To investigate the prevalence of obesity in affluent schoolchildren of Delhi.

This was a cross-sectional study covering over 4000 students. Anthropometric measurements and birth weights of all the students were recorded.

The study was carried out in a school catering to the affluent section of Indian society and included both boys and girls in the age range 4 to 17 years.

The heights and weights of the children were almost similar to those of the National Center for Health Statistics standards, and were much above the values reported by the Indian National Nutrition Monitoring Bureau, which largely captures rural children belonging to lower socio-economic strata in India. Of the subjects studied, 22% were overweight and 6% were obese. Only 6% of these children had low birth weight.

The prevalence of obesity is rising among children because of their change in lifestyle. Children born with a birth weight of ≥ 3 kg tended to have higher body mass index in their adolescent years and maybe consequently in their adult years. Nutrition education can play an important part in reducing the incidence of overweight/obesity and its associated complications.

The aims of this study were to assess the changes that have occurred in food patterns in Europe over the last 40 years based on food availability data and to compare the stability of the traditional Mediterranean diet in the south of Europe in this period.

An ecological study carried out on the basis of Food and Agriculture Organization food balance sheets for three geographical areas of Europe (Mediterranean, north and east) over two time periods: 1961–1963 and 1998–2000. The average availability of total energy, energy provided from macronutrients and food groups was calculated for each area and each period studied.

Over the last 40 years total energy availability and energy availability from lipids have increased considerably in the three European areas, while the percentage of energy from carbohydrates has fallen. The greatest changes have occurred in Mediterranean Europe, with an increase of 20.1% in total energy availability, an increase of 48.1% in energy availability from lipids and a fall of 20.5% from carbohydrates. Moreover, Mediterranean Europe showed a significant fall in the energy supplied by cereals (29.9%) and wine (55.2%), while the contribution of milk (77.8%) and dairy products (23.6%) increased.

The results of this study suggest that European Mediterranean countries should take nutrition policy action to maintain their traditional healthy food pattern, with a cultural added value. This implies actions at all levels, including raising awareness of consumers, collaboration with the food sector and a call to set the agenda of the concerned politicians and stakeholders.

To identify regimen, individual, community and cultural factors that affect adoption and adherence to weekly vitamin A supplementation in Ghana.

Fifty semi-structured interviews were conducted with women who would be eligible for vitamin A supplementation, 30 with husbands, and 13 with drug sellers, birth attendants and health workers. Six focus group discussions were also conducted with women. These interviews were followed by a 4-month capsule trial with 60 women. Data from a previously conducted communication channel survey of 332 women were also reviewed.

The study was conducted in Kintampo District in central Ghana.

Participants for the semi-structured interviews and focus groups were selected from four villages and the district capital, and women in the capsule trial were selected at random from two villages.

Knowledge of vitamins was low and taking ‘medicines’ for long periods and when healthy is a new concept. In spite of this, long-term supplementation will be accepted if motives are explained, specific questions answered and clear instructions are given. Potential barriers included the idea of ‘doctor’ medicines as curative, false expectations of the supplement, forgetting to take the supplement, losing the supplement, travelling, lack of motivation, perceived side-effects, concerns that the supplement is really family planning or will make delivery difficult, and concerns about taking the supplement with other ‘doctor’ or herbal medicine, or when pregnant or breast-feeding, or if childless.

Successful supplementation programmes require appropriately designed information, education and communication strategies. Designing such strategies requires pre-programme formative research to uncover barriers and facilitators for supplementation.

To validate a 171-item semi-quantitative food-frequency questionnaire (FFQ) for measurement of nutrient intake in an intervention trial based on walnut supplementation.

Free-living adults from Southern California were randomly assigned to either an intervention (walnut-supplemented) or a control diet. The prescribed 6-month intervention was ≥ 28 g of walnuts per day for the walnut-supplemented group and ≤ 2 g of walnuts per day for the control group. Participants provided at least six 24-hour dietary recalls and completed a self-administered FFQ.

Eighty-seven adults aged 30–72 years (48 females, 39 males).

Our findings from validation (by correlation with six diet recall measures) of the measurement of 32 nutrients by the FFQ are as follows. We found significant positive correlations (corrected for measurement error) between the FFQ and diet recalls for total energy (r = 0.34), total carbohydrate (r = 0.42), vegetable protein (r = 0.43), total fat (r = 0.51), polyunsaturated fat (r = 0.77), total fibre (r = 0.60), linoleic acid (r = 0.78) and α-linolenic acid (r = 0.79) – the last nutrient being an excellent nutrient biomarker of the intervention (walnut supplementation). Significant positive correlations were also found for vitamin C (r = 0.96) and certain minerals (r = 0.46–0.80 for calcium, phosphorus, magnesium, iron and potassium). Uncorrected correlations were also high (r>0.40) for retinol, β-carotene, folate and alcohol. Both diet recalls and FFQ showed a similar significant difference in α-linolenic acid content between the walnut-supplemented and control diets.

The FFQ demonstrated good relative validity in the estimation intake of some of the major nutrients in a dietary intervention trial and was a particularly valid estimate of an important nutrient biomarker of walnut supplementation.

To identify the impact of body mass index (BMI) and Western advertising and media on the stage of the nutrition transition among Jordanian women, and to evaluate their impact on eating styles and body image.

A randomised cross-sectional survey that included a variety of culturally measured Likert-type scales and body size images. In addition, BMI was calculated based on measured height and weight.

In the homes of the participants. The data were collected by female interviewers who worked for the Jordan Department of Statistics.

The sample was based on a random and representative selection of 800 mostly urban Jordanian women. A pre-test sample of 100 women was also used to validate the instruments.

Women tended to agree that they ate based on emotional cues. They had high levels of disordered eating attitudes and behaviours and 42.1% were considered restrained eaters. However, these women also had higher than expected body esteem levels and desired a healthy body size. As expected, being obese was associated with a desire to lose weight, being a restrained and emotional eater, and having more disordered eating attitudes and behaviours. Similarly, Western advertising and media were associated with restrained and emotional eating, desired weight loss, and disordered eating attitudes and behaviours.

There is a need to develop health education materials that explain the influence of obesity on health and the negative psychological and physical consequences of restrained and emotional eating, building on the current cultural preferences of healthy body size. Further implications and suggestions for future research are discussed.

To examine the prevalence and risk factors of vitamin deficiencies among older Thai adults.

The cross-sectional study was conducted in four rural communities, one from each of the four main regions of Thailand. In total, 2336 subjects aged 60 years and over were recruited. Anthropometric variables, demographic data, blood glucose and lipid profile, albumin, globulin and blood levels of vitamin A, β-carotene, folic acid, vitamin B12, vitamin C, vitamin E and vitamin B1 were all measured.

The prevalence of vitamin deficiencies was 0.6% for vitamin B12, 6.1% for vitamin A, 9.9% for vitamin C, 30.1% for vitamin B1, 38.8% for erythrocyte folate, 55.5% for vitamin E and 83.0% for β-carotene. Male gender was a common risk factor for at least three vitamin deficiencies, i.e. β-carotene, folate and vitamin E. Being a manual worker was a common risk factor of β-carotene and vitamin B1 deficiency. Poor income was found as a risk factor only in erythrocyte folate deficiency while increasing age was a significant factor only in vitamin C deficiency.

The prevalence of vitamin deficiencies among older Thai people was quite different from that found in Western countries, reflecting different socio-economic backgrounds. Vitamin deficiency was not only from poor food intake but also from the dietary habit of monotonous food consumption in older people. Some common associated factors of atherosclerosis were also significantly related to folate and vitamin E deficiencies.

To validate four scales – outcome expectancies for purchasing fruit and for purchasing vegetables, and comparative outcome expectancies for purchasing fresh fruit and for purchasing fresh vegetables versus other forms of fruit and vegetables (F&V).

Survey instruments were administered twice, separated by 6 weeks.

Recruited in front of supermarkets and grocery stores; interviews conducted by telephone.

One hundred and sixty-one food shoppers with children (18 years or younger).

Single dimension scales were specified for fruit and for vegetable purchasing outcome expectancies, and for comparative (fresh vs. other) fruit and vegetable purchasing outcome expectancies. Item Response Theory parameter estimates revealed easily interpreted patterns in the sequence of items by difficulty of response. Fruit and vegetable purchasing and fresh fruit comparative purchasing outcome expectancy scales were significantly correlated with home F&V availability, after controlling for social desirability of response. Comparative fresh vegetable outcome expectancy scale was significantly bivariately correlated with home vegetable availability, but not after controlling for social desirability.

These scales are available to help better understand family F&V purchasing decisions.

The aim of the study was to determine the relationship between fermented and unfermented dairy product consumption and Helicobacter pylori seropositivity in a Mexican population.

Dietary interviews were conducted as part of a population-based case–control study in 2005. Serum was obtained for each participant to determine H. pylori seropositivity status. Adjusted odds ratios were estimated from multivariate logistic regression models.

Mexico City, Mexico.

A random sample of 464 healthy adult residents.

The overall seroprevalence of H. pylori in the study sample was 75.4%. In fully adjusted models, compared with those who did not consume yoghurt, there was a protective effect of eating up to one serving per week of yoghurt and more than one serving per week of yoghurt (odds ratio (OR) = 0.57, 95% confidence interval (CI) 0.35–0.94 and OR = 0.45, 95% CI 0.24–0.86, respectively), with a P for trend of 0.01. There were no effects for the consumption of unfermented dairy products (milk and cheese).

This study suggests that yoghurt consumption may have a protective effect against H. pylori seropositivity. Additional studies are needed to determine whether consumption of yoghurt or other fermented dairy products can prevent or eradicate H. pylori infection.

This study investigates how lifecourse, immigrant status and acculturation, and neighbourhood of residence influence food purchasing and preparation among low-income women with children, living in the USA. This research sought to understand physical and economic access to food, from both ‘individual’ and ‘community’ perspectives.

This study used qualitative methodology (focus groups) to examine the mechanisms and pathways of food preparation and purchasing within the context of daily life activity for US- and foreign-born women, living in the USA. The study methodology analysed notes and verbatim transcripts, summarised recurring responses and identified new themes in the discussions.

A total of 44 women were purposively sampled from two metropolitan areas in Massachusetts, USA, based on (1) neighbourhood of residence and (2) primary language spoken. All focus groups were conducted in community health centres and community centres co-located with offices of the special supplemental nutritional programme for Women, Infants, and Children.

Analysis of key response themes suggested that scarcity of food and physical access to food purchasing points did not influence food purchasing and preparation as much as (1) limited time for food shopping, cooking and family activities; and (2) challenges in transportation to stores and childcare. The study results demonstrated differing attitudes toward food acquisition and preparation between immigrant and US-born women and between women who lived in two metropolitan areas in the western and eastern regions of the state of Massachusetts, USA.

The findings illustrate ‘hidden’ constraints that need to be captured in measures of physical and economic access and availability of food. US policies and programmes that aim to improve access, availability and diet quality would benefit from considering the social context of food preparation and purchasing, and the residential environments of low-income women and families.

To measure change in fruit and vegetable (F&V) consumption among elementary-school children after the introduction of a salad bar programme as a lunch menu option in the US Department of Agriculture’s (USDA) reimbursable lunch programme in Los Angeles Unified School District (LAUSD).

A cross-sectional sample of children was interviewed before and after a salad bar intervention (1998 and 2000, respectively) utilising a 24-hour food recall questionnaire. Frequencies of F&V consumption were calculated.

The evaluation took place in three LAUSD elementary schools participating in the salad bar programme and the USDA reimbursable lunch programme.

Three hundred and thirty-seven children in 2nd–5th grade (7–11 years old).

After the salad bar was introduced, there was a significant increase in frequency (2.97 to 4.09, P < 0.001) of F&V consumed among the children studied. The increase in frequency of F&V consumed was almost all due to an increase during lunch (84%). Mean energy, cholesterol, saturated fat and total fat intakes were significantly lower in the children after the salad bar was introduced in the schools compared with the intakes in the children before the salad bar was introduced.

A salad bar as a lunch menu option in the USDA reimbursable lunch programme can significantly increase the frequency of F&V consumption by elementary-school children living in low-income households.

To estimate the potential impact of zinc biofortification of rice and wheat on public health in India and to evaluate its cost-effectiveness compared with alternative interventions and international standards.

The burden of zinc deficiency (ZnD) in India was expressed in disability-adjusted life years (DALYs) lost. Current zinc intakes were derived from a nationally representative household food consumption survey (30-day recall) and attributed to household members based on adult equivalent weights. Using a dose–response function, projected increased zinc intakes from biofortified rice and wheat were translated into potential health improvements for pessimistic and optimistic scenarios. After estimating the costs of developing and disseminating the new varieties, the cost-effectiveness of zinc biofortification was calculated for both scenarios and compared with alternative micronutrient interventions and international reference standards.

India.

Representative household survey (n = 119 554).

The calculated annual burden of ZnD in India is 2.8 million DALYs lost. Zinc biofortification of rice and wheat may reduce this burden by 20–51% and save 0.6–1.4 million DALYs each year, depending on the scenario. The cost for saving one DALY amounts to $US 0.73–7.31, which is very cost-effective by standards of the World Bank and the World Health Organization, and is lower than that of most other micronutrient interventions.

Not only may zinc biofortification save lives and prevent morbidity among millions of people, it may also help accommodate the need to economise and to allocate resources more efficiently. Further research is needed to corroborate these findings.

To appraise critically the relevance and value of the evidence base to promote and support the duration of breast-feeding, with a specific focus on disadvantaged groups.

A systematic review was conducted of intervention studies relevant to enhancing the duration of breast-feeding; topics included public health, public policy, clinical issues, and education, training and practice change. A systematic search was conducted. Eighty studies met the inclusion criteria. Data were systematically extracted and analysed. Full results and recommendations are reported elsewhere. Here a critique of the evidence base – topics, quality and gaps – is reported.

Many studies were substantially methodologically flawed, with problems including small sample sizes, inconsistent definitions of breast-feeding and lack of appropriate outcomes. Few were based on relevant theory. Only a small number of included studies (10%) were conducted in the UK. Very few targeted disadvantaged subgroups of women. No studies of policy initiatives or of community interventions were identified. There were virtually no robust studies of interventions to prevent and treat common clinical problems, or of strategies related to women's health issues. Studies of health professional education and practice change were limited. Cost-effectiveness studies were rare.

Policy goals both in the UK and internationally support exclusive breast-feeding until 6 months of age. The evidence base to enable women to continue to breast-feed needs to be strengthened to include robust evaluations of policies and practices related to breast-feeding; a step change is needed in the quality and quantity of research funded.

To pilot the design and methodology for a large randomised controlled trial (RCT) of two interventions to promote healthier food purchasing: culturally appropriate nutrition education and price discounts.

A 12-week, single-blind, pilot RCT. Effects on food purchases were measured using individualised electronic shopping data (‘Shop ’N Go’ system). Partial data were also collected on food expenditure at other (non-supermarket) retail outlets.

A supermarket in Wellington, New Zealand.

Eligible customers were those who were the main household shoppers, shopped mainly at the participating store, and were registered to use the Shop ’N Go system. Ninety-seven supermarket customers (72% women; age 40 ± 9.6 years, mean ± standard deviation) were randomised to one of four intervention groups: price discounts, nutrition education, a combination of price discounts and nutrition education, or control (no intervention).

There was a 98% follow-up rate of participants, with 85% of all reported supermarket purchases being captured via the electronic data collection system. The pilot did, however, demonstrate difficulty recruiting Maori, Pacific and low-income shoppers using the electronic register and mail-out.

This pilot study showed that electronic sales data capture is a viable way to measure effects of study interventions on food purchases in supermarkets, and points to the feasibility of conducting a large-scale RCT to evaluate the effectiveness of price discounts and nutrition education. Recruitment strategies will, however, need to be modified for the main trial in order to ensure inclusion of all ethnic and socio-economic groups.

The term conjugated linoleic acid (CLA) refers to several positional and geometric conjugated dienoic isomers of linoleic acid (LA), of which the trans-10,cis-12 isomer has been reported to reduce adiposity and increase lean mass in mice and other animals when included at ≤1% of the diet. However, most dietary CLA in humans is obtained from dairy products, accounting for the cis-9,trans-11 CLA isomer, also known as rumenic acid, for more than 90% of the total CLA intake. Commercial CLA preparations industrially produced, containing trans-10,cis-12 and cis-9,trans-11 CLA isomers in diverse proportions, are attracting consumers’ interest because of the purported body fat-lowering effects of CLA, coupled to the perception of a ‘natural’ compound devoid of harmful effects. Nevertheless, despite numerous studies on CLA effects on body composition for nearly a decade, the mechanisms by which CLA isomers elicit their effects remain largely unknown. The purpose of this paper is to provide an updated review of the studies performed on animals and humans, as well as to describe the potential mechanisms involved in CLA effects on body weight and composition and metabolism.

Literature review.

Experiments in humans have not been able to show a significant effect on body weight, body composition or weight regain related to either of the CLA isomers. In fact, some studies suggest a tendency towards a decrease in body fat mass and an increase in body lean mass, while some others raise concern about the possibility of deleterious effects of trans-10,cis-12 CLA on lipid profile, glucose metabolism and insulin sensitivity.

Evidence regarding effectiveness of CLA in humans is not concluding.

To investigate the association between pregravid weight status and diet quality.

Institute of Medicine body mass index (BMI) cut-off points of < 19.8 kg m− 2 for underweight, 19.8–26.0 kg m− 2 for normal weight, >26.0–29.0 kg m− 2 for overweight and >29 kg m− 2 for obese were used to categorise women's weight status. Dietary information was obtained by self-report at 26–28 weeks' gestation using a modified Block food-frequency questionnaire. The Diet Quality Index for Pregnancy (DQI-P) included: servings of grains, vegetables and fruits, folate, iron and calcium intake, percentage calories from fat, and meal pattern score. Multinomial logistic regression models were used to estimate the association between weight status and tertiles of DQI-P controlling for potential individual confounders.

A clinical-based population recruited through four prenatal clinics in central North Carolina.

A total of 2394 women from the Pregnancy, Infection and Nutrition study were included in this analysis.

Evidence of a dose–response relationship was found between BMI and inadequate servings of grains and vegetables, and iron and folate intake. Pregravid obesity was associated with 76% increased odds of falling into the lowest diet quality tertile compared with underweight women after controlling for potential confounders.

A modest association was found between pregravid weight status and diet quality. If corroborated, these findings suggest that overweight pregnant women should be targeted for nutrition counselling interventions aimed to improve diet quality.

To evaluate the prevalence and identify some predictors of misreporting in an elderly Belgian population and to assess the effect of underreporting on estimated intakes of macronutrients and foods.

A 1-day food record was completed by 2083 adult men and women aged 65 years or more. Individuals whose energy intake was lower than 0.90 × BMR (basal metabolic rate) were defined as underreporters. Overreporting was defined as energy intake greater than 2 × BMR.

Underreporting and overreporting occurred in 13.6% and 7.9% of food records, respectively. Results from logistic regression models indicated that gender and body mass index (BMI) were predictors of misreporting. Whereas women were more likely to underreport energy intake, the prevalence of overreporting was higher in men. Underreporting was more prevalent among obese people and overreporting more prevalent in normal-weight subjects. Smoking status and education level did not predict underreporting; however, overreporting was more likely to occur in more highly educated subjects. A cultural difference in reporting of nutrient intakes was also found, with the percentage of underreporters being higher among Walloons compared with Flemish.

BMI seemed to be one of the most important factors in misreporting. This calls for special attention when dietary surveys are performed on obese or lean people.

To evaluate the nutritional composition of worksite canteen lunches and to examine the impact of two meal serving systems on employee intake, i.e. buffet style with a fixed price for a varied number of dishes and à la carte style with a separate price for each item on the menu.

Laboratory technicians observed employees' food selection and collected identical dishes. Food items were weighed separately to calculate the content of fruit and vegetables. The content of protein, fat and ash of each dish was chemically analysed and the carbohydrate and energy content calculated.

Fifteen randomly chosen worksite canteens in Denmark: eight canteens serving buffet style and seven canteens with an à la carte line.

one hundred and eighty randomly chosen employees having lunch at the worksite canteens.

The average percentage energy from fat was 37 ± 12 among men and 33 ± 12 among women. No association was found between the meal serving system and energy intake or macronutrient composition. Eating at canteens serving buffet style, on the other hand, was associated with an increased intake of fruit and vegetables, on average 76 g, and a lower energy density of the food for both genders.

The results highlight the possibilities of promoting healthy food choices in the catering sector and the need to identify models of healthy catering practice. Serving buffet style appears to be a promising strategy in order to increase fruit and vegetable consumption in food served away from home.

The primary objective was to evaluate the rate at which non-English dietary supplement advertisements distributed in a sampled ethnic minority community are in compliance with the federal advertising regulations. The secondary objective was to assess the availability of supporting evidence to substantiate the advertised health claims.

Cross-sectional study.

The contents of dietary supplement advertisements from the Los Angeles Korea Times and the Los Angeles Korea Daily were evaluated during the month of July 2005. After removing duplicate advertisements, the percentage of advertisements making prohibited disease claims and DSHEA (Dietary Supplement Health and Education Act) disclaimer statements was determined. The presence of data substantiating advertised claims was determined by requesting data from the manufacturers and browsing the manufacturers' websites. An observational technique was utilised for content analysis, and data analysis was conducted using quantitative descriptive statistics.

Disease claims were present in 84.5%, while DHSEA disclaimer statements were present in only 18.4% of the advertisements. Data to substantiate the claims were provided by 53.4% of the manufacturers. The majority of the additional information consisted of repetition of the advertised claims and consumer testimonies. Experimental data were available for only 13.6% of the products.

The high rate of non-compliance with federal regulations suggests a need for better oversight of non-English promotions of dietary supplements.

This study aimed to explore the associations between breast-feeding, dietary intakes and other related factors and subclinical vitamin A deficiency (SVAD) in children aged 0–5 years in an area in China where mild vitamin A deficiency (VAD) is found.

Data were from a population-based cross-sectional study with 1052 children aged 0–5 years. SVAD cases were identified by the indicator of serum retinol ≤ 20 μg dl− 1. Breast-feeding status, dietary intakes and other factors were collected through a pre-designed questionnaire.

The prevalence of SVAD in children aged 0–5 years was 6.9%. Logistic regression analysis showed that the odds ratio of SVAD for breastfeeding was 3.56 (95% confidence limits (95% CL) 2.17–5.82). After adjustment for sex, age in categories, residence, mother's education, mother's occupation, vitamin A preparation supplements, rank in siblings and diarrhoea, the odds ratio for breast-feeding fell to 2.38 (95% CL 1.13–4.95). The odds ratios for breast-feeding within children aged 1 year were 5.46 (95% CL 2.07–15.03) and 4.6 (95% CL 1.72–12.82) before and after adjustment of other confounders, respectively. The odds ratios for breast-feeding did not show statistical significance within children aged 0 or 2 years. The odds ratios decreased, but remained statically significant after further adjustments for individual dietary factor or all dietary factors.

Breast-feeding was a risk factor of SVAD for children, especially for those aged 1 year. The differences in dietary intakes and other established risk factors could not fully explain the increased risk. This finding implies that prolonged breast-feeding alone may not ensure protection of children from VAD in an area with mild SVAD.