Because farmers’ markets include a variety of fruits and vegetables, shopping at farmers’ markets would likely improve diet quality among low-income consumers, as well as promote sustainable direct farm-to-consumer business models. However, not much is known about how to promote farmers’ market shopping among low-income consumers. Therefore, the purpose of the present paper was to examine barriers to and facilitators of shopping at farmers’ markets and associations between shopping at farmers’ markets and self-reported dietary behaviours (fruit and vegetable, sugar-sweetened beverage and fast-food consumption) and BMI.

Cross-sectional analyses of associations between farmers’ market shopping frequency, awareness of markets, access to markets, dietary behaviours and BMI.

Department of Social Services, Pitt County, eastern North Carolina, USA.

Between April and July 2013, Supplemental Nutrition Assistance Program (SNAP) participants (n 205) completed a quantitative survey.

Barriers to shopping at farmers’ markets included does not accept SNAP/electronic benefit transfer, out of the way and lack of transportation. Farmers’ market shopping was associated with awareness of farmers’ markets (estimate =0·18 (se 0·04), P<0·001). Fruit and vegetable consumption was positively associated with farmers’ market shopping (estimate =1·06 (se 0·32), P=0·001).

Our study is one of the first to examine SNAP participants’ farmers’ market shopping, distance to farmers’ markets and dietary behaviours. Barriers to shopping at farmers’ markets and increasing awareness of existing markets should be addressed in future interventions to increase SNAP participants’ use of farmers’ markets, ultimately improving diet quality in this high-risk group.

Breakfast skipping has been reported to be associated with type 2 diabetes (T2D), but the results are inconsistent. No meta-analyses have applied quantitative techniques to compute summary risk estimates. The present study aimed to conduct a meta-analysis of observational studies summarizing the evidence on the association between breakfast skipping and the risk of T2D.

Systematic review and meta-analysis.

Relevant studies were identified by a search of PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI) and SINOMED up to 9 August 2014. We also reviewed reference lists from retrieved articles. We included studies that reported risk estimates (including relative risks, odds ratios and hazard ratios) with 95 % confidence intervals for the association between breakfast skipping and the risk of T2D.

Eight studies involving 106 935 participants and 7419 patients with T2D were included in the meta-analysis.

A pooled adjusted relative risk for the association between exposure to breakfast skipping and T2D risk was 1·21 (95 % CI 1·12, 1·31; P=0·984; I2=0·0 %) in cohort studies and the pooled OR was 1·15 (95 % CI, 1·05, 1·24; P=0·770; I2=0·0 %) in cross-sectional studies. Visual inspection of a funnel plot and Begg’s test indicated no evidence of publication bias.

Breakfast skipping is associated with a significantly increased risk of T2D. Regular breakfast consumption is potentially important for the prevention of T2D.

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.

We conducted a meta-analysis to evaluate the relationship between vitamin E and age-related cataract (ARC).

The fixed- or random-effect model was selected based on heterogeneity. Meta-regression was used to explore potential sources of between-study heterogeneity. Publication bias was evaluated using Begg’s test. The dose–response relationship was assessed by a restricted cubic spline model.

Relevant studies were identified by a search of PubMed and the Cochrane Library to May 2014, without language restrictions.

Studies involved samples of people of all ages.

Dietary vitamin E intake, dietary and supplemental vitamin E intake, and high serum tocopherol levels were significantly associated with decreased risk of ARC, the pooled relative risk was 0·73 (95 % CI 0·58, 0·92), 0·86 (95 % CI 0·75, 0·99) and 0·77 (95 % CI 0·66, 0·91), respectively. Supplemental vitamin E intake was non-significantly associated with ARC risk (relative risk=0·92; 95 % CI 0·78, 1·07). The findings from dose–response analysis showed evidence of a non-linear association between dietary vitamin E intake and ARC. The risk of ARC decreased with dietary vitamin E intake from 7 mg/d (relative risk=0·94; 95 % CI 0·90, 0·97).

The findings of the meta-analysis indicated that dietary vitamin E intake, dietary and supplemental vitamin E intake, and high level of serum tocopherol might be significantly associated with reduced ARC risk.

To determine the impact of an implementation intervention designed to introduce policies and practices supportive of healthy eating in centre-based child-care services. Intervention strategies included staff training, resources, incentives, follow-up support, and performance monitoring and feedback.

A quasi-experimental design was used to assess change over 20 months in healthy eating policy and practice in intervention and comparison child-care services.

The Hunter New England (HNE) region of New South Wales (NSW), Australia.

All centre-based child-care services (n 287) in the intervention region (HNE) were invited and 240 (91 % response rate) participated. Two hundred and ninety-six services in the rest of NSW were randomly selected as a comparison region and 191 participated (76 % response rate). A sub-analysis was conducted on those services that provided children food (n 196 at baseline and n 190 at follow-up). Ninety-six provided menus for analysis at baseline (HNE, n 36; NSW, n 50) and 102 provided menus at follow-up (HNE, n 50; NSW, n 52).

Services in the intervention region were significantly more likely to provide only plain milk and water for children (P = 0·018) and to engage parents in nutrition policy or programmes (P = 0·002). They were also more likely (P = 0·056) to have nutrition policy on home packed food. In addition, menus of services that provided lunch were significantly more likely to comply with healthy eating guidelines for sweetened drinks (P < 0·001), fruit (P < 0·001) and vegetables (P = 0·01).

An implementation intervention was able to modify policy and practice in a large number of child-care services so that they were more supportive of healthy eating.

To determine the prevalence and correlates of anaemia in male and female adolescents in Riyadh, Kingdom of Saudi Arabia.

A cross-sectional community-based study.

Five primary health-care centres in Riyadh.

We invited 203 male and 292 female adolescents aged 13–18 years for interview, anthropometric measurements and complete blood count. Blood Hb was measured with a Coulter Cellular Analysis System using the light scattering method.

Using the WHO cut-off of Hb<12 g/dl, 16·7 % (n 34) of males and 34·2 % (n 100) of females were suffering from anaemia. Mean Hb in males and females was 13·5 (sd 1·4) and 12·3 (sd 1·2) g/dl, respectively. Values for mean cell volume, mean cell Hb, mean corpuscular Hb concentration and red cell distribution width in male and female adolescents were 77·8 (sd 6·2) v. 76·4 (sd 10·3) μm3, 26·1 (sd 2·7) v. 25·5 (sd 2·6) pg, 32·7 (sd 2·4) v. 32·2 (sd 2·6) g/dl and 13·9 (sd 1·4) v. 13·6 (sd 1·3) %, respectively. Multivariate logistic regression revealed that a positive family history of Fe-deficiency anaemia (OR=4·7; 95 % CI 1·7, 12·2), infrequent intake (OR=3·7; 95 % CI 1·3, 10·0) and never intake of fresh juices (OR=3·5; 95 % CI 1·4, 9·5) and being 13–14 years of age (OR=3·1; 95 % CI 1·2, 9·3) were significantly associated with anaemia in male adolescents; whereas in females, family history of Fe-deficiency anaemia (OR=3·4; 95 % CI 1·5, 7·6), being overweight (OR=3·0; 95 % CI 1·4, 6·1), no intake of fresh juices (OR=2·6; 95 % CI 1·4, 5·1), living in an apartment (OR=2·0; 95 % CI 1·1, 3·8) and living in a small house (OR=2·5; 95 % CI 1·2, 5·3) were significantly associated with anaemia.

Anaemia is more prevalent among Saudi female adolescents as compared with males. Important factors like positive family history of Fe-deficiency anaemia, overweight, lack of fresh juice intake and low socio-economic status are significantly associated with anaemia in adolescents.

To conduct a systematic review aimed at identifying and characterizing the experience-based household food security scales and to synthesize their psychometric properties.

Search in the MEDLINE, LILACS and SciELO databases, using the descriptors (‘food insecurity’ OR ‘food security’) AND (‘questionnaires’ OR ‘scales’ OR ‘validity’ OR ‘reliability’). There was no limitation on the period of publication. All articles had their titles and abstracts analysed by two reviewers. The studies of interest were read in their entirety and the relevant information extracted using a standard form.

The initial bibliographic search identified 299 articles. Of these, the 159 that seemed to meet the criteria for inclusion were read fully. After consultation of the bibliographic references of these articles, twenty articles and five documents were added, as they satisfied the previously determined criteria for inclusion. Twenty-four different instruments were identified; all were brief and of easy application. The majority were devised in the USA. Forty-seven references reported results of psychometric studies. The instruments that presented the highest number of psychometric studies were the Core Food Security Measurement/Household Food Security Survey Module (CFSM/HFSSM) and the Self-Perceived Household Food Security Scale.

There are a number of structured scales available in the literature for characterization of household food insecurity. However, despite some psychometric studies already existing about the majority of the instruments, it is observed that, except for the studies of the CFSM/HFSSM, these are still restricted to appraisal of a few aspects of reliability and validity.

To quantify the association between breast-feeding and Helicobacter pylori infection, among children and adolescents.

We searched MEDLINETM and ScopusTM up to January 2013. Summary relative risk estimates (RR) and 95 % confidence intervals were computed through the DerSimonian and Laird method. Heterogeneity was quantified using the I2 statistic.

Twenty-seven countries/regions; four low-income, thirteen middle-income and ten high-income countries/regions.

Studies involving samples of children and adolescents, aged 0 to 19 years.

We identified thirty-eight eligible studies, which is nearly twice the number included in a previous meta-analysis on this topic. Fifteen studies compared ever v. never breast-fed subjects; the summary RR was 0·87 (95 % CI 0·57, 1·32; I2=34·4 %) in middle-income and 0·85 (95 % CI 0·54, 1·34; I2=79·1 %) in high-income settings. The effect of breast-feeding for ≥4–6 months was assessed in ten studies from middle-income (summary RR=0·66; 95 % CI 0·44, 0·98; I2=65·7 %) and two from high-income countries (summary RR=1·56; 95 % CI 0·57, 4·26; I2=68·3 %). Two studies assessed the effect of exclusive breast-feeding until 6 months (OR=0·91; 95 % CI 0·61, 1·34 and OR=1·71; 95 % CI 0·66, 4·47, respectively).

Our results suggest a protective effect of breast-feeding in economically less developed settings. However, further research is needed, with a finer assessment of the exposure to breast-feeding and careful control for confounding, before definite conclusions can be reached.

To assess the relationships between maternal breast-feeding intention, attitudes, self-efficacy and knowledge at 7 months’ gestation with exclusive or full breast-feeding at 3months postpartum.

Prospective cohort study with structured home interviews during pregnancy and 3 months after delivery.

Two rural sub-districts of Kishoreganj district, Bangladesh.

Mother–infant dyads.

Over 80 % of 2178 pregnant women intended to exclusively breast-feed (EBF). Maternal positive attitudes, self-efficacy and knowledge about breast-feeding were positively associated with EBF intention (all P<0·05). All mothers except one reported initiating breast-feeding and 99·6 % of children were still breast-fed at 3 months. According to 24 h dietary recalls, we categorized 985 (45·2 %) infants as EBF at 3 months (47·8 % among mothers with EBF intention; 31·7 % among mothers with no EBF intention; P<0·05) and 551 (25·3 %) infants as predominantly breast-fed at 3 months (24·2 % among mothers with EBF intention; 30·8 % among mothers with no EBF intention; P<0·05). Prenatal EBF intention was associated with EBF (OR=1·48, 95 % CI 1·14, 1·91) and with full breast-feeding (OR=1·34, 95 % CI 1·04, 1·72) at age 3 months. EBF at age 3months was not associated with maternal breast-feeding knowledge, attitudes or self-efficacy.

Despite widespread expressed maternal EBF intention and universal breast-feeding initiation, prevalence of both exclusive and full breast-feeding at 3months remains lower than WHO recommendations. EBF intention predicts breast-feeding behaviours, suggesting the importance of prenatal counselling to improve infant feeding behaviours.

To compare and evaluate the dietary quality of young and older sedentary Mexican-American women. Understanding key dietary concerns, while considering developmental transition periods and cultural relevance, can provide insight for developing appropriate nutrition interventions.

Cross-sectional dietary data were collected using unannounced 24 h diet recalls to assess nutrient intake adequacy (Estimated Average Requirement cut-point method) and dietary quality (Healthy Eating Index (HEI) 2010).

Mujeres en Acción and Madres para la Salud, two community-based physical activity interventions.

Participants were 139 young (28 (sd 6) years) and 124 older (55 (sd 7) years) overweight/obese sedentary Mexican-American women (BMI=25·0–35·0 kg/m2) of low socio-economic status.

Older women consumed less Ca, Fe, folate, empty calories and energy from carbohydrate, but more fruit, vegetables, greens and beans, and fibre than younger women (all P<0·05). Over 60 % of all participants had an intake below recommendations for fibre, Ca, vitamin E, vitamin C and folate. Both groups had low total HEI-2010 scores (62 for older and 63 for younger women; NS), with 57 % of older and 48 % of younger women classified as having a poor diet.

Despite differences in nutrient requirements according to developmental transition periods (childbearing v. perimenopausal), overall, older and younger Mexican-American women generally had low-quality diets and may benefit from dietary quality improvement.

Adequate Zn and Mg intakes may be beneficial for the prevention and treatment of mental health problems, such as depression, anxiety and attention-deficit hyperactivity disorder. We aimed to investigate the prospective association between dietary intakes of Zn and Mg and internalising and externalising behaviour problems in a population-based cohort of adolescents.

Prospective analysis (general linear mixed models) of dietary intakes of Zn and Mg assessed using a validated FFQ and mental health symptoms assessed using the Youth Self-Report (YSR), adjusting for sex, physical activity, family income, supplement status, dietary misreporting, BMI, family functioning and energy intake.

Western Australian Pregnancy Cohort (Raine) Study.

Adolescents (n 684) at the 14- and 17-year follow-ups.

Higher dietary intake of Mg (per sd increase) was significantly associated with reduced externalising behaviours (β=−1·45; 95 % CI −2·40, −0·50; P=0·003). There was a trend towards reduced externalising behaviours with higher Zn intake (per sd increase; β=−0·73; 95 % CI −1·57, 0·10; P=0·085).

The study shows an association between higher dietary Mg intake and reduced externalising behaviour problems in adolescents. We observed a similar trend, although not statistically significant, for Zn intake. Randomised controlled trials are necessary to determine any benefit of micronutrient supplementation in the prevention and treatment of mental health problems in adolescents.

To provide a richer understanding of food access and purchasing practices among US urban food desert residents and their association with diet and BMI.

Data on food purchasing practices, dietary intake, height and weight from the primary food shopper in randomly selected households (n 1372) were collected. Audits of all neighbourhood food stores (n 24) and the most-frequented stores outside the neighbourhood (n 16) were conducted. Aspects of food access and purchasing practices and relationships among them were examined and tests of their associations with dietary quality and BMI were conducted.

Two low-income, predominantly African-American neighbourhoods with limited access to healthy food in Pittsburgh, PA, USA.

Household food shoppers.

Only one neighbourhood outlet sold fresh produce; nearly all respondents did major food shopping outside the neighbourhood. Although the nearest full-service supermarket was an average of 2·6 km from their home, respondents shopped an average of 6·0 km from home. The average trip was by car, took approximately 2 h for the round trip, and occurred two to four times per month. Respondents spent approximately $US 37 per person per week on food. Those who made longer trips had access to cars, shopped less often and spent less money per person. Those who travelled further when they shopped had higher BMI, but most residents already shopped where healthy foods were available, and physical distance from full-service supermarkets was unrelated to weight or dietary quality.

Improved access to healthy foods is the target of current policies meant to improve health. However, distance to the closest supermarket might not be as important as previously thought, and thus policy and interventions that focus merely on improving access may not be effective.

To assess vitamin D status among Cypriot adolescents and investigate potential determinants including BMI and body fat percentage (BF%).

Participants had cross-sectional assessments of serum vitamin D, physical activity, dietary vitamin D intake and sun exposure. Linear and logistic regression models were used to explore the associations of vitamin D with potential predictors.

Hospitals, Cyprus, November 2007–May 2008.

Adolescents (n 671) aged 16–18 years.

Mean serum vitamin D was 22·90 (sd 6·41) ng/ml. Only one in ten children had sufficient levels of vitamin D (≥30 ng/ml), while the prevalence of vitamin D deficiency (12–20 ng/ml) and severe deficiency (<12 ng/ml) was 31·7 % and 4·0 %, respectively. Lower vitamin D was associated with winter and spring season, female gender, reduced sun exposure in winter and darker skin. Participants with highest BMI and BF% when compared with a middle reference group had increased adjusted odds of vitamin D insufficiency (OR = 3·00; 95 % CI 1·21, 7·45 and OR = 5·02; 95 % CI 1·80, 13·97, respectively). A similar pattern, although not as strong, was shown for vitamin D deficiency with BF% (OR = 1·81; 95 % CI 1·04, 3·16) and BMI (OR = 1·51; 95 % CI 0·85, 2·67). Participants in the lowest BMI and BF% groups also displayed compromised vitamin D status, suggesting a U-shaped association.

Vitamin D deficiency in adolescence is very prevalent in sunny Cyprus, particularly among females, those with darker skin and those with reduced sun exposure in winter. Furthermore, vitamin D status appears to have a U-shaped association with adiposity measures.

The objective of the present study was to investigate associations between sugar intake and overweight using dietary biomarkers in the Norfolk cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Norfolk).

Prospective cohort study.

EPIC-Norfolk in the UK, recruitment between 1993 and 1997.

Men and women (n 1734) aged 39–77 years. Sucrose intake was assessed using 7 d diet diaries. Baseline spot urine samples were analysed for sucrose by GC-MS. Sucrose concentration adjusted by specific gravity was used as a biomarker for intake. Regression analyses were used to investigate associations between sucrose intake and risk of BMI>25·0 kg/m2 after three years of follow-up.

After three years of follow-up, mean BMI was 26·8 kg/m2. Self-reported sucrose intake was significantly positively associated with the biomarker. Associations between the biomarker and BMI were positive (β=0·25; 95 % CI 0·08, 0·43), while they were inverse when using self-reported dietary data (β=−1·40; 95 % CI −1·81, −0·99). The age- and sex-adjusted OR for BMI>25·0 kg/m2 in participants in the fifth v. first quintile was 1·54 (95 % CI 1·12, 2·12; Ptrend=0·003) when using biomarker and 0·56 (95 % CI 0·40, 0·77; Ptrend<0·001) with self-reported dietary data.

Our results suggest that sucrose measured by objective biomarker but not self-reported sucrose intake is positively associated with BMI. Future studies should consider the use of objective biomarkers of sucrose intake.

To evaluate dietary intake based on the Chinese Food Pagoda (CFP) and to determine what factors may be associated with adherence to CFP guidelines for older Chinese.

This cross-sectional population-based study used 24 h recall over three consecutive days to assess dietary intake and adherence to CFP among older Chinese participating in the China Health and Nutrition Survey 2009.

Nine provinces across four diverse regions (Northeast, East Coast, Central and West).

A total of 2745 older Chinese, aged 60–69 years (n 1563) and ≥70 years (n 1182), with dietary data.

None of the participants reached all ten food group recommendations. More than half of the participants exceeded the recommended amount for grains (63 %), oil (62·8 %) and salt (55·7 %). Ten per cent of the participants consumed dairy, while merely 0·5 % met the recommended amount. Average Chinese Food Pagoda Score (CFPS) was 3·3 in men and 3·5 in women, far below the maximum possible score of 10. Women had 0·26 higher CFPS than men (P<0·001; 95 % CI 0·16, 0·36). People living in medium and high urbanicity areas had significantly higher scores than those living in low urbanicity areas (P<0·001). Also, there were significant differences in CFPS according to gender, BMI, work status, education level and region.

Few older Chinese are meeting the intake of the various food groups based on the recommendations in the CFP guidelines, thus increasing the risk of malnutrition and non-communicable diseases. Action is needed to increase dissemination and uptake of nutrition education, with interventions targeted at socio-economic regions. Moreover, specific dietary guidelines for older Chinese people should be developed.

To determine the potential predictors of body size dissatisfaction in Chinese children.

The Child’s Body Image Scale was used to assess body size perception and dissatisfaction. BMI was calculated from objectively measured height and weight. Predictors of body size dissatisfaction were examined by logistic regression analysis.

Hong Kong, China.

Six hundred and twenty children (53 % boys, aged 6·1–12·9 years) from a state-run primary school.

Female sex (adjusted OR (AOR)=1·91; 95 % CI 1·32, 2·76), age (AOR=2·62; 95 % CI 1·65, 4·16 for 8–10 years; AOR=2·16; 95 % CI 1·38, 3·38 for >10 years), overweight (AOR=6·23; 95 % CI 3·66, 10·60) and obesity (AOR=19·04; 95 % CI 5·64, 64·32) were positively associated with desire to be thinner. Size misperception was a strong predictor of body size dissatisfaction, irrespective of actual weight status (AOR=1·90; 95 % CI 1·02, 3·54 for overestimation; AOR=0·43; 95 % CI 0·27, 0·67 for underestimation).

Body size dissatisfaction is prevalent among Chinese children as young as 6 years. Female sex, age, overweight, obesity and overestimation of size were associated with increased desire to be thinner. These findings emphasise the importance of preventing body image issues from an early age.

To describe how Indigenous Peoples understand how to enhance use of their food systems to promote sustainability, as demonstrated in several food-based interventions.

Comments contributed by partners from case studies of Indigenous Peoples and their food systems attending an international meeting were implemented with public health interventions at the community level in nine countries.

The Rockefeller Foundation Bellagio Conference Center in Bellagio, Italy, where experiences from case studies of Indigenous Peoples were considered and then conducted in their home communities in rural areas.

Leaders of the Indigenous Peoples’ case studies, their communities and their academic partners.

Reported strategies on how to improve use of local food systems in case study communities of Indigenous Peoples.

Indigenous Peoples’ reflections on their local food systems should be encouraged and acted upon to protect and promote sustainability of the cultures and ecosystems that derive their food systems. Promoting use of local traditional food biodiversity is an essential driver of food system sustainability for Indigenous Peoples, and contributes to global consciousness for protecting food biodiversity and food system sustainability more broadly. Key lessons learned, key messages and good practices for nutrition and public health practitioners and policy makers are given.

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 main objectives were to assess the adequacy of the micronutrient intakes of lactating women in a peri-urban area in Nepal and to describe the relationships between micronutrient intake adequacy, dietary diversity and sociodemographic variables.

A cross-sectional survey was performed during 2008–2009. We used 24 h dietary recall to assess dietary intake on three non-consecutive days and calculated the probability of adequacy (PA) of the usual intake of eleven micronutrients and the overall mean probability of adequacy (MPA). A mean dietary diversity score (MDDS) was calculated of eight food groups averaged over 3 d. Multiple linear regression was used to identify the determinants of the MPA.

Bhaktapur municipality, Nepal.

Lactating women (n 500), 17–44 years old, randomly selected.

The mean usual energy intake was 8464 (sd 1305) kJ/d (2023 (sd 312) kcal/d), while the percentage of energy from protein, fat and carbohydrates was 11 %, 13 % and 76 %, respectively. The mean usual micronutrient intakes were below the estimated average requirements for all micronutrients, with the exception of vitamin C and Zn. The MPA across eleven micronutrients was 0·19 (sd 0·16). The diet was found to be monotonous (MDDS was 3·9 (sd 1·0)) and rice contributed to about 60 % of the energy intake. The multiple regression analyses showed that MPA was positively associated with energy intake, dietary diversity, women’s educational level and socio-economic status, and was higher in the winter.

The low micronutrient intakes are probably explained by low dietary diversity and a low intake of micronutrient-rich foods.

Chronic stress and repeated physiological attempts at stress adaptation may result in ‘fatigue’ and suboptimal performance of multiple physiological systems, i.e. allostatic load (AL). Although carotenoids have been linked with individual cardiovascular, metabolic and inflammatory biomarkers, little is known about the relationship of carotenoids with the multi-system biomarker measure of stress, AL. The present study examined the association of serum concentrations of carotenoids with AL among middle-aged adults.

Cross-sectional. AL score was calculated based on nine risk-rated indicators (systolic and diastolic blood pressure, pulse rate, total and HDL-cholesterol, glycosylated Hb, sex-specific waist-to-hip ratio, albumin and C-reactive protein).

Middle-aged (45–64 years, n 3387) men and women participants in the Third National Health and Nutrition Examination Survey, NHANES III (1988–1994).

Serum β-carotene concentration was inversely associated with high AL after adjusting for age, education, race/ethnicity, serum cotinine, alcohol consumption, physical activity and other carotenoids (α-carotene, β-cryptoxanthin, lycopene, lutein/zeaxanthin). Females in the lowest β-carotene quartile were 2·94 (95 % CI 1·74, 4·94) times and males 2·90 (95 % CI 1·43, 5·89) times as likely to have high AL, compared with peers in the highest quartile (P for linear trend 0·001 and 0·018 for females and males, respectively). Mean serum β-carotene concentrations were also inversely associated with the number of ‘high-risk’ AL components (P for linear trend <0·001 and 0·004 for females and males, respectively).

Our study adds to evidence linking low β-carotene levels with unfavourable health outcomes.