To provide a better understanding of dietary intakes of pregnant women in low- and middle-income countries.

Systematic review was performed to identify relevant studies which reported nutrient intakes or food consumption of pregnant women in developing countries. Macronutrient and micronutrient intakes were compared by region and the FAO/WHO Estimated Average Requirements. Food consumption was summarized by region.

Developing countries in Africa, Asia, and the Caribbean and Central/South America.

Pregnant women in the second or third trimester of their pregnancies.

From a total of 1499 retrieved articles, sixty-two relevant studies were analysed. The ranges of mean/median intakes of energy, fat, protein and carbohydrate were relatively higher in women residing in the Caribbean and Central/South America than in Africa and Asia. Percentages of energy from carbohydrate and fat varied inversely across studies in all regions, whereas percentage of energy from protein was relatively stable. Among selected micronutrients, folate and Fe intakes were most frequently below the Estimated Average Requirements, followed by Ca and Zn. Usual dietary patterns were heavily cereal based across regions.

Imbalanced macronutrients, inadequate micronutrient intakes and predominantly plant-based diets were common features of the diet of pregnant women in developing countries. Cohesive public health efforts involving improving access to nutrient-rich local foods, micronutrient supplementation and fortification are needed to improve the nutrition of pregnant women in developing countries.

The objective of the current analysis was to explore the association of multiple micronutrients with Hb concentration among pregnant women in a South Asian setting, a topic that has not been adequately explored.

Sociodemographic, anthropometric and micronutrient status (plasma ferritin, transferrin receptor, retinol, α- and γ-tocopherol, folate, vitamin B12, Zn) and Hb concentration were assessed at early pregnancy.

The biochemical sub-study was nested within a double-blind, placebo-controlled, community-based vitamin A and β-carotene supplementation trial in rural north-western Bangladesh (JiVitA). All assessments were conducted before trial supplementation was initiated.

A systematic sample of 285 women was selected from those enrolled in the biochemical sub-study.

Seventeen per cent of women were mildly anaemic; moderate and severe anaemia was uncommon (2·1 %). α-Tocopherol, vitamin B12 and Zn deficiencies were common (43·5 %, 19·7 % and 14·7 %, respectively); however, vitamin A, folate and Fe deficiencies were comparatively rare (7·4 %, 2·8 % and <1 %, respectively). Plasma Zn, vitamin B12 and α-tocopherol were positively associated and plasma γ-tocopherol was negatively associated with Hb (P < 0·05) after adjustment for gestational age, inflammation status, season and nutritional status measured by mid-upper arm circumference.

Among pregnant women in rural Bangladesh with minimal Fe deficiency, plasma Zn, vitamin B12, and α- and γ-tocopherol concentrations were associated with Hb concentration. Appreciating the influence on Hb of micronutrients in addition to those with known associations with anaemia, such as Fe, folate, and vitamin A, is important when addressing anaemia in similar settings.

Adequate iodine and Fe intakes are imperative during pregnancy to prevent fetal defects, but such data are not available in the Democratic Republic of Congo. We aimed to assess iodine and Fe status in pregnant women from Lubumbashi.

Cross-sectional study. We measured urinary iodine concentration (UIC) in random urine samples using a modified Sandell–Kolthoff digestion method; the WHO reference medians were used to classify iodine intake as deficient, adequate, more than adequate or excessive. Serum ferritin concentrations were measured by immunoenzymatic assay and considered insufficient when <12 ng/ml.

Maternity units from rural, semi-urban and urban areas of Lubumbashi, Democratic Republic of Congo.

Two hundred and twenty-five randomly selected pregnant women attending prenatal consultation, seventy-five postpartum women and seventy-five non-pregnant women as controls.

Overall median UIC in pregnant women was 138 (interquartile range: 105–172) μg/l, indicating iodine deficiency, whereas postpartum and non-pregnant women had adequate iodine intake: median UIC = 144 μg/l and 204 μg/l, respectively. Median UIC values were lower in late pregnancy than in early pregnancy: in the first, second and third trimester respectively 255 μg/l, 70 μg/l and 88 μg/l in the rural area; 306 μg/l, 166 μg/l and 68 μg/l in the semi-urban area; and 203 μg/l, 174 μg/l and 99 μg/l in the urban area. Fe was insufficient in 39 % of pregnant women compared with 21 % of non-pregnant and postpartum women. In the third trimester, deficiencies in both iodine and Fe were high: 40 %, 12 % and 18 % in the rural, semi-urban and urban areas, respectively.

Our data suggest that pregnant women are at risk of iodine and Fe deficiencies in Lubumbashi. Country policies fighting against iodine and Fe deficiencies during pregnancy should be reinforced.

To describe the prevalence of iron depletion (ID), iron-deficiency anaemia (IDA) and risk of haemoconcentration during pregnancy and at delivery and to assess the influence of initial Fe stores and Fe supplementation on that prevalence.

Longitudinal study.

Hospital Universitari Sant Joan de Reus (Catalonia, Spain).

Two hundred and eighty-five pregnant women. Serum ferritin and Hb were measured in the first, second and third trimesters and at delivery. Women were classified according to initial Fe stores as ID or no ID (serum ferritin ≥12 μg/l) and according to Fe supplement use as supplemented or non-supplemented.

Initial ID was 16·2 %. At delivery, 45·7 % had ID, 13·5 % IDA and 13·3 % had risk of haemoconcentration. Initial ID and non-supplemented groups had significantly higher prevalences of ID and IDA and lower risk of haemoconcentration at delivery than the other groups. In the multiple logistic models, no initial ID and Fe supplementation exerted a protective effect against ID at delivery (adjusted OR = 0·28; 95 % CI 0·13, 0·58 and adjusted OR = 0·39; 95 % CI 0·22, 0·69, respectively). Moderate Fe supplementation did not seem to clearly prevent IDA (adjusted OR = 0·91; 95 % CI 0·42, 1·96) or to enhance the haemoconcentration (adjusted OR = 1·42; 95 % CI 0·58, 3·50).

The prevalence of ID and IDA was high in late pregnancy in healthy pregnant women, particularly in those with initial ID and/or those not taking supplements. Starting pregnancy with no ID and/or taking moderate Fe supplementation decreased the likelihood of ID at delivery. The risk of haemoconcentration was high at delivery, but did not seem to be promoted by Fe supplementation. Further research is necessary to determine the most appropriate nutritional advice for pregnant women.

To assess food and nutrient intakes and compliance with nutritional recommendations in pregnant women according to selected sociodemographic characteristics.

Cross-sectional study based on data from the INMA-Valencia cohort (Spain), which recruited pregnant women between 2004 and 2005. Information on maternal sociodemographics and anthropometry was collected. Dietary intake was assessed through an FFQ. Intakes of foods were compared with Spanish food-based dietary guidelines. Intake inadequacy for nutrients was assessed using the Dietary Reference Intakes of the US Institute of Medicine.

Valencia, Spain.

We studied 822 pregnant women who had information on dietary intake during their first trimester of pregnancy.

More than 50 % of pregnant women did not meet the guidelines for cereals and legumes; reported intakes of carbohydrates, n-3 and n-6 fatty acids were below recommendations and exceeded the total fat intake according to dietary references. Dietary inadequacy for folate, Fe and vitamin E ranged from 99 % to 68 %. Vegetable intake was related to age only. Younger and less educated women showed lower intakes of protein and n-3 fatty acids and higher intakes of trans-fatty acids as well as greater inadequacy for micronutrients. Spanish women reported lower intakes of fruit and carbohydrates and higher intakes of protein, total fat, SFA, MUFA and n-3 fatty acids compared with their foreign-born counterparts.

Women in the studied area have inadequate intakes of several nutrients relevant during pregnancy. Age, education and country of origin are factors significantly related to dietary intake and adequacy.

The aim of the present study was to examine the prevalence and associated factors of dietary supplement use, particularly supplements containing vitamin D and fatty acids, in pregnant women enrolled in a multi-national study.

The Environmental Determinants of Diabetes in the Young (TEDDY) study is a prospective longitudinal cohort study. Maternal dietary supplement use was self-reported through questionnaires at month 3 to 4 postpartum.

Six clinical research centres; three in the USA (Colorado, Georgia/Florida and Washington) and three in Europe (Sweden, Finland and Germany).

Mothers (n 7326) to infants screened for high-risk HLA-DQ genotypes of type 1 diabetes.

Ninety-two per cent of the 7326 women used one or more types of supplement during pregnancy. Vitamin D supplements were taken by 65 % of the women, with the highest proportion of users in the USA (80·5 %). Overall, 16 % of the women reported taking fatty acid supplements and a growing trend was seen in all countries between 2004 and 2010 (P < 0·0001). The use was more common in Germany (32 %) and the USA (24 %) compared with Finland (8·5 %) and Sweden (7·0 %). Being pregnant with the first child was a strong predictor for any supplement use in all countries. Low maternal age (<25 years), higher education, BMI ≥ 25·0 kg/m2 and smoking during pregnancy were factors associated with supplement use in some but not all countries.

The majority of the women used dietary supplements during pregnancy. The use was associated with sociodemographic and behavioural factors, such as parity, maternal age, education, BMI and maternal smoking.

To evaluate the effect of fibre intake on the evolution of maternal BMI from pregnancy to postpartum and to identify dietary patterns associated with fibre intake.

Cohort study. Food intake was obtained using an FFQ. Focused principal component analysis was used focusing on the variables: postpartum weight retention and total dietary fibre intake. Poisson regression models with robust variance were built in order to measure the effect of fibre intake during the postpartum period on obesity risk.

Primary care clinics in southern Brazil.

Pregnant women (n 370) were followed until the 5th month postpartum.

The highest contribution to fibre intake came from the consumption of beans. Consumption of bread and rice indicated a common Brazilian food pattern along with beans. Participants retained a median of 4·4 (interquartile range 0·6, 7·9) kg of weight gained during pregnancy. Obesity risk, defined as an unfavourable evolution of BMI during pregnancy and postpartum, was present in 189 (55·1 %) women. Individual food items did not have an important effect on weight retention. In Poisson regression adjusting for maternal age, pre-pregnancy BMI and total gestational weight gain, inadequate postpartum fibre intake increased obesity risk by 24 % (relative risk = 1·24; 95 % CI 1·05, 1·47).

Important maternal weight retention occurred in these women. Adequate fibre intake may reduce obesity risk in the period following childbirth.

Pre-pregnancy obesity has been associated with adverse birth outcomes. Poor essential fatty acid (EFA) and micronutrient status during pregnancy may contribute to these associations. We assessed the associations between pre-pregnancy BMI and nutritional patterns of maternal micronutrient and EFA status during mid-pregnancy.

A cross-sectional analysis from a prospective cohort study. Women provided non-fasting blood samples at ≤20 weeks’ gestation that were assayed for red cell EFA; plasma folate, homocysteine and ascorbic acid; and serum retinol, 25-hydroxyvitamin D, α-tocopherol, soluble transferrin receptors and carotenoids. These nutritional biomarkers were employed in a factor analysis and three patterns were derived: EFA, Micronutrients and Carotenoids.

The Antidepressant Use During Pregnancy Study, Pittsburgh, PA, USA.

Pregnant women (n 129).

After adjustment for parity, race/ethnicity and age, obese pregnant women were 3·0 (95 % CI 1·1, 7·7) times more likely to be in the lowest tertile of the EFA pattern and 4·5 (95 % CI 1·7, 12·3) times more likely to be in the lowest tertile of the Carotenoid pattern compared with their lean counterparts. We found no association between pre-pregnancy obesity and the Micronutrient pattern after confounder adjustment.

Our results suggest that obese pregnant women have diminished EFA and carotenoid concentrations.

To evaluate the ability of an FFQ, designed for use in Brazilian pregnant women, to estimate nutrient intakes during pregnancy.

A prospective study was conducted among 103 pregnant women attended by the Brazilian national health-care service. Food intake during pregnancy was evaluated by three 24 h dietary recalls (24hR), one per trimester of pregnancy, and also by two FFQ. The FFQ with eighty-five food items included questions about frequency of intake and portion sizes during two periods: the first 24 weeks of pregnancy and the pregnancy period as a whole. Deattenuated Pearson's correlation coefficients and joint classification into quartiles of nutrient intake were applied.

Ribeirão Preto, São Paulo State, Brazil.

One hundred and three pregnant women, aged 18–35 years.

Acceptable correlation coefficients (r > 0·35) were found for Ca, K, Zn, Mg, fibre, vitamin C, niacin and folic acid for intake for the first 24 weeks; and for energy, lipids, protein, carbohydrate, Fe, K, Zn, fibre, vitamin B6, riboflavin and niacin for the gestational period as a whole. A high proportion of study participants (≥70 %) were categorized into the same or adjacent quartiles for estimated energy, carbohydrate, Ca, K, fibre, Zn, cholesterol, vitamin A, riboflavin, niacin, vitamin C, vitamin E and folic acid. Gross misclassification ranged from 2·3 % (dietary fibre) to 12·5 % (vitamin A, thiamin and SFA).

The FFQ is a useful tool for assessing categories of nutrient intake during pregnancy, since a high proportion of women were classified into the same or adjacent quartiles.

FFQ are popular instruments for assessing dietary intakes in epidemiological studies but have not been validated for use in severely obese pregnancy. The aim of the present study was to compare nutrient intakes assessed by an FFQ with those obtained from a food diary among severely obese pregnant women.

Comparison of an FFQ containing 170 food items and a food diary for 4 d (three weekdays and one weekend day); absolute agreement was assessed using the paired t test and relative agreement by Pearson/Spearman correlation, cross-classification into tertiles and weighted kappa values.

Antenatal metabolic clinic for severely obese women.

Thirty-one severely obese (BMI at booking ≥40·0 kg/m2) and thirty-two lean control (BMI = 20·0–24·9 kg/m2) pregnant women.

The findings showed that nutrient intakes estimated by the FFQ were significantly higher than those from the food diary; average correlation was 0·32 in obese and 0·43 in lean women. A mean of 48·5 % of obese and 47·3 % of lean women were correctly classified, while 12·9 % (obese) and 10·0 % (lean) were grossly misclassified. Weighted κ values ranged from −0·04 to 0·79 in obese women and from 0·16 to 0·78 in lean women.

Overall, the relative agreement between the FFQ and food diary was lower in the obese group than in the lean group, but was comparable with earlier studies conducted in pregnant women. The validity assessments suggest that the FFQ is a useful tool for ranking severely obese pregnant women according to the levels of their dietary intake.

The health benefits of exercise are clear. In targeting interventions it would be valuable to know whether characteristic patterns of physical activity (PA) are associated with particular population subgroups. The present study used cluster analysis to identify characteristic hourly PA patterns measured by accelerometer.

Cross-sectional design.

Objectively measured PA in Hong Kong adults.

Four-day accelerometer data were collected during 2009 to 2011 for 1714 participants in Hong Kong (mean age 44·2 years, 45·9 % male).

Two clusters were identified, one more active than the other. The ‘active cluster’ (n 480) was characterized by a routine PA pattern on weekdays and a more active and varied pattern on weekends; the other, the ‘less active cluster’ (n 1234), by a consistently low PA pattern on both weekdays and weekends with little variation from day to day. Demographic, lifestyle, PA level and health characteristics of the two clusters were compared. They differed in age, sex, smoking, income and level of PA required at work. The odds of having any chronic health conditions was lower for the active group (adjusted OR = 0·62, 95 % CI 0·46, 0·84) but the two groups did not differ in terms of specific chronic health conditions or obesity.

Implications are drawn for targeting exercise promotion programmes at the population level.

To assess the validity of a 161-item quantitative FFQ (QFFQ) that was developed to evaluate dietary risk factors for a colorectal adenoma case–control study.

A cross-sectional validation study of the QFFQ against 4 d food diary using Pearson correlation coefficients, cross-classification, weighted κ statistics and Bland–Altman plotting.

Two hospitals in São Paulo, Brazil.

Ninety-seven healthy Japanese-Brazilian adults (40–75 years) were recruited. One participant was excluded from the analysis due to unusual energy intake report.

Mean daily nutrient intakes from the QFFQ were higher than from the food diary. The mean Pearson correlation coefficient for nutrient intakes between the QFFQ and the average of the 4 d food diary was 0·43, and increased to 0·45 after correcting correlations for attenuation due to residual day-to-day variation in the food diary measurements. Adjustment for total energy and further adjustment for age and gender decreased the correlation; however, 77 % of observations remained in the same or adjacent quartiles with a mean weighted κ of 0·22. Bland–Altman plots on loge-transformed data showed no linear trend between the differences and means for energy, fat, protein, total folate and vitamin C. Compared with the food diary, the QFFQ showed consistently reasonable performance for dietary fibre, total folate, retinol, riboflavin and vitamin C.

This investigation supports the relative validity of the QFFQ as a method for assessing long-term dietary intake. The instrument will be a useful tool in the analysis of diet–adenoma associations in the case–control study.

A diet rich in phyto-oestrogens has been suggested to protect against a variety of common diseases but UK intake data on phyto-oestrogens or their food sources are sparse. The present study estimates the average intakes of isoflavones, lignans, enterolignans and coumestrol from 7 d food diaries and provides data on total isoflavone, lignan and phyto-oestrogen consumption by food group.

Development of a food composition database for twelve phyto-oestrogens and analysis of soya food and phyto-oestrogen consumption in a population-based study.

Men and women, aged 40–79 years, from the general population participating in the Norfolk arm of the European Prospective Investigation into Cancer and Nutrition (EPIC-Norfolk) between 1993 and 1997, with nutrient and food data from 7 d food diaries.

A subset of 20 437 participants.

The median daily phyto-oestrogen intake for all men was 1199 μg (interquartile range 934–1537 μg; mean 1504 μg, sd 1502 μg) and 888 μg for all women (interquartile range 710–1135 μg; mean 1205 μg, sd 1701 μg). In soya consumers, median daily intakes were higher: 2861 μg in men (interquartile range 1304–7269 μg; mean 5051 μg, sd 5031 μg) and 3142 μg in women (interquartile range 1089–7327 μg; mean 5396 μg, sd 6092 μg). In both men and women, bread made the greatest contribution to phyto-oestrogen intake – 40·8 % and 35·6 %, respectively. In soya consumers, vegetable dishes and soya/goat's/sheep's milks were the main contributors – 45·7 % and 21·3 % in men and 38·4 % and 33·7 % in women, respectively.

The ability to estimate phyto-oestrogen intake in Western populations more accurately will aid investigations into their suggested effects on health.

To evaluate long-term patterns of weight change and progression to overweight and obesity during adulthood.

Prospective study. Changes in mean BMI, waist circumference (WC) and weight were assessed over a mean 26-year follow-up (1971–1975 to 1998–2001). Mean BMI (95 % CI) and mean WC (95 % CI) of men and women in BMI and age groups were computed. Mean weight change in BMI and age categories was compared using analysis of covariance.

Framingham Heart Study Offspring/Spouse Nutrition Study.

Men and women (n 2394) aged 20–63 years.

During follow-up, increases in BMI (men: 2·2 kg/m2; women: 3·7 kg/m2) and WC (men: 5·7 cm; women: 15·1 cm) were larger in women than men. BMI gains were greatest in younger adults (20–39 years) and smallest in obese older adults (50–69 years). The prevalence of obesity doubled in men (to 33·2 %) and tripled in women (to 26·6 %). Among normal-weight individuals, abdominal obesity developed in women only. The prevalence of abdominal obesity increased 1·8-fold in men (to 53·0 %) and 2·4-fold in women (to 71·2 %). Weight gain was greatest in the youngest adults (20–29 years), particularly women. Gains continued into the fifth decade among men and then declined in the sixth decade; in women gains continued into the sixth decade.

Patterns of weight change and progression to obesity during adulthood differ in men and women. Preventive intervention strategies for overweight and obesity need to consider age- and sex-specific patterns of changes in anthropometric measures.

The current study prospectively examines the intra-uterine hypothesis by comparing maternal, paternal and grandparental lineage influences on children's diet and also maternal–child aggregation patterns during pregnancy and early childhood.

Prenatal dietary information was available for expectant mothers, fathers and up to four grandparents through a detailed validated semi-quantitative FFQ. At 6-year follow-up, when children averaged 5 years of age, dietary information was re-collected for mothers and a subset of maternal grandmothers using the same FFQ. Child's FFQ version was used for children. Anthropometric and sociodemographic variables were also collected.

Three-generation familial cohort representative of the contemporary Irish national population.

Children aged 5 years (n 567) and their parents and grandparents.

Associations for energy, macronutrient and fibre intakes were compared using Pearson's correlations, intra-class correlations (ICC) and linear regression models, adjusted for energy and potential confounders. Significant, moderate-strength positive correlations were observed for nutrient intakes in children's nuclear families (ICC (range) = 0·22–0·28). The father–child associations (r (range) = 0·13–0·20) were weaker than the mother–child associations (r (range) = 0·14–0·33). In general, associations were stronger for maternal postnatal intake–child intake than for maternal prenatal intake–child intake, except for percentage of energy from fat (adjusted β = 0·16, 95 % CI 0·05, 0·26; P = 0·004), which was stronger for maternal prenatal intake, specifically in non-breast-fed children (adjusted β = 0·28, 95 % CI 0·12, 0·44; P = 0·001). Among all grandparents, correlations were significant only for maternal grandmother–mother pairs (r (range) = 0·10–0·36). Significant positive ICC were observed for nutrient intakes of maternal grandmother–mother–child triads (ICC (range) = 0·12–0·27), not found in paternal lines.

These findings suggest that maternal-environment programming influences dietary intake.

We examined associations between snack frequency, sociodemographic characteristics, BMI, dietary and eating behaviour. In order to identify whether various subgroups of high-frequency snack consumers exist, we investigated underlying food patterns and lifestyle factors.

The data were based on the Swiss Food Panel Questionnaire of 2010, which included an FFQ, questions relating to sociodemographics and lifestyle factors. Data were examined using ANOVA, regression analysis and hierarchical cluster analysis. Gender differences were also investigated in the analysis of the data.

A sample of 6189 adults participating in the Swiss Food Panel filled in a questionnaire (response rate 30 %).

The sample consisted of both men and women, with a mean age of 54·4 (sd 13·5) years.

There was no association between snack frequency and BMI. Consumption frequency of sweets and savouries as well as fruit intake increased with increasing snack frequency. Additionally, three different subgroups of high-frequency snack consumers could be revealed: healthy, moderate and unhealthy dietary-pattern groups. The latter included respondents who were less health-conscious and was characterized by high alcohol consumption frequency, daily breakfast skipping and watching television during the main meal.

High snack frequency occurred in the context of healthy as well as unhealthy dietary behaviour and lifestyle patterns. Women made healthier dietary food choices and were more likely to consume fruits as snacks, while men chose unhealthy foods, such as sweets and savouries, more often.

To systematically review the efficacy and safety of oral Fe therapy in pre-school children (1–5 years) with non-anaemic Fe deficiency, determined by children's developmental and haematological status and the incidence of reported side-effects.

A random-effects model was used to show mean differences with 95 % confidence intervals of developmental and haematological scores between Fe-treated and non-treated groups.

MEDLINE, EMBASE, Cochrane library and bibliographies of identified articles were searched up to September 2011. Randomized and observational studies were assessed by two reviewers independently. Quality of the trials was assessed on the basis of concealment of allocation, method of randomization, masking of outcome assessment and completeness of follow-up.

From the titles of 743 articles, full text review was completed on forty-six and two randomized trials of acceptable quality met the inclusion criteria. The two trials included a total of sixty-nine children.

One study showed a statistically significant difference in the post-treatment Mental Developmental Index score among children who received oral Fe therapy v. no therapy (mean difference = 6·3, 95 % CI 1·5, 11·0, P value not provided). Both studies showed significant improvement in serum ferritin level (μg/l: mean difference = 51·1, 95 % CI 33·6, 68·6, P < 0·01 and mean difference = 17·1, 95 % CI 7·5, 26·6, P value not provided, respectively) in children who received Fe therapy.

Evidence is insufficient to recommend oral Fe therapy to children with non-anaemic Fe deficiency. There is urgent need of conducting adequately powered, randomized trials examining the efficacy of oral Fe therapy in pre-school children with non-anaemic Fe deficiency.

Financial constraint is the underpinning determinant of household food insecurity; however, there has been little research examining the impact that increasing the ‘money available’ to food-insecure households could have on food purchasing. The main objective of the present study was to examine the effect of additional money (in the form of supermarket vouchers) on food expenditure in food-insecure households with children.

A parallel randomized controlled trial with a 4-week baseline phase followed by a 4-week intervention phase. Households were randomized to either receive vouchers (coupons) for 4 weeks or a control group that did not receive any vouchers.

Dunedin, New Zealand.

Low-income households with children (≤18 years) reporting food insecurity (n 214).

The mean monetary value of the vouchers received by households was $NZ 17·00 per week. The voucher group spent $NZ 15·20 (95 % CI 1·46, 28·94) more per week on food during the intervention phase compared with the control group (P = 0·030). There were no differences in expenditure between the voucher and the control group for the food groups ‘fruit and vegetables’ (mean difference: $NZ 0·46; 95 % CI −1·97, 2·89; P = 0·709), ‘meat and poultry’ (mean difference: $NZ 0·29; 95 % CI −3·07, 3·64; P = 0·866) and ‘dairy’ (mean difference: $NZ 0·82; 95 % CI −0·75, 2·42; P = 0·302).

Providing money via supermarket vouchers to food-insecure households resulted in an increase in overall expenditure on food.

The present study explored parents’ requirements for healthy eating support prior to the development of a tailored intervention.

A cross-sectional study of parents attending children's centres.

Children's centres in Cornwall (rural south-west England) and Islington (urban London borough).

A total of 261 parents (94·2 % female) of pre-school children (aged 2–5 years) completed a questionnaire on factors influencing food choice, and preferences for and views on healthy eating support.

Parents reported that health, taste, freshness and quality were the most important factors influencing their food choices for their pre-school children. The importance of individual factors varied according to level of educational attainment. Over a third (38 %) of parents said they wanted more advice on healthy eating for children. Less educated parents showed the greatest interest in learning more about several aspects: what a ‘healthy diet’ means, how to prepare and cook healthy food, how to understand food labels, budgeting for food, examples of healthy food and snacks for children, appropriate portion sizes for children and ways to encourage children to eat well.

There was demand for healthy eating support among parents of pre-school children, especially those who are less educated, in one rural and one urban area of England.