the replacement of relatively few important high-saturated fat products by available lower-saturated fat alternatives can significantly reduce saturated fat intake and increase the proportion of individuals complying with recommended intake levels.

The increasing prevalence of overweight and obesity among children is of special concern. Inverse associations between sleep length and overweight have been found in children. Short sleeping hours result in hormonal changes, which increase perceived hunger and appetite. This could affect food intake, and consequently lead to overweight. The aim is to find out whether there is an association between adequate sleep and food consumption among 10–11-year-old school children in Finland. One thousand two hundred and sixty-five children (response rate 79 %), aged 9–11, from thirty-one schools filled in a questionnaire about their health behaviour. Inadequate sleep was measured as short sleeping hours during school nights and weekend nights, difficulties in waking up in the morning and tiredness during the day. Food consumption patterns were measured by two consumption indices, energy-rich foods and nutrient-dense foods, based on a short FFQ (sixteen items). Inadequate sleep is associated with food consumption patterns. Boys with shorter sleep duration during school nights, and who were felt tired during the day, were more likely to consume energy-rich foods. Girls with shorter sleep duration during school nights consumed more likely energy-rich foods and less likely nutrient-dense foods. Adjusting for physical activity and screen time weakened the explored associations. The associations with energy-rich foods were stronger for boys than for girls. Sleeping habits are associated with food consumption patterns. Shorter sleep duration during school nights in school children is associated with higher consumption of energy-rich foods.

Fe status is difficult to assess in the presence of infections. To assess the role of the acute- phase response (APR) and other predictors of serum ferritin and transferrin receptor, we conducted a cross-sectional study among pulmonary tuberculosis (PTB) patients in Mwanza, Tanzania. The acute- (serum ferritin) phase protein, serum α1-antichymotrypsin (ACT) and serum ferritin and serum soluble transferrin receptor (sTfR) were measured, and data on smoking, soil and alcohol intake, and infection status were collected. Linear regression analysis was used to assess the role of elevated serum ACT and other predictors of serum ferritin and serum sTfR. Of 655 patients, 81·2 % were sputum positive (PTB+) and 47·2 % HIV+. Mean serum ACT was 0·72 g/l, with 91·1 % above 0·4 g/l. Among females and males, respectively, geometric mean serum ferritin was 140·9 and 269·1 μg/l (P < 0·001), and mean serum sTfR 4·3 and 3·8 mg/l (P < 0·001). Serum sTfR was increased 0·5 mg/l and log serum ferritin increased linearly with serum ACT >0·4 g/l. PTB+ and HIV infection, alcohol drinking and smoking were the positive predictors of serum ferritin, and female sex, soil eating, Schistosoma mansoni and hookworm infection were the negative predictors. Similarly, smoking and HIV infection were the negative predictors of serum sTfR, and female sex, soil eating and PTB+ were the positive predictors. Serum ferritin and serum sTfR are affected by the APR, but may still provide information about Fe status. It may be possible to develop algorithms, based on the markers of the APR and Fe status, to assess the Fe status among the patients with tuberculosis or other infections eliciting an APR.

Analysis of the epidemiological effects of overall dietary patterns offers an alternative approach to the investigation of the role of diet in CHD. We analysed the role of blood lipid-related dietary patterns using a two-step method to confirm the prospective association of dietary pattern with incident CHD. Analysis is based on 7314 participants of the Whitehall II study. Dietary intake was measured using a 127-item FFQ. Reduced rank regression (RRR) was used to derive dietary pattern scores using baseline serum total and HDL-cholesterol, and TAG levels as dependent variables. Cox proportional hazard regression was used to confirm the association between dietary patterns and incident CHD (n 243) over 15 years of follow-up. Increased CHD risk (hazard ratio (HR) for top quartile: 2·01 (95 % CI 1·41, 2·85) adjusted for age, sex, ethnicity and energy misreporting) was observed with a diet characterised by high consumption of white bread, fried potatoes, sugar in tea and coffee, burgers and sausages, soft drinks, and low consumption of French dressing and vegetables. The diet–CHD relationship was attenuated after adjustment for employment grade and health behaviours (HR for top quartile: 1·81; 95 % CI 1·26, 2·62), and further adjustment for blood pressure and BMI (HR for top quartile: 1·57; 95 % CI 1·08, 2·27). Dietary patterns are associated with serum lipids and predict CHD risk after adjustment for confounders. RRR identifies dietary patterns using prior knowledge and focuses on the pathways through which diet may influence disease. The present study adds to the evidence that diet is an important risk factor for CHD.