The aims of the present paper were to assess the nutritional status of children under 5 years old using the 2006 WHO Child Growth Standards (‘the WHO standards’) and to compare the results with those obtained using the National Center for Health Statistics/WHO international growth reference (‘the NCHS reference’).

This was a community-based cross-sectional survey. The WHO standards were used to calculate Z-scores of height-for-age (HAZ), weight-for-age (WAZ), weight-for-height (WHZ) and BMI-for-age (BMIZ).

Fifty counties of thirteen mid-western provinces, China.

A total 8041 children aged <5 years were measured during a 2-month period from August to October 2006.

The prevalence of stunting, underweight and wasting were 30·2 %, 10·2 % and 2·9 %, respectively. The prevalence of overweight and the possible risk of overweight were as high as 4·1 % and 16·8 %. Further analysis among the children with possible risk of overweight found that the percentage of stunting (HAZ < −2) was 57·6 %, the percentage with −2 ≤ HAZ ≤ 2 was 41·0 % and the percentage with HAZ > 2 was only 1·4 %. The prevalence of stunting was 21·9 % and of underweight was 12·7 % by the NCHS reference.

Stunting was the most serious problem that was impeding child growth and development. The high rate of ‘overweight’ was a false impression, the truth being ‘stunting overweight’, and the way to solve it should be to increase protein and other nutrients in the diet at an early age.

We investigated the relationship between the intake of fish and the risk of death from prostate cancer.

Data were derived from a prospective cohort study in Japan. Fish consumption obtained from a baseline questionnaire was classified into the two categories of ‘low intake’ and ‘high intake’. The Cox proportional hazards model was used to estimate hazard ratios (HR) and 95 % confidence intervals.

Data for 5589 men aged 30–79 years were analysed.

A total of twenty-one prostate cancer deaths were observed during 75 072 person-years of follow-up. Mean age at baseline study of these twenty-one subjects was 67·7 years, ranging from 47 and 79 years old. Results showed a consistent inverse association of this cancer between the high v. low intake groups. The multivariate model adjusted for potential confounding factors and some other food items showed a HR of 0·12 (95 % CI 0·05, 0·32) for the high intake group of fish consumption.

These results support the hypothesis that a high intake of fish may decrease the risk of prostate cancer death. Given the paucity of studies examining the association between prostate cancer and fish consumption, particularly in Asian populations, these findings require confirmation in additional cohort studies.

To analyse the relationship between maternal intakes of fish and other seafood during pregnancy and child neurodevelopment at age 4 years. Although pregnant women are advised to limit seafood intakes because of possible neurotoxin contamination, several studies suggest that overall maternal seafood intakes are associated with improved child neurodevelopment, perhaps because of higher DHA intakes.

The study uses data from a prospective birth cohort study. Maternal seafood intakes were assessed using a semi-quantitative FFQ administered shortly after delivery. Multivariate linear regression was used to estimate associations between seafood consumption and scores on the McCarthy Scales of Children’s Abilities (MCSA). Analyses were stratified by breast-feeding duration as breast milk is a source of DHA during the postnatal phase of the brain growth spurt.

Menorca, Spain, 1997–2001.

Full-term children (n 392) with data on maternal diet in pregnancy, breast-feeding duration and neurodevelopment at age 4 years.

Among children breast-fed for <6 months, maternal fish intakes of >2–3 times/week were associated with significantly higher scores on several MCSA subscales compared with intakes ≤1 time/week. There was no association among children breast-fed for longer periods. Maternal intakes of other seafood (shellfish/squid) were, however, inversely associated with scores on several subscales, regardless of breast-feeding duration.

The study suggests that moderately high intakes of fish, but not other seafood, during pregnancy may be beneficial for neurodevelopment among children breast-fed for <6 months. Further research in other populations with high seafood intakes and data on additional potential confounders are needed to confirm this finding.

To study the effect of combining multiple (two or more) micronutrients with Fe supplementation on Hb response, when compared with placebo and with Fe supplementation, in children.

Electronic databases, personal files, hand search of reviews, bibliographies of books, and abstracts and proceedings of international conferences.

Randomized controlled trials evaluating change in Hb levels with interventions that included Fe and multiple-micronutrient supplementation in comparison to placebo alone or Fe alone were analysed in two systematic reviews.

Twenty-five trials were included in the review comparing Fe and micronutrient supplementation with placebo. The pooled estimate (random effects model) for change in Hb with Fe and micronutrient supplementation (weighted mean difference) was 0·65 g/dl (95 % CI 0·50, 0·80, P < 0·001). Lower baseline Hb, lower height-for-age Z score, non-intake of ‘other micronutrients’ and malarial non-hyperendemic region were significant predictors of greater Hb response and heterogeneity. Thirteen trials were included in the review comparing Fe and micronutrient supplementation with Fe alone. The pooled estimate for change in Hb with Fe and micronutrient supplementation (weighted mean difference) was 0·14 g/dl (95 % CI 0·00, 0·28, P = 0·04). None of the variables were found to be significant predictors of Hb response.

Synthesized evidence indicates that addition of multiple micronutrients to Fe supplementation may only marginally improve Hb response compared with Fe supplementation alone. However, addition of ‘other micronutrients’ may have a negative effect. Routine addition of unselected multiple micronutrients to Fe therefore appears unjustified for nutritional anaemia control programmes.

Physical inactivity poses a major risk for obesity and chronic disease, and is influenced by both genetic and environmental factors. However, the genetic association between physical activity (PA) level and obesity is not well characterized. Our aims were to: (i) estimate the extent of additive genetic influences on physical activity while adjusting for household effects; and (ii) determine whether physical activity and adiposity measures share common genetic effects.

The sample included 521 (42 % male) adult relatives, 18–86 years of age, from five large families in the Southwest Ohio Family Study.

Sport, leisure and work PA were self-reported (Baecke Questionnaire of Habitual Physical Activity). Total body and trunk adiposity, including percentage body fat (%BF), were measured using dual-energy X-ray absorptiometry. Abdominal visceral and subcutaneous adipose tissue mass were measured using MRI.

Heritabilities for adiposity and PA traits, and the genetic, household and environmental correlations among them, were estimated using maximum likelihood variance components methods. Significant genetic effects (P < 0·05) were found for sport (h2 = 0·26) and leisure PA (h2 = 0·17). Significant (P < 0·05) household effects existed for leisure PA (c2 = 0·25). Sport PA had a negative genetic correlation with central adiposity measurements adjusted for height (ρG > |−0·40|). Sport and leisure PA had negative genetic correlations with %BF (ρG > |−0·46|).

The results suggest that the association of sport and leisure PA with lower adiposity is due, in part, to a common genetic inheritance of both reduced adiposity and the predisposition to engage in more physical activity.

To determine iodine intake and urinary iodine excretion (UIE) in a group of pregnant Thai women and the concentration of thyroid-stimulating hormone (TSH) in their neonates.

A prospective cohort study.

Three districts of Songkhla, southern Thailand.

Two hundred and thirty-six pregnant women.

A quarter of the participants lacked knowledge of iodine and the prevention of iodine deficiency, although 70 % used iodized salt. Those who did not use iodized salt stated that they had no knowledge about iodine (57 %) and no iodized salt was sold in their village (36 %). The median iodine intake in the three districts was 205–240 μg/d, with 53–74 % of pregnant women having iodine intake <250 μg/d. The median UIE in the three districts was 51–106 μg/l, with 24–35 % having UIE < 50 μg/l. The mean neonatal TSH was 2·40 (sd 1·56) mU/l, with 8·9 % of neonates having TSH > 5 mU/l.

The studied women and their fetuses were at risk of mild iodine deficiency. About a quarter of the participants lacked knowledge of the importance of iodine. Education regarding the importance of iodine supplements and the promotion of iodized salt should be added to national health-care policies in order to prevent iodine-deficiency disorders, diseases that are subclinical but have long-term sequelae.

To evaluate the feasibility of the UK Nutrient Profile (NP) model for identifying ‘unhealthy’ food advertisements using a case study of New Zealand television advertisements.

Four weeks of weekday television from 15.30 hours to 18.30 hours was videotaped from a state-owned (free-to-air) television channel popular with children. Food advertisements were identified and their nutritional information collected in accordance with the requirements of the NP model. Nutrient information was obtained from a variety of sources including food labels, company websites and a national nutritional database.

From the 60 h sample of weekday afternoon television, there were 1893 advertisements, of which 483 were for food products or retailers. After applying the NP model, 66 % of these were classified as advertising high-fat, high-salt and high-sugar (HFSS) foods; 28 % were classified as advertising non-HFSS foods; and the remaining 2 % were unclassifiable. More than half (53 %) of the HFSS food advertisements were for ‘mixed meal’ items promoted by major fast-food franchises. The advertising of non-HFSS food was sparse, covering a narrow range of food groups, with no advertisements for fresh fruit or vegetables.

Despite the NP model having some design limitations in classifying real-world televised food advertisements, it was easily applied to this sample and could clearly identify HFSS products. Policy makers who do not wish to completely restrict food advertising to children outright should consider using this NP model for regulating food advertising.

Our objective was to assess the distribution of energy, macro- and micronutrient intakes by meal (breakfast, lunch, dinner and combined snacks) in a cross-sectional sample of schoolchildren.

Cross-sectional dietary survey in schoolchildren.

Twelve private and public schools in the urban setting of Quetzaltenango, Guatemala.

A total of 449 schoolchildren (from higher and lower socio-economic strata) were enrolled in the study.

Each child completed a single, pictorial 24 h prospective diary and a face-to-face interview to check completeness and estimate portion sizes. Estimated daily intakes were examined by mealtime as: (i) absolute intakes; (ii) relative nutrient distribution; and (iii) critical micronutrient density (i.e. nutrient density in relation to the WHO Recommended Nutrient Intakes/median age-specific Guatemalan energy requirements).

The daily distribution of energy intake was 24 % at breakfast, 30 % at lunch, 23 % at dinner and 23 % among snacks. Lunch was also the leading meal for macronutrients, providing 35 % of proteins, 27 % of fat and 30 % of carbohydrate. The distribution of selected micronutrients did not follow the pattern of energy, insofar as lunch provided relatively more vitamin C and Zn, whereas breakfast led in terms of vitamins A and D, thiamin, riboflavin, folate, Ca and Fe.

Meal-specific distribution of energy, macro- and micronutrients provides a unique and little used perspective for evaluation of children’s habitual intake, and may provide guidance to strategies to improve dietary balance in an era of coexisting energy overnutrition and micronutrient inadequacy.

To understand how access to natural resources may contribute to nutrition.

In each of the two major seasons, data were collected during a 7 d period using observations, semi-structured interviews, anthropometric measures and a weighed food consumption survey.

Four rural communities selected to represent inland and coastal areas of the Gamba Complex in Gabon.

In each community, all individuals from groups vulnerable to malnutrition, i.e. children aged 0–23 months (n 41) and 24–59 months (n 63) and the elderly (n 101), as well as women caregivers (n 96).

In most groups, household access to natural resources was associated with household access to food but not with individual nutritional status. In children aged 0–23 months, access to care and to health services and a healthy environment were the best predictors of length-for-age (adjusted R2: 14 %). Health status was the only predictor of weight-for-height in children aged 24–59 months (adjusted R2: 14 %). In women caregivers, household food security was negatively associated with nutritional status, as was being younger than 20 years (adjusted R2: 16 %). Among the elderly, only nutrient adequacy predicted nutritional status (adjusted R2: 5 %).

Improving access to care and health for young children would help reverse the process of undernutrition. Reaching a better understanding of how the access of individuals to both food and other resources relate to household access could further our appreciation of the constraints to good nutrition. This is particularly relevant in women to ensure that their possibly important contribution to the household is not at their own expense.

The first aim was to evaluate BMI cross-sectionally over a period of 14 years (1992 to 2005) in 43 343 army men and the second was to compare BMI using the paired data of 1497 army men. The data were analysed as a function of the military ranking system, used as an indicator for socio-economic position.

Multiple cross-sectional and longitudinal design.

A significant increase of BMI between age categories was detected over the 14-year period; BMI remained stable in each age category. In the paired cohort, median BMI increased during the same period from 23·9 (interquartile range 3·3) kg/m2 to 24·7 (interquartile range 3·5) kg/m2 (P < 0·0001). This age-dependent evolution was present in all military rankings. From age 40 years or more, BMI indicated a significant increase in the prevalence of overweight and obesity.

For the total cohort, BMI remained stable in each age category. For the paired cohort, BMI increased over time. The military leadership should emphasize prevention in order to reduce the health-care costs and disease burden in this cohort. This emphasis on prevention should target those aged less than 40 years.

To consider the use of systematic methods for categorising foods according to their nutritional quality (‘nutrient profiling’) as a strategy for promoting public health through better dietary choices.

We describe and discuss several well-developed approaches for categorising foods using nutrient profiling, primarily in the area of food labelling and also with respect to advertising controls. The best approach should be able to summarise and synthesise key nutritional dimensions (such as sugar, fat and salt content, energy density and portion size) in a manner that is easily applied across a variety of products, is understandable to users and can be strictly defined for regulatory purposes.

Schemes that provide relative comparisons within food categories may have limited use, especially for foods that are not easily categorised. Most nutrient-profiling schemes do not clearly identify less-healthy foods, but are used to attract consumers towards products with supposedly better profiles. The scheme used in the UK to underpin the colour-coded ‘traffic light’ signalling on food labels, and the one used by the UK broadcasting regulator Ofcom to limit advertising to children, together represent the most developed use of nutrient profiling in government policy-making, and may have wider utility.

Nutrient profiling as a method for categorising foods according to nutritional quality is both feasible and practical and can support a number of public health-related initiatives. The development of nutrient profiling is a desirable step in support of strategies to tackle obesity and other non-communicable diseases. A uniform approach to nutrient profiling will help consumers, manufacturers and retailers in Europe.

To test the viability of the Mediterranean diet as an affordable low-energy-density model for dietary change.

Foods characteristic of the Mediterranean diet were identified using previously published criteria. For these foods, energy density (kJ/100 g) and nutrient density in relation to both energy ($/MJ) and nutrient cost were examined.

Some nutrient-rich low-energy-density foods associated with the Mediterranean diet were expensive, however, others that also fit within the Mediterranean dietary pattern were not.

The Mediterranean diet provides a socially acceptable framework for the inclusion of grains, pulses, legumes, nuts, vegetables and both fresh and dried fruit into a nutrient-rich everyday diet. The precise balance between good nutrition, affordability and acceptable social norms is an area that deserves further study. The new Mediterranean diet can be a valuable tool in helping to stem the global obesity epidemic.

To evaluate the diet of 7-year-old children by comparison with food-based dietary guidelines (FBDG) and reference values for nutrient intake.

Food and nutrient intake was assessed by 3 d weighed dietary records of 7-year-olds in six randomly chosen schools in Reykjavik, Iceland. Height and weight were measured. The diet of 165 children (62 % of sample) was evaluated by the Icelandic FBDG and the Nordic reference values (NRV) for nutrient intake.

Six randomly chosen schools in Reykjavik, Iceland.

The FBDG on fruits and vegetables was reached by less than 20 % of the children. A total of 52 % reached the FBDG to eat fish twice a week and 41 % to use vitamin D supplement. The FBDG on dairy was reached by 66 % of the children. Mean intake of SFA gave 13·9 % of the total energy intake (E%), which is higher than the NRV, 9·3E% of MUFA and 3·8E% of PUFA, both lower than the NRV (for all differences P < 0·001). Added sugar gave 12·1E%, which exceeds the upper level (P < 0·001). Fibre intake was 2·1 g/MJ and lower than the NRV (P < 0·001). Mean intake of micronutrients was above the recommended intake (RI), except for iodine, 109·0 μg/d, and vitamin D, 6·1 μg/d, which was lower than the RI (P = 0·006 and P < 0·001, respectively).

Fruit, vegetable, fish and dairy, as well as vitamin D supplement, need to be increased in the diet of 7-year-old children to reach the FBDG and the reference values for nutrient intake. Dietary changes to increase the quality of fat and carbohydrate are needed as well.

To examine the effect of Seventh-day Adventist (SDA) membership on ‘immunity’ to the secular effects of changes in BMI.

Three independent, cross-sectional, screening surveys conducted by Sydney Adventist Hospital in 1976, 1986 and 1988 and a survey conducted among residents of Melbourne in 2006.

Two hundred and fifty-two SDA and 464 non-SDA in 1976; 166 SDA and 291 non-SDA in 1986; 120 SDA and 300-non SDA in 1988; and 251 SDA and 294 non-SDA in 2006.

Height and weight measured by hospital staff in 1976, 1986 and 1988; self-reported by respondents in 2006.

The mean BMI of non-SDA men increased between 1986 and 2006 (P < 0·001) but did not change for SDA men or non-SDA women. Despite small increases in SDA women’s mean BMI (P = 0·030) between 1988 and 2006, this was no different to that of SDA men and non-SDA women in 2006. The diet and eating patterns of SDA men and women were more ‘prudent’ than those of non-SDA men and women, including more fruit, vegetables, grains, nuts and legumes, and less alcohol, meat, sweetened drinks and coffee. Many of these factors were found to be predictors of lower BMI.

The ‘prudent’ dietary and lifestyle prescriptions of SDA men appear to have ‘immunised’ them to the secular effects of changes that occurred among non-SDA men’s BMI. The dietary and lifestyle trends of SDA women did not reflect the increase in their BMI observed in 2006.

This exploratory study assessed how 8–13-year-old children categorised and labelled fruit and vegetables (FaV), and how these were influenced by child characteristics, to specify second-level categories in a hierarchical food search system for a computerised 24 h dietary recall (hdr).

Two sets of food cards, sixty-seven for fruit (F) and sixty-four for vegetables (V), with pictures and names of FaV from ten professionally defined food categories were sorted, separately, by each child into piles of similar foods. Demographic data, BMI and 6-n-propylthiouracil (PROP) taster status were obtained.

Participants attended the Children’s Nutrition Research Center in the summer of 2006.

In all, 152 8–13-year-old children, predominantly English-speaking, of whom sixteen were predominantly Spanish-speaking.

Children created an average of 8·5 (5·3) piles with 7·9 (11·4) cards per pile for the F, and an average of 10·1 (4·8) piles with 6·2 (7·9) cards per pile for the V. No substantial differences in Robinson clustering were detected across subcategories for each of the demographic characteristics, BMI or PROP sensitivity. Children provided clusters names that were mostly ‘Taxonomic – Professional’ labels, such as salads, berries, peppers, for both F (51·8 %) and V (52·1 %).

These categories should be tested to assess their ability to facilitate search of FaV items in a computerised 24 hdr for children in this age group.

To describe the relationships between physical activity, lifestyle determinants and obesity in adolescent Israeli schoolchildren.

Cross-sectional survey.

The MABAT Youth Survey was a nationally representative, school-based study of youth in grades 7 to 12 (ages 11–19 years).

Self-administered questionnaires assessed health behaviours and anthropometric indices were measured. Logistic regression analysis was used to examine the associations between obesity, physical activity, socio-economic status and other lifestyle habits. One-way ANOVA was used to determine mean physical activity levels (MET values) by BMI categories.

The prevalence of overweight was 13–15 % and of obesity 4–9 % depending on gender and ethnicity, and was higher among the non-Jewish sectors. Thirty-six per cent and 57 % of Jewish girls and boys, and 40 % and 58 % of non-Jewish girls and boys, respectively, were optimally active. Boys from low socio-economic schools and those who slept for less than 6 h at night were less active. Girls from middle school were found to be 53 % more optimally physically active among Jews, and 89 % more among non-Jews, compared with girls from high school (P = 0·001); girls with less educated parents were also less physically active. No clear relationship was found between the level of obesity and physical activity.

Physical inactivity was strongly related to gender, age, social status, sleeping habits, hookah smoking, and parental educational status. Education and intervention programmes should focus on these risk factors.

To examine changes in breast-feeding take-up rates among young children in Scotland and to assess whether maternal education or occupation-based social class is a stronger and better predictor of breast-feeding take-up.

Binary logistic regression models were developed from the first sweep of the Growing Up in Scotland longitudinal survey, for the two cohorts of children.

A national representative survey for Scotland.

A baby cohort of 5012 singletons born over a 12-month period between June 2004 and May 2005, and a toddler cohort of 2732 singletons born over a 12-month period between June 2002 and May 2003.

Mothers from more privileged social classes and those with more educational qualifications resulted as more likely to breast-feed. However, maternal education was a better and more robust predictor of breast-feeding take-up compared with social class. There were no significant differences in breast-feeding take-up between the two cohorts and only minor differences between mothers aged 20–29 years and those who stated an intention to bottle-feed prior to birth.

The study suggests that the importance of maternal education in influencing breast-feeding has been somewhat overlooked in research based in more developed countries. The results indicate that, compared with occupation-related social class, maternal education is a more informative, accurate and useful lens through which to understand and explain patterns of breast-feeding take-up.

Amidst a hunger–obesity paradox, the purpose of the present study was to examine the grocery shopping behaviour and food stamp usage of low-income women with children to identify factors influencing their food choices on a limited budget.

Focus groups, which included questions based on Social Cognitive Theory constructs, examined food choice in the context of personal, behavioural and environmental factors. A quantitative grocery shopping activity required participants to prioritize food purchases from a 177-item list on a budget of $US 50 for a one-week period, an amount chosen based on the average household food stamp allotment in 2005.

Ninety-two low-income women, with at least one child aged 9–13 years in their household, residing in the Twin Cities, Minnesota, USA.

Participants' mean age was 37 years, and 76% were overweight or obese (BMI≥25·0kg/m2). Key findings suggest that their food choices and grocery shopping behaviour were shaped by not only individual and family preferences, but also their economic and environmental situation. Transportation and store accessibility were major determinants of shopping frequency, and they used various strategies to make their food dollars stretch (e.g. shopping based on prices, in-store specials). Generally, meat was the most important food group for purchase and consumption, according to both the qualitative and quantitative data.

Efforts to improve food budgeting skills, increase nutrition knowledge, and develop meal preparation strategies involving less meat and more fruits and vegetables, could be valuable in helping low-income families nutritionally make the best use of their food dollars.