To describe the consumption of ready-to-eat-breakfast cereals (RTEBCs) in Irish adults and its impact on adequacy and safety of micronutrient intakes and compliance with dietary recommendations.

Analysis for this paper used data from the North/South Ireland Food Consumption Survey that estimated habitual food intake using a 7-day food diary in a representative sample of adults aged 18–64 years (n=1379; 662 men, 717 women).

Despite the small quantity consumed (mean 28.6gday-1 or 4.7% of total energy intake), RTEBCs made an important contribution to the mean daily intake of carbohydrate (8.1%), starch (10.8%), dietary fibre (9.8%) and non-starch polysaccharides (NSP) (10.8%) in consumers. Increased consumption was associated with a more fibre-dense diet and with greater compliance with dietary recommendations for fat, carbohydrate and NSP. Fortified RTEBCs contributed significantly to mean daily intakes of iron (18%), thiamin (14%), riboflavin (17%), niacin (15%), vitamin B6 (13%), total folate (18%) and vitamin D (10%) and most of the contribution was from micronutrients added to RTEBCs. Increased consumption of fortified RTEBCs was associated with an increased nutrient density for a number of micronutrients and with a lower prevalence of dietary inadequacy of calcium, iron, riboflavin and folate, particularly in women. However, it was not associated with intakes in excess of the Tolerable Upper Intake Level for any micronutrient.

The consumption of RTEBCs is associated with improved compliance with dietary recommendations for fat, carbohydrate and fibre, with a more micronutrient-dense diet and a reduced risk of dietary inadequacy for calcium, iron, riboflavin and folate, without increasing the risk of excessive intakes of micronutrients.

To investigate the prevalence of vitamin A deficiency among lactating women in a poor urban population of Bangladesh, and to examine the relationship between various factors and vitamin A status.

Cross-sectional study.

Maternal and child health clinic in Dhaka City, Bangladesh.

A total of 120 lactating women aged 17–37 years were randomly selected from women who attended a local maternal and child health clinic in Dhaka City for immunisation of their children. Various socio-economic, personal characteristics, dietary intakes of vitamin A and anthropometric data were collected. Serum retinol (vitamin A) concentration was determined as a measure of vitamin A status.

Of the subjects, 37% had low serum vitamin A levels (<30 μg dl−1), with 13.3% having sub-clinical vitamin A deficiency (<20 μg dl−1). Eighty-seven per cent had vitamin A intakes below the recommended dietary allowance. The lactating women who were either illiterate or received only informal education had significantly (P = 0.002) lower serum vitamin A levels compared with those who received formal education. The women whose husbands received formal education had significantly (P = 0.05) higher serum vitamin A levels than those whose husbands were either illiterate or received only informal education. The serum vitamin A levels of women in households with poor sanitation/latrine practice were significantly (P = 0.03) lower than those of women in households with good sanitation/latrine practice. The women with one child had significantly (P = 0.015) lower serum vitamin A levels than those with two or more children. Women with a lactation period of 6 months or more had significantly (P = 0.034) lower serum vitamin A levels than women with a lactation period of less than 6 months. The women who consumed less than the median vitamin A intake (274.8 μg day−1) had significantly (P = 0.01) lower serum vitamin A levels than those who consumed more than the median vitamin A intake. By multiple regression analysis, education level of the women, number of living children, duration of lactation and dietary intake of vitamin A were found to have significant independent relationships with serum vitamin A. The overall F-ratio (6.8) was highly significant (P = 0.000), the adjusted R2 was 0.16 (multiple R = 0.44).

A significant proportion of poor, urban, lactating women in Bangladesh have vitamin A deficiency. Among the various factors, education level of the women, number of living children, duration of lactation and dietary intake of vitamin A appear to be important in influencing the vitamin A status of these women.

To identify food sources of fat, to compare food and nutrient intakes at different levels of relative fat intake, and to examine the contribution of different food groups to the variation in relative fat intake. Relative fat intake was expressed as energy contributed by fat in percentage of non-alcohol energy.

Cross-sectional analysis of baseline data from the Malmö Diet and Cancer Study. An interview-based diet history method, a structured questionnaire and anthropometric measurements were used to obtain data. Analysis of variance compared food and nutrient intakes across quintiles of relative fat intake. Stepwise regression examined the contribution of food groups to the variation in relative fat intake.

Baseline examinations were conducted between 1991 and 1996 in the city of Malmö, southern Sweden.

A sub-sample of 7055 women and 3240 men of the Malmö Diet and Cancer cohort.

The major fat sources were dairy products, margarines, meat & meat products, and cakes & buns. Most plant foods, especially fruit, vegetables and breakfast cereals, were negatively associated with fat intake. Low fat consumers had significantly higher intakes of dietary fibre, vitamin C, β-carotene, folic acid, iron, zinc and calcium. Intakes of all types of fatty acids and fat-soluble vitamins were positively associated with fat consumption.

The results suggest that many food groups and nutrients may confound the associations between relative fat intake and disease. Plant foods, especially, are important to consider in studies of fat intake and disease risk.

To determine low-income consumers' attitudes and behaviour towards fruit and vegetables, in particular issues of access to, affordability of and motivation to eat fruit and vegetables.

Questionnaire survey mailed to homes owned by a large UK housing association.

Participants were 680 low-income men and women, aged 17–100 years.

Age, employment, gender, smoking and marital status all affected attitudes towards access, affordability and motivation to eat fruit and vegetables. Few (7%) participants experienced difficulty in visiting a supermarket at least once a week, despite nearly half having no access to a car for shopping. Fruit and vegetables were affordable to this low-income group in the amounts they habitually bought; purchasing additional fruits and vegetables was seen as prohibitively expensive. Less than 5% felt they had a problem with eating healthily and yet only 18% claimed to eat the recommended 5 or more portions of fruit and vegetables every day.

Supported by research, current UK Government policy is driven by the belief that low-income groups have difficulties in access to and affordability of fruit and vegetables. Findings from this particular group suggest that, of the three potential barriers, access and affordability were only a small part of the ‘problem’ surrounding low fruit and vegetable consumption. Thus, other possible determinants of greater consequence need to be identified. We suggest focusing attention on motivation to eat fruit and vegetables, since no dietary improvement can be achieved if people do not recognise there is a problem.

Malnutrition rates in Sierra Leone are among the highest in the world. However, policy-makers do not always recognise the fight against malnutrition as a policy priority to ensure the healthy human capital needed to fight poverty and achieve sustained positive economic growth.

The analysis presented here was conducted by an intersectoral and inter-agency group of Sierra Leonean senior policy advisors to quantify some of the potential human and economic benefits of improved policies and programmes to reduce malnutrition.

The analysis revealed that 46% of child deaths in Sierra Leone are attributable to malnutrition, the single greatest cause of child mortality in the country. In the absence of adequate policy and programme action, malnutrition will be the underlying cause of an estimated 74000 child deaths over the next five years. The analysis also revealed that if current levels of iodine deficiency remain unchanged over the next five years, 252000 children could be born with varying degrees of mental retardation as a result of intrauterine iodine deficiency. Finally, the analysis showed that, in the absence of adequate policy and programme action to reduce the unacceptable rates of anaemia in women, the monetary value of agricultural productivity losses associated with anaemia in the female labour force over the next five years will exceed $94.5 million.

Sustained investment in nutrition in Sierra Leone could bring about enormous human and economic benefits to develop the social sector, revitalise the economy, and attain the poverty reduction goals that Sierra Leone has set forth.

To describe the calculations and approaches used to design experimental diets of differing saturated fatty acid (SFA) and monounsaturated fatty acid (MUFA) compositions for use in a long-term dietary intervention study, and to evaluate the degree to which the dietary targets were met.

Fifty-one students living in a university hall of residence consumed a reference (SFA) diet for 8 weeks followed by either a moderate MUFA (MM) diet or a high MUFA (HM) diet for 16 weeks. The three diets were designed to differ only in their proportions of SFA and MUFA, while keeping total fat, polyunsaturated fatty acids (PUFA), trans-fatty acids, and the ratio of palmitic to stearic acid, and n – 6 to n – 3 PUFA, unchanged.

Using habitual diet records and a standardised database for food fatty acid compositions, a sequential process of theoretical fat substitutions enabled suitable fat sources for use in the three diets to be identified, and experimental margarines for baking, spreading and the manufacture of snack foods to be designed. The dietary intervention was largely successful in achieving the fatty acid targets of the three diets, although unintended differences between the original target and the analysed fatty acid composition of the experimental margarines resulted in a lower than anticipated MUFA intake on the HM diet, and a lower ratio of palmitic to stearic acid compared with the reference or MM diet.

This study has revealed important theoretical considerations that should be taken into account when designing diets of specific fatty acid composition, as well as practical issues of implementation.

To describe the lifestyle characteristics and nutrient intakes of the Oxford cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC).

Cohort of men and women recruited through general practices or by post to include a high proportion of non meat-eaters. Dietary, anthropometric and lifestyle data were collected at baseline and four diet groups were defined.

United Kingdom.

In total, 65 429 men and women aged 20 to 97 years, comprising 33 883 meat-eaters, 10 110 fish-eaters, 18 840 lacto-ovo vegetarians and 2596 vegans.

Nutrient intakes and lifestyle factors differed across the diet groups, with striking differences between meat-eaters and vegans, and fish-eaters and vegetarians usually having intermediate values. Mean fat intake in each diet group was below the UK dietary reference value of 33% of total energy intake. The mean intake of saturated fatty acids in vegans was approximately 5% of energy, less than half the mean intake among meat-eaters (10–11%). Vegans had the highest intakes of fibre, vitamin B1, folate, vitamin C, vitamin E, magnesium and iron, and the lowest intakes of retinol, vitamin B12, vitamin D, calcium and zinc.

The EPIC–Oxford cohort includes 31 546 non meat-eaters and is one of the largest studies of vegetarians in the world. The average nutrient intakes in the whole cohort are close to those currently recommended for good health. Comparisons of the diet groups show wide ranges in the intakes of major nutrients such as saturated fat and dietary fibre. Such variation should increase the ability of the study to detect associations of diet with major cancers and causes of death.

The World Health Organization (WHO) recommends a daily intake of at least 400?g of vegetables and fruit. The aim of this paper was to evaluate the public health benefit of meeting this WHO recommendation by applying a statistical method that combines estimated intake distributions and simulated intake changes.

The benefit of an increased consumption of vegetables and fruit was quantified by the preventable proportion of diseases. This proportion was estimated by a general formula derived in the paper that incorporates individual relative risks. Three different strategies of increasing usual intake were simulated and compared. The first strategy assumes that all individuals increase their intake by the same amount, the second assumes a constant increase among low consumers, and the third simulates individual increments necessary to meet the WHO recommendation. Calculations were made for three different scenarios with varying relative risks.

The third simulation strategy turned out to be the most appropriate one to quantify the potential health gain of the current dietary recommendation. Applying this strategy to prevent cancer, the proportion of preventable cases was country-specific. Estimates for France and Sweden were 21.9% and 19.3%, respectively, which are somewhat lower than the non-specific figure published by the World Cancer Research Fund.

To improve estimates of the preventable proportion of diseases, the estimation formula presented here can be applied. Its application requires intake data to estimate the initial intake distribution in the population and to simulate adequate dietary changes.

Household budget surveys (HBSs) have been used to assess nutritional information for epidemiological purposes. The agreement between this information and other comparable data needs to be examined. The aim of this project was to compare household food expenditure data between two British HBSs: the National Food Survey (NFS) and the Family Expenditure Survey (FES).

Household food expenditure data were compared between the NFS and the FES for the years from 1982 to 1993. Differences in expenditure were assessed by year, by household composition, by income group and by region; for trends across time for all households and for regional, household composition and income group variations.

Great Britain.

Approximately 88 000 NFS households and 85 000 FES households surveyed between 1982 and 1993 were used in this analysis.

Marked differences between the food expenditure data provided by the two surveys were observed. Furthermore, differences in time trends were substantial, which can lead to different conclusions regarding changes in consumption patterns.

There is no obvious reason for the differences in household food expenditure between the NFS and the FES. Methodological differences between the two surveys cannot provide a full explanation for these discrepancies. The NFS and FES are now merged into a single survey (the Expenditure and Food Survey). If HBSs are to be used for epidemiological purposes their validity needs to be established.

This study investigated 5-year trends in body weight, overweight and obesity and their association with sociodemographic variables in a large, multi-ethnic community sample of Australian adults.

This prospective population study used baseline and 5-year follow-up data from participants in the Melbourne Collaborative Cohort Study (MCCS).

Population study in Melbourne, Australia.

In total, 12 125 men and 17 674 women aged 35–69 years at baseline.

Mean 5-year weight change in this sample was +1.58 (standard deviation (SD) 4.82) kg for men and +2.42 (SD 5.17) kg for women. Younger (35–44 years) men and, in particular, women gained more weight than older adults and were at highest risk of major weight gain (≥5 kg) and becoming overweight. Risk of major weight gain and associations between demographic variables and weight change did not vary greatly by ethnicity. Education level showed complex associations with weight outcomes that differed by sex and ethnicity. Multivariate analyses showed that, among men, higher initial body weight was associated with decreased likelihood of major weight gain, whereas among women, those initially overweight or obese were about 20% more likely to experience major weight gain than underweight or healthy weight women.

Findings of widespread weight gain across this entire population sample, and particularly among younger women and women who were already overweight, are a cause for alarm. The prevention of weight gain and obesity across the entire population should be an urgent public health priority. Young-to-mid adulthood appears to be a critical time to intervene to prevent future weight gain.

The aim of this paper is to describe the source and the scope of social inequalities in infant feeding practices. It examines the extent to which different recommendations are followed in different social groups and highlights the main factors influencing the total adherence to three recommendations at the population level.

The study follows a representative sample (n = 2103) of the children born in 1998 in the province of Québec (Canada). Detailed information on breast-feeding and complementary feeding was collected at 5 and 17 months by face-to-face interviews with the mother. The independent variables were mother's age, mother's education level, poverty level, family type, socio-economic status (SES) and living area. Odds ratios (adjusted for baby's rank in the family, birth weight and premature birth) are presented for breast-feeding, and for formula and cows' milk consumption, at different ages. The adherence to a combined indicator cumulating three recommendations (breast-fed at birth, complementary food at 4 months or later and cows' milk at 9 months or later) is also presented.

The analysis indicates that adherence to the recommendations is low in Québec. Breast-feeding initiation, duration and its exclusivity improved with mother's age and education level and SES. Adherence to the different recommendations was interrelated, indicating an accumulation of bad nutritional circumstances for children in low-SES families. The odds of being fed in accordance with the three studied recommendations, when living in a family with the highest SES, was 2.3 times higher than when living in a family with the lowest SES. When living with a highly educated mother, the odds ratio was 2.7 times higher than when living with a low-educated mother. For mother's age, the odds ratio reached 3.7 for children from mothers aged ≥35 years, in comparison with children from mothers ≤24 years old. When SES or mother's education level was combined with mother's age, the children in the best situation were >8 more times likely than the least privileged children to be fed in accordance with these recommendations. Living area was not related with infant feeding during the first year of life

Breast-feeding and nutrition could be related with different health and cognitive outcomes in childhood and later in life. Consequently, social disparities in diet during infancy could play a role in the development of social and health inequalities more broadly observed at the population level. Intervention to improve adherence to breast-feeding and nutrition recommendations in infancy should be prioritised and evaluated for its impact on the reduction on infant diet inequalities over time

To describe the meal patterns and food use on weekdays among 10- to 11-year-old Finnish children and to analyse these in relation to family's socio-economic status and the child's behaviour.

Cross-sectional study on a cohort of 404 children aged 10–11 years in the rural town of Ylivieska, mid-western Finland.

A food-frequency questionnaire including questions on meal patterns and food use and the Child Behaviour Checklist (CBCL) completed by the parents and the child together.

Practically all children (99%) ate breakfast regularly, 94% had a daily school lunch and 80% had dinner at home daily. Vegetables were consumed daily at home by 26% and fruits or berries by 21%, while 46% of the children had salad daily at school. Twenty-four per cent ate sweets daily or nearly so on weekdays. The children from families of high socio-economic status ate vegetables more often, and fewer of them used butter or high-fat milk. The children with no regular family dinner ate sweets and fast foods more often, and had higher total CBCL problem scores than those with a regular family dinner.

Skipping meals appears not to be common among Finnish children aged 10–11 years, but a considerable proportion consume sweets frequently and vegetables infrequently. High family socio-economic status and a tendency to eat together are associated with healthy food choices among schoolchildren.

To describe obesity among students of public schools in São Paulo and to identify risk factors for this nutritional and physical activity disorder.

Case– control study of obese and non-obese schoolchildren to study risk factors for obesity.

Anthropometric survey including 2519 children attending eight elementary public schools in Sã o Paulo, Brazil.

Schoolchildren aged 7–10 years, of whom 223 were obese (cases; weight-for-height greater than or equal to two standard deviations(≥2SD) above the median of the National Center for Health Statistics (NCHS) reference population) and 223 were eutrophic (controls; weight-for-height ±1SD from NCHS median).

Parents or guardians of the 446 cases and controls were interviewed about the children's eating behaviours and habits.

The prevalence of obesity (weight-for-height ≥2SD) in the surveyed population was 10.5%. A logistic regression model fitted to the case–control dataset showed that obesity was positively associated with the following factors: birth weight ≥3500 g (odds ratio (OR) 1.83, 95% confidence interval (CI) 1.21–2.78), child's appetite at meals (OR 3.81, 95% CI 2.49–5.83), watching television for 4h per day or longer (OR 2.07, 95% CI 1.32–3.24), mother's schooling>4 years (OR 1.85, 95% CI 1.25–2.75) and parents' body mass index ≥ 30 kgm−2(OR 2.50, 95% CI 1.43–4.37).

The explanatory multivariate model points to preventive measures that would encourage knowledge of the children and their guardians in relation to a balanced diet and a less sedentary lifestyle, such as reducing television viewing. Schoolchildren with a birth weight of 3500g or more or whose parents are obese should receive special attention in the prevention of obesity.

This study aimed to determine the accuracy with which children aged 5 to 7 years were able to report the food eaten at a school lunch.

Two hundred and three children (103 boys, 100 girls) aged 5–7 years were recruited from three primary schools in Oxford.

Trained investigators made observational records of the school dinner and packed lunch intakes of four or five children per session. Children were interviewed within two hours of finishing the lunchtime meal and asked to provide a free recall of their meal. When the child had completed the recall, non-directive prompts were used to assess if the child was able to remember anything else. Foods recalled were classified as matches (recalled food agreed with observation), omissions (failed to report a food observed) or phantoms (recalled food was not observed).

The percentage of accurate recall was significantly higher (P<0.01) in children eating packed lunch (mean 70±29%) than in children consuming school dinners (mean 58±27%). This difference may have been due to increased familiarity of foods in packed lunches. Leftovers were not readily reported in this age group. Prompts and cues enhanced recall by all children.

This study indicated that there was a wide range in the ability of children aged 5–7 years to recall intake from a packed lunch and/or school dinner. This dietary assessment method is unlikely to be suitable at an individual level. Investigators using dietary recall to estimate food intake in children aged 5–7 years need to be aware of the limitations of this method.

This review examines the extent to which differences in nutrition could explain the diversity of health in Europe and how dietary patterns might contribute to the overall burden of disease in the region.

Europe.

Between-country variations and time trends in dietary and health patterns in Europe are described, taking into account recent evidence on east-west mortality differentials. Existing information on the contribution of dietary factors to the overall burden of disease in Europe and to the burden of cardiovascular diseases and cancer is then reviewed, including a discussion of the methodological challenges that face those seeking to quantify this burden accurately.

While evidence from ecological data have long suggested that variations in health patterns in Europe may be at least partly attributed to differences in dietary intake, recent research into the major risks to disease, disability and death is confirming the importance of poor nutrition to major health problems and overall disease burden in Europe. Findings from the Global Burden of Disease 2000 study suggest that 4.4% of the overall burden of disease in the region could be attributed to low fruit and vegetable intake, and 7.8% to overweight and obesity.

The burden of disease attributed to poor nutrition in Europe appears to be substantial and probably underestimated. However, better quantification of the contribution of nutrition to the region's burden of disease awaits further research to assess the dietary intake of Europeans and to explore the relationship between nutritional factors and health outcomes in diverse parts of Europe.

The objective of the present review is to assess the impact of universal salt iodisation in Nigeria during the last five years, with reference to some of the sentinel sites studied previously during a 1995 multi-centre study.

The method of goitre classification by palpation was employed using the new internationally accepted method in which the classification is simply graded as 0, 1 or 2. The multistage random sampling method was used and states and local government areas were already selected by virtue of their known status for iodine deficiency disorders (IDD). Schools were randomly chosen in each local government area and children aged 8–12 years in each school were determined. A percentage of the children was then included in the study to give a sample size greater than the minimum number allotted to the school. A total of 2372 schoolchildren (1420 males and 952 females) in 11 local government areas were examined; urine samples were collected from 537 children and analysed for urinary excretion of iodine. The method known as the Sandell–Kolthoff reaction was adopted, in which the iodide in the urine samples catalyses the reduction of ceric ammonium sulphate (yellow colour) to the cerous form (colourless) in the presence of arsenious acid. The degree of reduction in colour intensity of the yellow ceric ammonium sulphate is proportional to the iodine content in the urine sample.

The results from this study show that the median urinary iodine excretion for this sampled population in Nigeria, drawn mostly from IDD-endemic areas, is 14.65 μg dl−1 with a mean value of 13.39 μg dl−1.

This finding would suggest that Nigeria, in general terms, has achieved the goal of universal salt iodisation and should now focus its attention on constant monitoring in order to sustain this iodisation level.

The insulin-like growth factor (IGF) system has been implicated in the aetiopathogenesis of cancer, cardiovascular disease and diabetes. Since dietary factors and ethnicity are considered contributory to the development of these diseases, we examined the IGF system in relation to nutritional intake by ethnic group.

Dietary intake in 257 subjects of White European, African-Caribbean and Pakistani ethnic origin living in Manchester, UK was assessed using ethnic-group-specific food-frequency questionnaires to assess habitual nutrient intake over the previous 12 months. Fasting IGF-I, IGF-II and IGF-binding protein-1 (IGFBP-1) concentrations were determined and their relationship to specific dietary constituents was analysed.

Analysis by quintiles of nutrient intake showed a significant increase in circulating IGF-I concentration with increasing dietary fat intake (F for trend = 3.9, P < 0.01), saturated fat intake (F = 3.3, P = 0.01) and for protein intake (F = 4.2, P < 0.01). There was also a significant increase in IGF-II by quintiles of dietary protein intake (F = 2.7, P < 0.05). There was a trend for increasing IGF-I with increasing energy intake. The relationships between circulating concentration of IGFBP-1, an acute regulator of IGF action, and fat/protein intake were opposite to those for IGF-I and IGF-II. Multiple linear regression modelling showed that people of Pakistani origin and older subjects had lower levels of IGF-I (Pakistani origin vs. others, P < 0.001) (age, P < 0.001 for both). There was an independent inverse relationship between IGF-I and dietary carbohydrate intake (P = 0.036).

This study provides evidence for a dietary contribution to regulation of the IGF system, although the effects of ethnicity on circulating IGF levels remain dominant. We propose that the IGF system's influences on cancer risk in specific ethnic groups are potentially modifiable by dietary intervention.

We investigated behavioural and socio-economic factors associated with obesity and weight dissatisfaction among Finnish adolescents.

A total of 60252 Finnish adolescents aged 14 to 16 years filled in a questionnaire about their health, health behaviour and socio-economic background. Food choices were obtained by using a short food-frequency questionnaire. Obesity was defined as a weight at least 120% of the sex- and height-specific mean weight for subjects.

Of girls and boys, 54% and 66%, respectively, were satisfied with their weight. Among dissatisfied normal-weight adolescents, 81% of girls but only 48% of boys thought they were overweight. Of obese boys, 25% were satisfied with their weight. For both genders, obesity and weight dissatisfaction were associated with economic problems in the family. In girls, an association was also found with poor school performance, low educational level of parents and not having evening meals at home; and in boys, with physical inactivity and not eating school lunch. Smoking was more common among girls who were dissatisfied with their weight. Differences in food choices were small between different weight and weight satisfaction categories.

Having normal weight and being satisfied with that weight are favourable for an adolescent. Obesity and weight dissatisfaction are associated mostly with disadvantageous health behaviours and low socio-economic status. Health behaviour seems to be associated more with weight satisfaction than with actual weight.

The European Physical Activity Surveillance System (EUPASS) research project compared several physical activity (PA) measures (including the International Physical Activity Questionnaire (IPAQ)) in a time series survey in eight countries of the European Union. The present paper describes first results provided by the different instruments regarding PA participation, frequency and duration, both at the European and national levels. The purpose of the present study is to explore and compare the specific quality and usefulness of different indicators rather than to provide valid and reliable prevalence data. Thus, the main focus is on discussion of the methodological implications of the results presented.

A time series survey based on computer-aided telephone interviewing (CATI) was carried out in eight European countries over a six-month period. The study provided for about 100 realised interviews per month in each country (i.e. ~600 per country). Descriptive statistical analysis was used to: (1) report IPAQ results on vigorous, moderate and light PA and sitting, as well as on the overall measure of calories expenditure (MET min−1), in the different countries; (2) compare these results with national PA indicators tested in EUPASS; and (3) compare IPAQ results with other European studies.

First, the scores for the different PA categories as well as for the overall measure of calories expenditure provided by the IPAQ appeared rather high compared with previous studies and public health recommendations. Second, the different PA measurements used in EUPASS provided completely different results. For example, national indicators used in Germany and The Netherlands to date neither corresponded in absolute values (e.g. means of PA or sitting) nor correlated with the IPAQ in any significant way. Third, comparing EU countries, the ranking for vigorous, moderate and light activities by use of the IPAQ differed from that of other European studies. For example, in the present analysis, German respondents generally showed higher scores for PA than the Finns and the Dutch, while, in contrast, findings from other studies ranked Finland before The Netherlands and Germany.

The present analysis highlights some methodological implications of the IPAQ instrument. Among other things, differences in overall scores for PA as well as in the ranking of nations between the present results using IPAQ and other measures and studies may partly be due to the concepts of PA behind the measurements. Further analysis should investigate if the range of PA-related categories provided by the IPAQ is fully appropriate to measure all relevant daily activities; it may also consider the public health implications of mixing up different contexts of PA (e.g. work, leisure-time, transportation) in the IPAQ short version.

Iodine deficiency disorders (IDD) are endemic in the mountain regions of Armenia. Universal salt iodisation has been chosen as the control measure.

(1) To measure the prevalence of iodine deficiency in the Armenian population; (2) to evaluate household use of iodised salt; and (3) to monitor iodised salt promotion strategies.

Cross-sectional study on a nationally representative sample of 2627 households, including 3390 children under five and 2649 women of fertile age. Cluster sampling design on four population strata: residents, refugees, rural and urban.

Thyroid was palpable in one-third of the women, 6% of them having a visible goitre. Median of urinary iodine excretion in children was 139.5 μgl−1. One-third of the children showed low urinary iodine concentration. Iodised salt was consumed in 66% of the households. The national IDD control programme included modernisation of the Yerevan Salt Factory, legislative regulation of the iodine content of the salt, and public information by the media.

Armenia was still an endemic zone for goitre in 1997. The iodine status of children under five in 1997 was not considered alarming even though 33% of them had low values of urinary iodine. After four years of intervention strategies, the use of iodised salt has increased by 17%. Further efforts should be made to control salt imports and to monitor IDD indicators in vulnerable groups.