Elderly people may be at particular risk of Zn deficiency due to an increased prevalence of malnutrition. The aim of the present study was to evaluate the Zn status in community-living elderly people at risk of malnutrition.

Cross-sectional population-based survey. Individuals at risk of malnutrition were identified by the Malnutrition Universal Screening Tool. Zn status was assessed by measuring serum Zn. Logistic regression was performed to evaluate the association between the risk of malnutrition and Zn deficiency.

Municipality of Tromsø, Norway.

Random sample of 743 men and 778 women aged 65–87 years.

Zn deficiency was found in 10·1 % of the participants, including 13·1 % of the men and 7·3 % of the women. Among the men and women at risk of malnutrition, 31·0 % and 12·7 %, respectively, had Zn deficiency. In a model adjusted for age, gender, serum albumin and smoking status, Zn deficiency was positively associated with the risk of malnutrition (OR=2·2; 95 % CI 1·3, 3·6).

Overall, Zn deficiency was found in one out of ten community-living elderly people and was associated with the risk of malnutrition. Our results encourage the assessment of Zn status in elderly people at risk of malnutrition, with a special emphasis on elderly men.

Standard portions or substitution of missing portion sizes with medians may generate bias when quantifying the dietary intake from FFQ. The present study compared four different methods to include portion sizes in FFQ.

We evaluated three stochastic methods for imputation of portion sizes based on information about anthropometry, sex, physical activity and age. Energy intakes computed with standard portion sizes, defined as sex-specific medians (median), or with portion sizes estimated with multinomial logistic regression (MLR), ‘comparable categories’ (Coca) or k-nearest neighbours (KNN) were compared with a reference based on self-reported portion sizes (quantified by a photographic food atlas embedded in the FFQ).

The Danish Health Examination Survey 2007–2008.

The study included 3728 adults with complete portion size data.

Compared with the reference, the root-mean-square errors of the mean daily total energy intake (in kJ) computed with portion sizes estimated by the four methods were (men; women): median (1118; 1061), MLR (1060; 1051), Coca (1230; 1146), KNN (1281; 1181). The equivalent biases (mean error) were (in kJ): median (579; 469), MLR (248; 178), Coca (234; 188), KNN (−340; 218).

The methods MLR and Coca provided the best agreement with the reference. The stochastic methods allowed for estimation of meaningful portion sizes by conditioning on information about physiology and they were suitable for multiple imputation. We propose to use MLR or Coca to substitute missing portion size values or when portion sizes needs to be included in FFQ without portion size data.

Analysing dietary data to capture how individuals typically consume foods is dependent on the coding variables used. Individual foods consumed simultaneously, like coffee with milk, are given codes to identify these combinations. Our literature review revealed a lack of discussion about using combination codes in analysis. The present study identified foods consumed at mealtimes and by race when combination codes were or were not utilized.

Duplicate analysis methods were performed on separate data sets. The original data set consisted of all foods reported; each food was coded as if it was consumed individually. The revised data set was derived from the original data set by first isolating coded foods consumed as individual items from those foods consumed simultaneously and assigning a code to designate a combination. Foods assigned a combination code, like pancakes with syrup, were aggregated and associated with a food group, defined by the major food component (i.e. pancakes), and then appended to the isolated coded foods.

Healthy Aging in Neighborhoods of Diversity across the Life Span study.

African-American and White adults with two dietary recalls (n 2177).

Differences existed in lists of foods most frequently consumed by mealtime and race when comparing results based on original and revised data sets. African Americans reported consumption of sausage/luncheon meat and poultry, while ready-to-eat cereals and cakes/doughnuts/pastries were reported by Whites on recalls.

Use of combination codes provided more accurate representation of how foods were consumed by populations. This information is beneficial when creating interventions and exploring diet–health relationships.

To compare commonly used dietary screeners for fat intake and fruit and vegetable intake with 24 h dietary recalls among low-income, overweight and obese African-American women.

Three telephone interviews were completed; measures included two 24 h dietary recalls (a weekday and weekend day) using the Nutrition Data System for Research software, the Behavioral Risk Factor Surveillance System’s (BRFSS) Fruit and Vegetable Consumption Module and the National Cancer Institute’s (NCI) Percentage Energy from Fat Screener.

Participants were recruited from three federally qualified health centres in south-west Georgia, USA.

Participants (n 260) were African-American women ranging in age from 35 to 65 years. About half were unemployed (49·6 %) and 58·7 % had a high-school education or less. Most were obese (88·5 %), with 39·6 % reporting a BMI≥40·0 kg/m2.

Mean fruit and vegetable intake reported from the 24 h dietary recall was 2·66 servings/d compared with 2·79 servings/d with the BRFSS measure. The deattenuated Pearson correlation was 0·22, with notable variation by weight status, education level and age. Mean percentage of energy from fat was 35·5 % as reported from the 24 h dietary recall, compared with 33·0 % as measured by the NCI fat screener. The deattenuated Pearson correlation was 0·38, also with notable variation by weight status, education level and age.

Validity of brief dietary intake measures may vary by demographic characteristics of the sample. Additional measurement work may be needed to accurately measure dietary intake in obese African-American women.

To construct and evaluate an independent Children’s Index of Diet Quality (CIDQ).

A food consumption questionnaire, which contained twenty-five multiple-item questions on eating and food intake, was formulated and evaluated against 7 d food records. Key questions that best reflected a healthy diet, defined in criteria set by the nutrient recommendations, were searched and validated by correlation and analyses of receiver-operating characteristic curves.

A cohort of a young population of South-West Finland.

Participants (n 400) were 2–6-year-old children.

Fifteen questions were identified to best depict the children’s diet quality in reference to the recommendations. These questions were scored, summarized and further constructed into a three-class index (good, moderate and poor dietary quality) where higher scores depicted better diet quality. The CIDQ cut-off score of 14 points for good dietary quality had a sensitivity of 0·59 and a specificity of 0·82 and the cut-off score of 10 points, for at least moderate dietary quality, had a sensitivity of 0·77 and a specificity of 0·69. Higher index scores were related to higher dietary intakes of several vitamins, lower dietary intakes of SFA and cholesterol, and further with lower serum cholesterol and higher serum vitamin C concentrations.

The three-class food index was found to represent diet quality as defined in recommendations and evaluated against nutrient intakes from food diaries and biochemical markers. This self-standing index could provide an effective and low-burden method to obtain information about diet quality and guide future recommendations.

To date, no data exist on the agreement of food choice measured using an online tool with subsequent actual consumption. This needs to be shown before food choice, measured by means of an online tool, is used as a dependent variable to examine intake in the general population.

A ‘web-buffet’ was developed to assess food choice.

Choice was measured as planned meal composition from photographic material; respondents chose preferred foods and proportions for a main meal (out of a possible 144 combinations) online and the validity was assessed by comparison of a meal composed from a web-buffet with actual food intake 24–48 h later. Furthermore, correlations of food preferences, energy needs and health interest with meals chosen from the web-buffet were analysed.

Students: n 106 (Study I), n 32 (Study II).

Meals chosen from the web-buffet (mean=2998 kJ, sd=471 kJ) agreed with actual consumption (rs=0·63, P<0·001) but were on average 367 kJ (10·5 %) lower in energy than consumed meals (mean=3480 kJ, sd=755 kJ). Preferences were highly associated with chosen amounts and health interest was negatively correlated with the energy selected (rs=−0·40, P<0·001).

Meal composition choice in the web-buffet agrees sufficiently well with actual intake to measure food choice as a dependent variable in online surveys. However, we found an average underestimation of subsequent consumption. High correlations of preferences with chosen amounts and an inverse association of health interest with total energy further indicate the validity of the tool. Applications in behavioural nutrition research are discussed.

To assess the potential contribution of foods fortified with folic acid (FA) to target population intakes when included as part of a healthy breakfast.

Breakfast models aligned with the Spanish Dietary Guidelines were studied using the recommended, average and 95th percentile of serving sizes consumed by women of childbearing age. Food composition data were obtained from a database including FA analytical data from sixty-eight products and the Spanish food composition tables. Different scenarios were assessed with the inclusion of one, two or three FA-fortified products and with two different fortification levels: ≤33 µg/serving (L1) and ≥70 µg/serving (L4). FA contents provided by the different models for each scenario were compared with the Recommended Nutrient Intake (RNI) for folate and the Upper Level (UL) of intake for FA.

Madrid Region, Spain.

Women aged 16–49 years were considered.

Overall, simulation of ten breakfast models and three scenarios of product inclusion accounted for 20–25 % of total daily energy recommendations for women. Unfortified breakfast models provided on average 4–23 % of the folate RNI. Inclusion of one L4 FA-fortified food contributed 20–60 % of the RNI. Fortified yoghurt and milk had the highest FA contents per serving. Scenarios with two or three fortified products delivered 40–80 % of the RNI. None of the evaluated models exceeded the FA UL.

At existing levels of FA fortification, inclusion of fortified products as part of a regular breakfast meal could positively impact the nutritional quality of women’s diet without involving a risk of excessive FA exposure.

To determine the presence of nutrition labels on pre-packaged food products, as well as to analyse the types of presentation.

This was a descriptive study. The following characteristics were analysed: (i) presence and placement of the nutrition declaration (either as front-of-pack (FOP) or back-of-pack (BOP)); (ii) content of the presented information; (iii) presence of nutrition and health claims; and (iv) legibility of the written information.

Three different types of retailers in Belgrade, Serbia.

A total of 2138 pre-packaged food products from ten categories.

A nutrition declaration was found on 65·9 % of all tested products. It was displayed on the back of the packaging of 62·7 % of products and on the front of the packaging of 19·1 % of products. BOP was the most commonly observed in breakfast cereals, soft drinks, milk and instant soups (in total over 90 %), and the least common in meat products (21·5 %). FOP was predominantly displayed on breakfast cereals (65·0 %) and the least frequently on milk products (2·4 %). The ‘Big 4’ (energy value, protein, carbohydrate and fat contents) and the ‘Big 4 with additional information’ figured on 40·9 % of products. The ‘Big 8’ (‘Big 4’ plus sugar, saturated fat, fibre and sodium contents) and the ‘Big 8 with additional information’ were present less frequently (20·5 %). Nutrition claims and health claims appeared on very few products (6·6 % and 6·3 %, respectively). The proportion of products with insufficient legibility was 31·5 %.

Nutrition labelling in Belgrade, Serbia is not satisfactory. Mandatory regulations may be the best way to improve the current situation.

To evaluate the associations of women’s autonomy and social support with infant and young child feeding practices (including consumption of highly processed snacks and sugar-sweetened beverages) and nutritional status in rural Nicaragua.

Cross-sectional study. Feeding practices and children’s nutritional status were evaluated according to the WHO guidelines complemented with information on highly processed snacks and sugar-sweetened beverages. Women’s autonomy was assessed by a seventeen-item questionnaire covering dimensions of financial independence, household-, child-, reproductive and health-related decision making and freedom of movement. Women’s social support was determined using the Duke-UNC Functional Social Support Questionnaire. The scores attained were categorized into tertiles.

Los Cuatro Santos area, rural Nicaragua.

A total of 1371 children 0–35 months of age.

Children of women with the lowest autonomy were more likely to be exclusively breast-fed and continue to be breast-fed, while children of women with middle level of autonomy had better complementary feeding practices. Children of women with the lowest social support were more likely to consume highly processed snacks and/or sugar-sweetened beverages but also be taller.

While lower levels of autonomy and social support were independently associated with some favourable feeding and nutrition outcomes, this may not indicate a causal relationship but rather that these factors reflect other matters of importance for child care.

The purpose of the present study was to examine the association between parental eating behaviours and dietary patterns and feeding practices of infants and young children.

Data on infant-feeding practices were collected from each infant’s birth via parentally self-administered follow-up diaries. Three questionnaires, the Three-Factor Eating Questionnaire, the Food Neophobia Scale and the Index of Diet Quality, were administered when the children were aged 4 and 13 months.

South-western Finland.

Families participating in the STEPS longitudinal cohort study (n 1797).

Mean duration of exclusive breast-feeding was 2·4 months and total duration of breast-feeding averaged 8·1 months. The first solid food was introduced into children’s diets at the age of 3·9 months, on average. Mothers with highly restrictive eating were more likely to introduce solid foods sooner than mothers who ranked lower in these behaviours (3·8 months v. 4·0 months, P=0·012). Neophobic mothers breast-fed exclusively (2·0 v. 2·6 months, P=0·038) and in total (7·2 v. 8·5 months, P=0·039) for shorter times than average mothers, even after adjusting for various demographic characteristics. Fathers’ diet quality was associated with total breast-feeding duration and with introduction of complementary foods in unadjusted analyses and with total breast-feeding duration also after adjusting for confounding factors.

Mothers’ and fathers’ eating patterns and practices are associated with the feeding practices of infants and young children. Health promotion interventions seeking to improve parents’ eating patterns might lead to more favourable feeding practices for infants and young children.

To test the hypothesis that maternal psychological profiles relate to children’s quality of diet.

Cross-sectional study. Mothers provided information on their health-related psychological factors and aspects of their child’s mealtime environment. Children’s diet quality was assessed using an FFQ from which weekly intakes of foods and a diet Z-score were calculated. A high score described children with a better quality diet. Cluster analysis was performed to assess grouping of mothers based on psychological factors. Mealtime characteristics, describing how often children ate while sitting at a table or in front of the television, their frequency of takeaway food consumption, maternal covert control and food security, and children’s quality of diet were examined, according to mothers’ cluster membership.

Mother–child pairs (n 324) in the Southampton Initiative for Health. Children were aged 2–5 years.

Hampshire, UK.

Two main clusters were identified. Mothers in cluster 1 had significantly higher scores for all psychological factors than mothers in cluster 2 (all P<0·001). Clusters were termed ‘more resilient’ and ‘less resilient’, respectively. Children of mothers in the less resilient cluster ate meals sitting at a table less often (P=0·03) and watched more television (P=0·01). These children had significantly poorer-quality diets (β=−0·61, 95 % CI −0·82, −0·40, P≤0·001). This association was attenuated, but remained significant after controlling for confounding factors that included maternal education and home/mealtime characteristics (P=0·006).

The study suggests that mothers should be offered psychological support as part of interventions to improve children’s quality of diet.

To study how different meals contribute to intakes of fruits, vegetables, fish and whole grains in a group of Norwegian adults and in subgroups of this population. Moreover, to investigate the consequences of skipping the meal contributing most to the intake of each food group (main contributing meal).

Cross-sectional dietary survey in Norwegian adults. Dietary data were collected using two non-consecutive telephone-administered 24 h recalls. The recorded meal types were breakfast, lunch, dinner, supper/evening meal and snacks.

Nationwide, Norway (2010–2011).

Adults aged 18–70 years (n 1787).

Dinner was the main contributing meal for fish and vegetables, while snacks were the main contributing meal for fruit intake. For whole grains, breakfast was the main contributing meal. The main contributing meal did not change for any of the food groups when studying subgroups of the participants according to intake of each food group, educational level or age. A substantially lower intake of the food groups in question was found on days when the main contributing meal was skipped.

Intakes of fruits, vegetables, fish and whole grains largely depend on one meal type. Inclusion of these foods in other meals in addition to the main contributing meal, preferably replacing energy-dense nutrient-poor foods, should be promoted.

We examined the association between unhealthy snacking at school and academic outcomes in students from the Santiago Metropolitan Region (Chile).

Cross-sectional population-based study.

We measured the nutritional quality of snacks at school using an FFQ, and accounting for the amounts of saturated fat, fibre, sugar and salt in the foods, and academic outcomes using national standardized test scores in Language and Mathematics. Multivariate regression analyses modelled the relationship between unhealthy snacking at school (exposure), potential confounders and performance in Mathematics and Language (outcomes).

Random sample of 1073 students (13·1 (sd 2·3) years old) attending public, partially subsidized and private schools.

Fifty-six per cent of students ate items at snack time that were high in fat, sugar, salt and energy, and thus were considered to have unhealthy snaking. Thirty-six per cent and 8 % were considered to have poor-to-fair and healthy snacking, respectively. Unhealthy snacking significantly lowered the odds of good academic performance in both domains. Students having unhealthy snacks were 56 % less likely to pass in Language (fully adjusted OR=0·44; 95 % CI 0·23, 0·85) and 66 % less likely to pass in Mathematics (fully adjusted OR=0·34; 95 % CI 0·19, 0·64) compared with students having healthy snack items.

Schoolchildren eating unhealthy foods at snack time had worse academic performance in Language and Mathematics, as measured by a standardized test. Although association does not imply causation, these findings support the notion that academic and health-related behaviours are linked. More research is needed on the effect of school health programmes on educational outcomes.

The purpose of the present study was to examine the association between soya food consumption and insulin resistance using baseline data of the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study in Tokushima, Japan.

This cross-sectional study included 1274 subjects, aged 34–70 years at baseline, living in Tokushima Prefecture between 2008 and 2013. Fasting blood samples were collected and information on lifestyle characteristics including soya food intake and medical history were obtained using a structured self-administered questionnaire. The homeostasis model assessment of insulin resistance (HOMA-IR) was measured and those with HOMA-IR≥2·5 were defined as having insulin resistance. Multiple logistic regression models were used to analyse the association between soya product intake and the prevalence of insulin resistance.

Rural communities located in Tokushima Prefecture, Japan, between 2008 and 2013.

A total of 1148 adults (565 men and 583 women), aged 34–70 years.

The frequency of intake of miso soup, total non-fried soya products and total soya products showed significant inverse dose–response relationships with insulin resistance, after adjustments for potential confounders. When soya product intake was calculated as soya protein and isoflavone, the odds ratios of insulin resistance decreased significantly as the estimated intake of soya protein increased. Furthermore, significant inverse dose–response relationships were observed for total non-fried soya products and total soya products, after adjustment for total vegetable or total fibre consumption.

The present results indicate that the intake of soya products and non-fried soya products is associated with reduced insulin resistance in the Japanese population.

The present study aimed to review the association of conjugated linoleic acid (CLA) consumption in two forms, foods enriched in CLA and CLA supplements, with serum lipid profile in human studies.

Systematic review and meta-analysis.

Search process was conducted in PubMed, Cochrane Library, Google Scholar, Scopus and Science Direct. Clinical trials that investigated the association of CLA intakes either in the form of supplements or enriched foods with lipid profile in healthy adults were included. All outcomes were recorded as continuous variables, and the effect size was measured by analysis of the mean and standard deviation before and after the intervention for case and control groups.

Healthy adult population.

CLA supplementation was associated with a significant decrease in LDL cholesterol (mean difference=−0·218; 95 % CI −0·358, −0·077; P=0·002), a non-significant decrease in HDL cholesterol (mean difference=−0·051; 95 % CI −0·188, 0·086; P=0·468), a non-significant increase in total cholesterol (mean difference=0·009; 95 % CI −0·128, 0·146; P=0·896) and a non-significant decrease in TAG (mean difference=−0·065; 95 % CI −0·20, 0·07; P=0·344). Foods enriched with CLA were associated with significantly decreased LDL cholesterol (mean difference=−0·231; 95 % CI −0·438, −0·024; P=0·028), non-significantly increased HDL-C (mean difference=0·075; 95 % CI −0·121, 0·270; P=0·455), non-significantly decreased total cholesterol (mean difference=−0·158; 95 % CI −0·349, 0·042; P=0·124) and non-significantly decreased TAG (mean difference=−0·078; 95 % CI −0·274, 0·117; P=0·433).

According to our analysis, consumption of foods enriched with CLA or CLA supplements has favourable effects on LDL cholesterol levels.

The Social Ecological Model (SEM) has been used to describe the aetiology of childhood obesity and to develop a framework for prevention. The current paper applies the SEM to data collected at multiple levels, representing different layers of the SEM, and examines the unique and relative contribution of each layer to children’s weight status.

Cross-sectional survey of randomly selected households with children living in low-income diverse communities.

A telephone survey conducted in 2009–2010 collected information on parental perceptions of their neighbourhoods, and household, parent and child demographic characteristics. Parents provided measured height and weight data for their children. Geocoded data were used to calculate proximity of a child’s residence to food and physical activity outlets.

Analysis based on 560 children whose parents participated in the survey and provided measured heights and weights.

Multiple logistic regression models were estimated to determine the joint contribution of elements within each layer of the SEM as well as the relative contribution of each layer. Layers of the SEM representing parental perceptions of their neighbourhoods, parent demographics and neighbourhood characteristics made the strongest contributions to predicting whether a child was overweight or obese. Layers of the SEM representing food and physical activity environments made smaller, but still significant, contributions to predicting children’s weight status.

The approach used herein supports using the SEM for predicting child weight status and uncovers some of the most promising domains and strategies for childhood obesity prevention that can be used for designing interventions.

To investigate the resource efficiency and environmental impacts of producing one kilogram of edible protein from two plant- and three animal-protein sources.

Primary source data were collected and applied to commodity production statistics to calculate the indices required to compare the environmental impact of producing 1 kg of edible protein from kidney beans, almonds, eggs, chicken and beef. Inputs included land and water for raising animals and growing animal feed, total fuel, and total fertilizer and pesticide for growing the plant commodities and animal feed. Animal waste generated was computed for the animal commodities.

Desk-based study at the Department of Nutrition and Department of Occupational and Environmental Health, Loma Linda University.

None.

To produce 1 kg of protein from kidney beans required approximately eighteen times less land, ten times less water, nine times less fuel, twelve times less fertilizer and ten times less pesticide in comparison to producing 1 kg of protein from beef. Compared with producing 1 kg of protein from chicken and eggs, beef generated five to six times more waste (manure) to produce 1 kg of protein.

The substitution of beef with beans in meal patterns will significantly reduce the environmental footprint worldwide and should also be encouraged to reduce the prevalence of non-communicable chronic diseases. Societies must work together to change the perception that red meat (e.g. beef) is the mainstay of an affluent and healthy diet.

Non-pharmacological approaches to the treatment of depression and anxiety are of increasing importance, with emerging evidence supporting a role for lifestyle factors in the development of these disorders. Observational evidence supports a relationship between habitual diet quality and depression. Less is known about the causative effects of diet on mental health outcomes. Therefore a systematic review was undertaken of randomised controlled trials of dietary interventions that used depression and/or anxiety outcomes and sought to identify characteristics of programme success.

A systematic search of the Cochrane, MEDLINE, EMBASE, CINAHL, PubMed and PyscInfo databases was conducted for articles published between April 1971 and May 2014.

Of the 1274 articles identified, seventeen met eligibility criteria and were included. All reported depression outcomes and ten reported anxiety or total mood disturbance. Compared with a control condition, almost half (47 %) of the studies observed significant effects on depression scores in favour of the treatment group. The remaining studies reported a null effect. Effective dietary interventions were based on a single delivery mode, employed a dietitian and were less likely to recommend reducing red meat intake, select leaner meat products or follow a low-cholesterol diet.

Although there was a high level of heterogeneity, we found some evidence for dietary interventions improving depression outcomes. However, as only one trial specifically investigated the impact of a dietary intervention in individuals with clinical depression, appropriately powered trials that examine the effects of dietary improvement on mental health outcomes in those with clinical disorders are required.