To monitor trends in Danish food habits with respect to selected key elements, from 1995 to 1998, and to evaluate the appropriateness of the method developed for that purpose.

Two cross-sectional population surveys, in 1995 and 1998. Data collection by computer-assisted telephone interviews including 10 food-frequency questions, questions on type of fat used on sandwiches and drinking milk, and check questions on the previous day. Reproducibility was tested in a subgroup (n=222) in the 1998 survey.

The Danish Nutrition Council initiated the survey.

Men and women aged 15–90 years, 1007 in 1995 and 1024 in 1998. Samples of private telephone numbers were drawn from regional telephone registers, geographically stratified. Participation rates were 62%.

Significant differences were observed between 1995 and 1998, some of these in accordance with dietary guidelines (decreased use of whole milk and fat spread on bread, increased use of skimmed milk, salad vegetables, rice/pasta and fish). Other changes were opposite to dietary guidelines (increased use of soft butter, decreased use of soft margarine and low-fat spreads, potatoes, and fresh fruit). Differences in average consumption frequency amounted to 4–13%. Several results were confirmed by comparison with other data, and the reproducibility of the method was acceptable. Data were suitable for analysis of food use patterns, a relevant approach when assessing food habits in a lifestyle context.

The changes observed illustrate the dynamics of food habits and the need for frequent monitoring. This simple telephone method may be a valuable tool for that purpose, as a supplement to national dietary surveys, also in a public health context.

To summarise the methods of data collection on foods eaten outside the home in the National Food Survey (NFS) and the new (2001) Expenditure and Food Survey (EFS).

The treatment of foods eaten outside the home in the NFS was reviewed as part of a merger process with the UK household budget Family Expenditure Survey (FES). Problem issues were identified and the way these problems are being dealt with in the EFS is indicated.

United Kingdom.

Pilot EFS results indicate improved coverage of foods eaten outside the home, in a comparable period to the NFS.

The new EFS, which represents a merger of the NFS and the FES at the level of data collection and validation, is likely to preserve the qualities of the previous surveys and represents an improvement over them.

To estimate the prevalence and severity of anaemia among non-pregnant women in rural Bangladesh and describe its social distribution.

A cross-sectional study conducted in February–March 1996. Haemoglobin concentration was measured on a capillary blood sample by cyanmethaemoglobin method. The World Health Organization (WHO) classification was used to define anaemia.

Twelve randomly selected villages in Fulbaria thana of Mymensingh district, about 110 km northwest of Dhaka city in Bangladesh.

A systematically selected sample of 179 non-pregnant apparently healthy women aged 15–45 years.

Anaemia was highly prevalent (73%; 95%CI 67–79%). Most of the women had mild (52%) or moderate (20%) anaemia, but a few of them suffered from severe anaemia (1%). Ascaris was common (39%) while hookworm was not (1%). The anaemia prevalence had no statistically significant association with age, parity or Ascaris infestation (P>0.05). Women with less than 1 year of schooling, who were landless or who reported having an economic deficit in the household had significantly higher prevalence of anaemia (P<0.05). There was a significantly increasing trend in anaemia prevalence with decreasing socioeconomic situation (SES). However anaemia was common in all social strata.

Although the overall anaemia prevalence among non-pregnant rural women is high, only a few women suffer from severe anaemia. Women of all SES groups irrespective of their age and parity are affected by anaemia.

The effect on individual rankings and total intakes of nutrients of correcting total fruit and vegetable frequencies from a long food frequency questionnaire (FFQ) using the responses to two summary questions was examined in a group of women.

The performance of a self-administered FFQ in ranking individual levels of intake and estimating absolute levels of nutrient and energy intake was compared with the performance of the questionnaire when it was corrected for fruit and vegetable intake reported using the Block summary questions.

The study population included 123 women, aged between 18 and 54 years, who were recruited from the Family Planning Association Colposcopy Clinic in Sydney.

Substantial and significant differences (P<0.001) were found in fruit and vegetable intakes between the FFQ and the summary questions. Intake frequency by the FFQ was more than double that by the summary questions. When the FFQ was corrected for fruit and vegetable intakes using the summary questions, the intakes of beta-carotene, vitamins A and C, and dietary fibre were more than 20% lower (P<0.001) than the uncorrected results. However, this had little effect on ranking individuals. This study also examined seasonal differences in vegetable intakes and differences in nutrient intakes when either summer or winter vegetable consumption was substituted for seasonal vegetable intake in the FFQ. Although there were seasonal differences for some foods, the substitution had little effect on intake of nutrients.

These results indicate that important differences in intakes are observed when two methods, which appear to yield the same results, are used. Further work is needed to determine which, if either, of the two methods yields intakes that can be compared quantitatively with national references for assessing the adequacy of population intakes.

The aim of this research was to describe the variation in bread consumption within social classes and to link this consumption to health-related lifestyles in Finland from 1978 until 1998.

A cross-sectional survey on health-related behaviour and socio-demographic factors has been conducted annually since 1978.

Mailed questionnaire.

A random sample of 5000 Finns aged 15–64 years has been drawn annually. The response rate has varied from 84% to 68%.

The consumption of rye bread decreased, but among the female population a slight increase appeared in the 1990s. The consumption of rye bread was associated with a low educational level and a rural place of residence. White bread was consumed less than was rye bread. White bread was consumed more frequently by the less educated in urban areas. Contrary to white bread, the consumption of rye bread was not associated with smoking, exercise or alcohol consumption.

The traditional place of rye bread in the Finnish dietary pattern has remained rather constant. White bread consumption has been associated with an unhealthy lifestyle. As a result, those Finns who are concerned about their health avoid white bread but seem not to associate rye bread with a healthier lifestyle. In Finland, rye bread has a different image to the image of whole-grain or dark brown bread in many other western European countries.

To obtain measured anthropometric data for weight, height and other parameters not previously measured in the Irish population such as waist and hip circumferences and body composition.

A cross-sectional survey. Weight, height, waist circumference, hip circumference and body composition were measured according to standard procedures.

Northern Ireland and the Republic of Ireland, 1997–1999.

Random representative sample of 1379 adults aged 18–64 years. Results: With the exception of body fat, all anthropometric values were significantly higher for men than women (P < 0.001). All measurements were significantly higher in the 36–50-year-old age group compared with 18–35 year olds. Height was the exception, which decreased significantly with age (P < 0.05). Weight, height and body mass index (BMI) have increased in Ireland since last measured in 1988 and in 1990. Over the last decade, obesity has increased in men 2.5 fold from 8% to 20% and in women by 1.25 fold from 13% to 16%. Significantly more women have a normal BMI than men (50.4% vs. 33.3%; P < 0.05). Cut-off points for a high waist circumference and high waist-to-hip ratio identified 47% and 33% of the population, respectively, to be at an increased risk for cardiovascular disease. Social class did not have any significant effect on mean BMI. Location of residence influenced BMI but not in any consistent manner. Ex-smokers had a significantly higher BMI than nonsmokers and smokers (P < 0.05).

A revision of current recommendations for combating obesity is warranted to improve the health of the Irish population. Further research is needed to identify the factors that have contributed to the dramatic increase in the prevalence of obesity in men over the last decade and have resulted in a higher prevalence of obesity in men than in women.

To determine whether a short set of questions about foods in the household can provide information about the fat-related dietary behaviour of individual household members in less-acculturated Chinese populations.

Cross-sectional survey.

The study population included 244 adult females of Chinese ethnicity in Seattle, WA, and Vancouver, BC, Canada.

Bilingual interviewers collected information on the presence of 14 high-fat foods and seven reduced-fat foods in the household. Respondents were also asked about the consumption of foods and behaviour reflective of adoption of Western dietary practices, fat-related dietary behaviour, changes in consumption of high-fat foods since immigration, and sociodemographic characteristics.

Although this was a less-acculturated sample, many households had Western foods such as butter (58%), lunchmeats (36%), snack chips (43%), and 1% or skim milk (48%). Households with respondents who were younger, married, employed outside the home, and lived with young children had significantly more high-fat foods, while high education and longer percentage of life in North America were significantly associated with having more reduced-fat foods (P ≤ = 0.05). Participants living in households with more high-fat foods had higher-fat dietary behaviour than those with fewer high-fat foods (fat-related dietary behaviour score, 1.54 versus 1.28; P < 0.001). Women in households with more reduced-fat foods had a significantly decreased consumption of high-fat foods since immigration compared with those in households with fewer reduced-fat foods (P < 0.001). Western dietary acculturation was higher among women in households both with more high-fat foods and more reduced-fat food counterparts (P ≤ 0.05).

Our inventory of household foods was strongly associated with current dietary behaviour, changes in food consumption, and westernization of dietary patterns. This simple, practical measure may be a useful alternative dietary assessment tool in less-acculturated Chinese populations.

Laboratory data suggest that several different vitamins may inhibit the growth of mammary cancers, however epidemiologic data on the relationship between vitamin supplement use and breast cancer are inconsistent. We examined the association between self-reported vitamin supplement use and breast cancer among black women and white women.

The data came from a population-based, case–control study conducted in North Carolina between 1993 and 1996. Logistic regression models were used to calculate adjusted odds ratios (ORs) for breast cancer associated with the use of multivitamins or individual vitamin supplements.

Eligible cases were aged 20 to 74, and approximately 40% of the study population were black women. The analyses included 861 cases and 790 controls.

Among all women, there was little evidence for an association between any vitamin supplement and breast cancer. Modest inverse associations were observed among white women for use of multivitamins (OR = 0.81, 95% confidence interval (CI): 0.59–1.12), vitamin C (OR = 0.78, 95% CI: 0.54–1.14) and vitamin E (OR = 0.75, 95% CI: 0.49–1.13). There was no evidence that vitamin supplements reduced the risk of breast cancer among black women.

This study provided very limited support for the hypothesis that vitamin supplements may reduce the risk of breast cancer. Although dietary factors are likely an important influence in breast cancer aetiology, reductions in risk are most likely to be achieved through dietary modification rather than through vitamin supplementation.

Comparison of household and individual food consumption.

Combined household and individual food consumption survey carried out in Sweden in 1989. A random sample of 3000 subjects aged 0−74 years, the household to which the subject belonged constituted the household unit. Each household recorded all the foods it purchased over a 4-week period, except food eaten outside the home. For the selected subject, excluding children <1 year old, food intake was obtained with a simplified 7-day record. Food consumption from the two data sets was compared for the whole sample and for one-person households, respectively.

Reasonable agreement (±20%) was seen for many major foods including cereal products, milk, cheese, meat and meat products, and fish, and after correction for inedible part, fruit and vegetables. Purchases were lower for sweet bakery products, alcoholic beverages and potatoes, while the opposite was seen for oils and fats, cream and sugar. For one-person households the two data sets showed similar differences in consumption patterns between men and women. The gross differences observed can be explained by factors like home baking, eating out and recorded level of processing, e.g. as raw food including inedible part or as a prepared dish.

The results show reasonable agreement between purchased and eaten amounts for aggregated food groups but marked differences were seen for some important individual items. Household-based consumption data are useful for many purposes provided the limitations of the data are accounted for.

To evaluate habitual levels of physical activity in a nationally representative sample of adults in Ireland.

Cross-sectional survey using a self-administered questionnaire. Usual levels of work, recreational and household activities were evaluated in relation to anthropometric, demographic and socio-economic characteristics. The amount and intensity of all activities were quantified by assigning metabolic equivalents (METS) to each activity.

Republic of Ireland and Northern Ireland, 1997–1999.

Random sample of 1379 adults aged 18–64 years.

Men were approximately twice as active in work and recreational activity (139.7 ± 83.9 METS) as women (68.5 ± 49.8 METS; P < 0.001), but women were three times more active in household tasks (65.9 ± 58.7 METS vs. 22.6 ± 24.6 METS; P < 0.001). Overall levels of physical activity declined with increasing age, particularly leisure activity in men. In women the decline in work activity was offset by spending more time in household pursuits. Twenty-five per cent of the subjects were extremely overweight (body mass index (BMI) > 28kg m−2) or obese (BMI > 30kg m−2). Fewer obese subjects reported higher levels of work and leisure activities. However, a higher percentage of obese women reported participation in the higher levels of household activities. Participation rates in recreational activities were low. Walking was the most important leisure activity of both men (41%) and women (60%). In terms of hours per week spent in vigorous physical activity, men were more active than women, professional and skilled non-manual women were more active than women in other social classes, and younger subjects (aged 18–35 years) were more active than older subjects.

The holistic approach used in the assessment of physical activity in this study has revealed important and subtle differences in the activity patterns of men and women. Failure to fully characterise the respective activity patterns of men and women could lead to ill-informed public health policy aimed at promoting and sustaining lifetime habits of physical activity. The results suggest that simple population-focused programmes to promote physical activity are unlikely to offer the same chance of long-term success as more sensitive and individualised strategies.

(i) to describe energy and macronutrient requirements in healthy and diseased elderly patients from knowledge acquired about the age-related changes in energy balance (ii) to describe changes in body composition and the consequences of physical activity and exercise programs.

Aging in individuals considered healthy is associated with a reduction in muscle mass and strength (with consequences on autonomy), and an increase in fat mass mainly in the central area, the latter might increase the risk of cardiovascular disease. Body composition changes can be seen as a positive energy (fat) balance. The reduced fat-free mass is responsible for a low resting metabolic rate. Therefore, energy requirements are reduced all the more since physical activity is decreased. A simple means for calculating individuals' energy requirements from estimated resting metaboc rate and physical activity is not yet available in a validated form and is much required. Protein requirements are still debated.

Exercise programs can be implemented for increasing muscle mass and strength (resistance training) or for improving aerobic fitness and reducing fat mass (endurance exercise). It is not yet clear whether structured exercise programs or spontaneous physical activity have similar advantages. It is not known in which cases resistance, endurance, or a combination of both exercises should be recommended. The consequences of physical activity and exercise programs on energy and macronutrient requirements is not clear.

Diseased elderly persons are prone to malnutrition which impairs clinical and functional outcome. Malnutrition is the result of an energy intake inadequate to match energy requirements. Literature is very short of data on energy requirements in diseased elderly persons, who are under the complex influences of stress (increasing resting energy requirements), reduced body mass and physical activity (reducing energy requirements), plus potential effects of drugs. Almost nothing is known about macronutrient requirements.

Further studies are required to enable calculations of energy and macronutrient requirements of individuals, especially diseased. More work has to be done to understand the energy imbalance in the elderly (healthy and diseased). Careful evaluations of physical activity and exercise programs are necessary.