(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.

To provide an overview of the Household Food Consumption and Anthropometric Survey, undertaken in Poland from September to November 2000.

A sub-sample of households participating in the countrywide, representative household budget survey (HBS) was selected to participate in the Household Food Consumption and Anthropometric Survey. Four thousand two hundred (4200) individuals provided 24-hour recalls that were subsequently evaluated. Body weight and height together with the mid-arm, waist and hip circumferences were measured. Laboratory analyses of contaminants that may be present in selected individual diets will be undertaken.

Poland, 2000.

Four thousand two hundred individuals from 1362 households participating in the Polish HBS.

Preliminary analyses of height and weight, as well as energy and nutrient intakes, were undertaken in a sub-sample of 484 boys and girls aged 10–15 years. Energy intakes were generally in line with or above the Polish Recommendations.

Apart from serving as an important information source on individual food consumption and anthropometric status of the Polish population, the data collected through the Household Food Consumption and Anthropometric Survey will allow direct comparisons of food intake estimates, based on 24-hour recalls, with the results of the household budget survey. Such comparisons are expected to improve and refine interpretation of the data derived from both the individual nutrition survey and the household budget survey, and particularly to provide information on the importance of eating out, which is not covered in the Polish HBS.

For effective healthy eating promotion, it is necessary to understand the attitudes towards and beliefs about nutrition of the general public. The objective of this study was to provide data on attitudes towards eating a healthy diet and the perceived need to alter eating habits from a random sample of adults in the Republic of Ireland and in Northern Ireland, using a self-administered questionnaire.

Cross-sectional survey using a self-administered attitudinal questionnaire on beliefs and attitudes to healthy eating.

The survey was carried out between October 1997 and October 1999 in the Republic of Ireland and in Northern Ireland.

A randomly selected sample of 1256 adults from the Republic of Ireland and Northern Ireland completed the attitudinal questionnaire.

A majority of subjects (62%) perceived that they make conscious efforts to eat a healthy diet either most of the time or quite often, while just over half (52%) agreed that they do not need to make changes to their diet as it is healthy enough. Subjects most likely to make conscious efforts to try to eat a healthy diet were females, older subjects (51-64 years) and those with the highest intakes of fruit and vegetables and lowest quartile of fat (% food energy). When self-assessed adequacy of fruit and vegetables was examined, two-thirds of the total sample felt they ate too little fruit while just one-third felt they ate too little vegetables.

Results of the present study, in general, revealed good agreement between attitude and behaviour with respect to healthy eating. This suggests that people appear to be reasonably accurate at evaluating their own diet in terms of how healthy it is. In terms of the two food groups examined in this study, some optimistic bias was evident for vegetables but not for fruit. It may be useful therefore to assess attitudes and beliefs about healthy eating by way of examining attitudes to such food groups individually.

To investigate the usefulness of serum carotenoids as biomarkers of fruit and vegetable consumption.

Reproducibility study on three repeat measurements of serum carotenoids. Correlation analysis of carotenoids and dietary food intake, and regression analysis of potential predictive parameters for serum carotenoid levels.

New York, USA.

Women participating in the New York Women's Health Study, a prospective study of sex hormones, diet and breast cancer. Forty-eight women with three repeat blood samples and 302 women having a blood sample and a dietary history questionnaire.

Serum carotenoid concentrations were highly reproducible between one- and two-year repeat samples. Estimated fruit and vegetable consumption was positively correlated with serum carotenoid concentrations but correlation coefficients were low. Consumption of fruit was predictive for serum levels of beta-carotene, alpha-carotene and beta-cryptoxanthin, while vegetable consumption was predictive for serum beta-carotene, lutein, zeaxanthin and lycopene. Serum concentrations of cholesterol and triglycerides were predictive for serum carotenoids but adjustment for their levels had little or no influence on the correlation between fruit and vegetable consumption and serum carotenoid concentrations.

One single serum measurement of alpha-carotene, beta-carotene and lutein can accurately rank subjects according to their usual serum level. Serum concentrations, however, correlate only moderately with estimated dietary intake of fruits or vegetables and should therefore be used with caution as biomarkers of fruit and vegetable intake.

Diet is an important determinant of health outcomes, but physicians have few ways to identify persons with suboptimal diets. The purposes of this study were to examine the reproducibility of a short dietary assessment questionnaire (PrimeScreen) and to compare its results with those of a longer food frequency questionnaire and with plasma levels of selected nutrients.

Each subject completed two PrimeScreen questionnaires at an interval of 2 weeks and one full length, 131-item, semiquantitative food frequency questionnaire (SFFQ), and had a sample of blood drawn. We compared the PrimeScreen with two reference standards, the SFFQ and plasma levels of selected nutrients.

A large managed care organization in New England.

A total of 160 men and women, aged 19–65 years, participated.

For foods and food groups, the mean correlation coefficient (r) was 0.70 for reproducibility and 0.61 for comparability with the SFFQ. For nutrients, the mean r was 0.74 for reproducibility and 0.60 for comparability with the SFFQ. No substantial differences were evident by sex, race, body mass index, occupation or education. Correlation coefficients for the comparison of vitamin E, β-carotene and lutein/zeaxanthin intakes from the PrimeScreen with plasma levels were 0.33, 0.43 and 0.43, respectively. These values were similar to those comparing the SFFQ with plasma levels. The median time to complete PrimeScreen was 5 min; 87% of participants required fewer than 10 min.

A quick way to assess quality of diet among adults, PrimeScreen has adequate reproducibility and its results compare well with a longer food frequency questionnaire and biomarkers.

To compare intra- and inter-method reliability of a semi-quantitative food frequency questionnaire (FFQ) designed specifically to measure beta carotene (BC) and retinol intake, using two methods – the limits of agreement (LOA) and the correlation coefficient.

A cross-sectional study of dietary intake.

A randomized trial of vitamin A supplements in 2769 subjects with past asbestos exposure.

Data from 57 men and 26 women, aged 28–72 years, living in Western Australia.

The FFQ was administered at baseline (FFQ1) and repeated 1 year later (FFQ2). Four 1-week diet records (DRs) were completed during the year.

Mean agreement between FFQ2 and FFQ1 was 120% for BC and 98% for retinol. LOA were 47–306% and 21–459%, respectively. Mean agreement between FFQ2 and the DR was 149% for BC and 63% for retinol; LOA were 50–447% and 11–349%, respectively. Mean agreement and LOA varied across energy intakes. Between the DR and FFQ2, correlation coefficients were 0.36 for BC and 0.51 for retinol. These varied considerably across age, gender and energy intakes and were not in accordance with limits of agreement findings.

Although correlation coefficients were positive and significant, there was less than ideal intra-method and inter-method reliability shown by the limits of agreement method. Bias was uneven across the range of intakes, the LOA were wide and, compared with the DR, the FFQ significantly over-estimated BC and under-estimated retinol. This shows the limitations of calculating correlation coefficients alone, for assessing reliability and validity.

To identify, quantify and depict variation of food habits in Europe, using data from the DAFNE (DAta Food NEtworking) databank.

Household budget survey data of 12 European countries, namely Belgium, Germany, Greece, Hungary, Ireland, Italy, Luxembourg, Norway, Poland, Portugal, Spain and the United Kingdom, around 1990.

Data from the DAFNE databank are presented in simple pictorial presentations, which reveal considerable disparities in food habits. Furthermore, there appears to be nutritional variation within countries by socio-demographic groups, defined by their residence and educational level. The distribution patterns of food availability provide insights into the determinants of food preferences, as conditioned by current forces.

The factors influencing consumer choice are many and varied. Thus, in order to promote healthy eating, it is essential to identify the food habits of the target population. In this context, information derived from household budget surveys, used in the development of the DAFNE databank, could be very important.

Brassica vegetable consumption (e.g. broccoli) leads to excretion of isothiocyanates (ITC) in urine. We evaluated the consistency of ITC as a biomarker for dietary Brassica vegetable consumption across the types of vegetables and methods of preparation used in Western societies, and across consumption levels.

A single-armed behavioural intervention with duplicate baseline assessment and post-intervention assessment. Urinary ITC excretion and estrogen metabolites were measured from 24-hour urine samples. Dietary intake was measured by a 24-hour recall.

The behavioural intervention facilitated daily Brassica intake among participants by providing peer support, food preparation instruction, guided practice in a teaching kitchen, and other information.

Thirty-four healthy free-living postmenopausal women who recently had a negative screening mammogram at the University of Massachusetts Medical Center.

Urinary ITC excretion and total Brassica intake followed the same pattern over the intervention. The ITC biomarker significantly predicted Brassica intake when Brassica consumption averaged about 100 g day−1, but not when Brassica consumption averaged about 200 g day−1. Urinary ITC levels were somewhat higher when more raw vegetables were consumed as compared to lightly cooked vegetables, while the types of Brassica consumed appeared to have only a small, non-significant effect on urinary ITC levels.

Urinary ITC excretion would be a good exposure biomarker among populations regularly consuming a vegetable serving/day, but may be less accurate among populations with greater intake levels or a wide range of cooking practices.

To describe methods and dietary habits of a large population cohort.

Prospective assessment of diet using diet diaries and food-frequency questionnaires, and biomarkers of diet in 24-h urine collections and blood samples.

Free living individuals aged 45 to 75 years living in Norfolk, UK.

Food and nutrient intake from a food-frequency questionnaire on 23 003 men and women, and from a 7-day diet diary from 2117 men and women. Nitrogen, sodium and potassium excretion was obtained from single 24-h urine samples from 300 individuals in the EPIC cohort. Plasma vitamin C was measured for 20 846 men and women.

The food-frequency questionnaire (FFQ) and the food diary were able to determine differences in foods and nutrients between the sexes and were reliable as judged by repeated administrations of each method. Plasma vitamin C was significantly higher in women than men. There were significant (P<0.001) differences in mean intake of all nutrients measured by the two different methods in women but less so in men. The questionnaire overestimated dairy products and vegetables in both men and women when compared with intakes derived from the diary, but underestimated cereal and meat intake in men. There were some consistent trends with age in food and nutrient intakes assessed by both methods, particularly in men. Correlation coefficients between dietary intake assessed from the diary and excretion of nitrogen and potassium in a single 24-h urine sample ranged from 0.36 to 0.47. Those comparing urine excretion and intake assessed from the FFQ were 0.09 to 0.26. The correlations between plasma vitamin C and dietary intake from the first FFQ, 24-h recall or diary were 0.28, 0.35 and 0.40.

EPIC Norfolk is one of the largest epidemiological studies of nutrition in the UK and the largest on which plasma vitamin C has been obtained. Methods for obtaining food and nutrient intake are described in detail. The results shown here for food and nutrient intakes can be compared with results from other population studies utilising different methods of assessing dietary intake. The utility of different methods used in different settings within the main EPIC cohort is described. The FFQ is to be used particularly in pooled analyses of risk from diet in relation to cancer incidence within the larger European EPIC study, where measurement error is more likely to be overcome by large dietary heterogeneity on an international basis. Findings in the UK, where dietary variation between individuals is smaller and hence the need to use a more accurate individual method greater, will be derived from the 7-day diary information on a nested case–control basis. 24-h recalls can be used in the event that diary information should not be forthcoming from some eventual cases. Combinations of results utilising all dietary methods and biomarkers may also be possible.