To estimate the impact of choosing food products labelled either as low or high in salt on salt intake in the Finnish adult population.

The National FINDIET 2002 survey with 48-hour recalls from 2007 subjects aged 25–64 years. Sodium intake was calculated based on the Fineli® food composition database including the sodium content of natural and processed foods as well as the salt content of recipes. The distribution of salt intake was calculated in different ways: the present situation; assuming that all breads, cheeses, processed meat and fish, breakfast cereals and fat spreads consumed would be either ‘lightly salted’ or ‘heavily salted’ based on the current labelling practice; and, in addition, assuming that all foods would be prepared with 50% less or more salt.

Excluding underreporters, the mean salt intake would be reduced by 1.8 g in men and by 1.0 g in women if the entire population were to choose lightly salted products and further by 2.5 and 1.8 g, respectively, if also salt used in cooking were halved. Choosing heavily salted products would increase salt intake by 2.1 g in men and by 1.4 g in women. In the worst scenarios, salt intake would be further increased by 2.3 g in men and by 1.6 g in women.

These calculations show that the potential impact of labelling and giving consumers the possibility to choose products with less salt is of public health importance. In addition, strategies to reduce the salt content of all food groups are needed.

To study associations between reported sugar intake and salivary bacteria (mutans streptococci, MS and lactobacilli, LB), and sugar intake in relation to body mass index (BMI), in women and adolescents.

Cross-sectional study. Habitual dietary intake was reported in a questionnaire and whole saliva samples were collected and cultivated.

Stockholm, Sweden.

Four hundred and fourteen mothers and their 16-year-old children (57% girls).

Reported total sugar intake was significantly associated with LB in mothers (P = 0.001), but not in daughters and sons (P = 0.03 for mother–son interaction). When excluding lactose, the associations with LB and MS were significant in daughters (P = 0.032 and 0.005, respectively). High BMI and sugar intake from milk were independently associated with MS counts in mothers in a multiple regression model (R2 = 0.053). In daughters, sugar from beverages, candies/chocolates and fruits were all independently associated with MS counts (R2 = 0.074), whereas in sons, only mothers’ MS counts were associated (R2 = 0.084). High BMI, low intake from cooked meals and high intake of candies/chocolates were all independently associated with LB in mothers (R2 = 0.076), while, except for candies/chocolates in daughters, no significant associations were found in children. BMI was significantly associated with bacteria counts in both mothers and children, whereas reported sugar intake was not.

The associations between reported sugar intake and bacteria were generally weak. In mothers and daughters, some significant associations were found, but not in sons. Bacteria counts, but not reported sugar intake, were positively associated with BMI.

Information is needed on dietary adequacy of Arctic indigenous populations in Canada. Extensive work has been completed on composition of Arctic food and food use, and dietary reference intakes are available.

To complete the first comprehensive dietary adequacy assessment of three populations of adult Arctic indigenous people.

Dietary assessment interviews were conducted with randomly selected indigenous adults during two seasons in 44 representative communities of Yukon First Nations (n = 797), Dene/Métis, (n = 1007) and Inuit (n = 1525).

Twenty-four-hour recalls were used to derive adjusted distributions of usual nutrient intakes in four age/gender groups for assessment of dietary adequacy for carbohydrate, dietary fibre, protein, n–3 fatty acids, n–6 fatty acids, calcium, copper, iron, magnesium, manganese, phosphorus, selenium, zinc, vitamin A, riboflavin, folate, vitamin B6, vitamin C, vitamin D and vitamin E.

Nutrients with high prevalence of adequacy for most age/gender groups in all three cultures were protein, carbohydrate, n–3 fatty acids, iron, copper, zinc, manganese, selenium, riboflavin and vitamin B6; some individuals exceeded the upper intake level for iron, zinc, selenium, vitamin A and vitamin D. Estimated average requirement nutrients of concern for adequacy were magnesium, folate, vitamin A, vitamin C and vitamin E; however, a few age/gender groups were exceptions. Prevalence of inadequacy for AI nutrients which may be undesirably high were fibre, n–6 fatty acids and calcium. Vitamin D was more adequate in Inuit women and men than for Yukon First Nations or Dene/Métis.

Unique patterns of dietary adequacy exist among Arctic indigenous peoples. Local wildlife food sources and market food sources should be maximised for their nutrient contributions to Arctic diets.

To investigate item non-response in a postal food-frequency questionnaire (FFQ), and to assess the effect of substituting/imputing missing values on dietary intake levels in the Norwegian Women and Cancer study (NOWAC). We have adapted and probably for the first time applied k nearest neighbours (KNN) imputation to FFQ data.

Data from a recent reproducibility study were used. The FFQ was mailed twice (test–retest) about 3 months apart to the same subjects. Missing responses in the test FFQ were imputed using the null value (frequencies = null, amount = smallest), the sample mode, the sample median, KNN, and retest values.

A methodological substudy of NOWAC, a national population-based cohort.

A random sample of 2000 women aged 46–75 years was drawn from the cohort in 2002 (response 75%). The imputation methods were compared for 1430 women who completed at least 50% of the test FFQ.

We imputed 16% missing values in the overall test data matrix. Compared to null value imputation, the largest differences in estimated dietary intake were seen for KNN, and for food items with a high proportion of missing. Imputation with retest values increased total energy intake, indicating that not all missing values are caused by respondents failing to specify no consumption, and that null value imputation may lead to underestimation and misclassification.

Missing values in FFQs present a methodological challenge. We encourage the application and evaluation of newer imputation methods, including KNN, which may reduce imputation errors and give more accurate intake estimates.

To assess the validity of nutrient profiling Model WXYfm – developed for the purpose of regulating the promotion of ‘less healthy’ foods to children. The model ranks foods according to their healthiness and categorises foods into ‘healthier’ and ‘less healthy’ foods.

Convergent and discriminant validity was tested by comparing the way Model WXYfm categorises foods with the way the UK’s national food guide – the Balance of Good Health (BGH) – categorises foods. Construct validity was assessed by testing a hypothesis relating the constructs of ‘healthiness’ of foods (as measured by Model WXYfm) and the ‘healthiness’ of diets (measured using the Diet Quality Index) and assessing whether this hypothesis was confirmed or refuted by using data on the dietary patterns of subjects (n = 1117) of the National Diet and Nutrition Survey of adults carried out in Great Britain in 2000–01.

Model WXYfm showed good convergent and discriminant validity: the level of agreement between the way the model categorises foods and the way the BGH categorises foods was good (κ = 0.69). Model WXYfm also showed good construct validity: the energy intake from ‘less healthy’ foods amongst subjects with the least healthy diets was nearly twice the energy intake from ‘less healthy’ foods amongst the subjects with the healthiest diets.

Model WXYfm demonstrated good validity in categorising foods in a way that is related to the healthiness of diets both recommended and achieved. The methods for assessing the validity of a nutrient profile model used in this paper have not, to our knowledge, been used before.

To assess the prevalence of zinc inadequacy based on dietary intakes and plasma zinc concentrations and, simultaneously, the prevalence of inadequate intakes of energy, protein, calcium and iron.

A cross-sectional study of a convenience sample of subsistence farming households in Sidama, Southern Ethiopia.

Dietary intakes were calculated from 1-day weighed food records and 40 repeats from 99 pregnant women in the third trimester using analysed values of major staple foods for zinc, iron, calcium and phytate. The distribution of observed intakes was adjusted for usual intakes and the prevalence of inadequacy estimated using the estimated average requirement (EAR) cutpoint method. Prevalence of inadequacy for zinc, protein and iron intakes were compared with those based on biochemical measures.

Prevalence of zinc inadequacy was very high: 99% for US FNB EAR and 100% for IZiNCG EAR compared to 72% based on low plasma zinc concentrations. Corresponding prevalence estimates for iron were much lower: 4% for inadequate intakes based on US FNB EAR vs. 8.7% for iron deficiency anaemia (haemoglobin < 110 g l−1; ferritin < 12 μg l−1) and 32.3% for low storage iron. Prevalence of inadequacy for protein was 100% for adjusted intakes and 91% for serum albumin < 32 g l−1. For calcium, 74% were at risk for inadequate intakes.

The high prevalence of inadequate intakes of zinc and protein was reasonably consistent with those based on biochemical measures. Such dietary deficits could be overcome by regular consumption of cellular animal protein. In contrast, both dietary and biochemical measures of iron inadequacy were low.

To investigate the determinants of mild-to-moderate malnutrition in preschoolers.

Cross-sectional study conducted in October and November 1996, with a representative sample of 1740 children less than 5 years old from the city of Salvador, situated in the Brazilian Northeastern region. Socio-economic and dietary data were collected through a structured questionnaire. Anthropometric measures were performed in duplicate and data analysis was based upon the hierarchical model approach. Logistic regression analysis was used to estimate the prevalence ratio and to identify the determinants of mild-to-moderate deficits in weight-for-age and height-for-age Z-scores.

Family monthly income under US$67.00 per capita and family headed by a woman were the main basic determinants of mild-to-moderate weight-for-age and height-for-age deficits in the studied children. Household agglomeration, an underlying determinant, was associated with weight-for-age and height-for-age deficits. Among the immediate determinants, age above 6 months and dietary caloric availability in the lowest tertile (<930 kcal day−1) were also associated with weight-for-age deficits. In addition to these, hospitalisation in the 12 months preceding the interview was shown to be a predictor of mild-to-moderate weight-for-age and height-for-age deficits.

Adverse social and economic factors interact with family environmental factors to define food consumption and morbidity patterns that culminate in a high prevalence of mild-to-moderate malnutrition. The strengthening and restructuring of nutrition and healthcare actions, the definition of public policies that improve family income, and the adequate insertion of women in the labour market are possible strategies to reduce mild-to-moderate malnutrition and to sustain the decline already observed in severe malnutrition.

To assess the nutritional quality of food aid delivered by food banks in France and to identify practical modifications to improve it.

National-level data were collected for all food aid distributed by French food banks in 2004, and its nutrient content per 2000 kcal was estimated and compared with French recommendations for adults. Starting with the actual donation and allowing new foods into the food aid donation, linear programming was used to identify the minimum changes required in the actual donation to achieve the French recommendations.

French food-bank-delivered food aid does not achieve the French recommendations for dietary fibre, ascorbic acid, vitamin D, folate, magnesium, docosahexaenoic acid, α-linolenic acid and the percentage of energy from saturated fatty acids. Linear programming analysis showed that these recommendations are achievable if more fruits, vegetables, legumes and fish were collected and less cheese, refined cereals and foods rich in fat, sugar and/or salt. In addition, new foods not previously collected are needed, particularly nuts, wholemeal bread and rapeseed oil. These changes increased the total edible weight (42%) and economic value (55%) of the food aid donation, with one-third of its edible weight coming from fruits and vegetables, one-third from staples, one-quarter from dairy products and approximately a tenth from meat/fish/eggs.

Important changes in the types and amounts of food collected will improve the nutritional quality of food-bank-delivered food aid in France. Such changes are recommended to improve the diets of deprived French populations.

To analyse the nutritional status component of the nutrition transition in Chile in relation to the evolution of obesity rates in all age groups until 2005, comparing these with the goals established by the Ministry of Health for the period 2000–2010.

A descriptive study which includes data on the nutritional status of the Chilean population categorised by age. The data originate from: (1) institutions which administer nutritional programmes – the National Board for Day-Care Centres (JUNJI) and the National Board for School Assistance and Scholarships (JUNAEB); (2) the Ministry of Health and the National Institute of Statistics; and (3) epidemiological studies which include adolescents and the elderly.

The prevalence of obesity in pre-school children attending JUNJI was 10.6% in 2005; by age group, it was 6% in 2-year-olds, 11% in 3-year-olds and 14% in 4-year-olds. Among schoolchildren in first grade, obesity prevalence was 18.5%. In pregnant women, obesity has increased from 12% in 1987 to 33% in 2004. For adults, the 2003 National Health Survey showed that the prevalence of obesity (body mass index (BMI) ≥ 30 kg m−2) was 22% and of morbid obesity (BMI≥40 kg m−2), 1.3%. Obesity varied according to gender and educational level, being higher among women (25% vs. 19% in men) and adults from low socio-economic levels. In the elderly there was a high prevalence of obesity in the 60–64 years age group for both men (35.6%) and women (44.1%), decreasing to 18% and 26%, respectively, in those aged 75 years and older.

The goals for the decade (2000–2010) consider a reduction of obesity rates from 10% to 7% in pre-school children attending JUNJI, and from 16% to 12% in schoolchildren attending first grade. For pregnant women, the goal is to reduce the prevalence from 32% to 28%. Despite the implementation of initiatives in nutrition and physical activity, these have been insufficient to shift the rising trend in obesity. The explanation could be that after a rapid rise in obesity in children and pregnant women between 1987 and 2000, a stabilisation period or a ‘plateau’ is observed. In that situation, very effective interventions are required to reduce obesity, because it is extremely difficult to reverse the trend. Some positive experiences are being implemented in Chile, but government priorities are not focused in health promotion. A comprehensive State Policy in health promotion, that includes the public and private sectors related with obesity, is needed to reverse this trend.

Previous studies on the relationship of dietary intake to the neighbourhood food environment have focused on access to supermarkets, quantified by geographic distance or store concentration measures. However, in-store food availability may also be an important determinant, particularly for urban neighbourhoods with a greater concentration of small food stores. This study synthesises both types of information – store access and in-store availability – to determine their potential relationship to fruit and vegetable consumption.

Residents in four census tracts were surveyed in 2001 about their fruit and vegetable intake. Household distances to food stores in these and surrounding tracts were obtained using geographical information system mapping techniques. In-store fruit and vegetable availability was measured by linear shelf space. Multivariate linear regression models were used to measure the association of these neighbourhood availability measures with consumption.

Four contiguous census tracts in central-city New Orleans.

A random sample of 102 households.

Greater fresh vegetable availability within 100 m of a residence was a positive predictor of vegetable intake; each additional metre of shelf space was associated with 0.35 servings per day of increased intake. Fresh fruit availability was not associated with intake, although having a small food store within this same distance was a marginal predictor of fruit consumption.

The findings suggest the possible importance of small neighbourhood food stores and their fresh produce availability in affecting fruit and vegetable intake.

To determine the reliability and validity of scales measuring low-fat milk consumption self-efficacy and norms during school lunch among a cohort of 5th graders.

Two hundred and seventy-five students completed lunch food records and a psychosocial questionnaire measuring self-efficacy and norms for school lunch low-fat milk consumption during the fall and spring semesters of the 1998–1999 academic year. Test–retest reliability was assessed in participants who also completed the questionnaire in the spring semester (n = 262). Principal component analyses identified and confirmatory factor analyses confirmed latent variables. Bivariate correlations measured construct validity.

Houston-area middle school.

Fifth graders (n = 275) from one middle school in southeast Texas.

Two scales measuring psychosocial influences of low-fat milk consumption were identified and proved reliable in this population: milk self-efficacy and milk norms. Milk self-efficacy and norms were positively correlated with milk consumption and negatively correlated with consumption of sweetened beverages.

These questionnaires can be used in similar interventions to measure the impact of self-efficacy and norms for drinking low-fat milk during school lunch.

Among adults with diabetes attempting to change their own diets, we explored how these adults approached providing food for their children and how their children reacted to dietary changes in the household.

The research design used semi-structured parallel individual interviews of adults and a child (aged 10–17 years) in their home. Interviews were audio-taped, transcribed, coded and analysed for themes.

Subjects included families in which one inner-city African American or Latino adult with diabetes had completed a diabetes intervention promoting healthy dietary behaviours.

We completed 29 interviews (14 adult–child pairs and one child). Adults approached making dietary changes for themselves and also providing food for their family in different ways, ranging from expecting everyone to eat the same thing to preparing two separate meals. Many children resisted dietary changes while fewer acquiesced. Among children who went along with changes, some reported resisting initially then adjusting, while others did not resist because the food still tasted good or they could obtain preferred foods outside the house. The intersection of adults’ meal strategies and children’s reactions to the changes can be used to categorise families into different patterns. These patterns highlight the tension between an adult who must make dietary changes to control diabetes and a child who is not necessarily motivated to change.

From this framework we suggest hypotheses about how these patterns might influence dietary behaviour in adults and children. Understanding these patterns could guide interventions to assist parents in successfully including children in their dietary changes.