To assess the effects of socio-economic status (SES) on BMI, waist:hip ratio (WHR) and waist circumference (WC) in a group of Iranian women.

A cross-sectional study was conducted on 888 women in Sistan and Baluchestan Province. SES was measured using level of education. In addition, parity, marital status and physical activity were assessed. Standardized measurements were taken, BMI and WHR were calculated.

Low education level was a strong determinant of overweight and obesity among Iranian women. After controlling for age, women with higher education level had significantly lower BMI, WC and parity. Multiple linear regression analysis found a significant negative association of BMI and WC with education level and a significant positive association of BMI and WC with parity. Significant factors associated with obesity by a logistic regression model were education level (OR for university graduates v. illiterate or low literacy levels: 1·00 v. 3·70; P = 0·01), living with spouse (OR for married v. single subjects: 1·00 v. 0·15; P = 0·05), parity (OR for more than five v. less than two pregnancies: 1·00 v. 0·34; P = 0·03) and WC (OR for <0.88 cm v. ≥0.88 cm: 1·00 v. 11·20; P = 0·001).

The present study revealed that educational level, multiple pregnancies, marital status and lack of exercise are some possible explanations for the obesity among Sistan and Baluchestan women.

The Mediterranean diet is rich in fat and starch, and hence may be related to overweight. We therefore investigated the relationship between adherence to a Mediterranean diet and body mass index (BMI) and waist-to-hip ratio (WHR).

Data were obtained from the control group of a network of case–control studies on cancer conducted in major teaching and general hospitals in four Italian areas between 1991 and 2002. An interviewer-administered validated 78-item food-frequency questionnaire was used to obtain information on the subjects’ habitual diet. Information on socio-economic factors, lifestyle habits and anthropometric measures was also collected. A Mediterranean diet score (MDS) was derived on the basis of eight characteristics of the Mediterranean diet.

Subjects were 6619 patients (3090 men, 3529 women) admitted to hospital for a wide spectrum of acute, non-neoplastic conditions, unrelated to known risk factors for cancer and long-term modifications of diet.

In multiple linear regression models adjusted for age, study centre, education, tobacco smoking, occupational physical activity and total energy intake, the MDS was not related to BMI (β = 0.05 for men and −0.04 for women) or WHR (β = 0.000 and 0.001, respectively) in both sexes.

Adherence to the major characteristics of the Mediterranean diet is unrelated to BMI and WHR, confirming previous data from Greece and Spain.

The progression from impaired glucose tolerance (IGT)/impaired fasting glucose (IFG) to type 2 diabetes can be prevented or delayed through intensive lifestyle changes. How to translate this to implementation across whole communities remains unclear. We now describe the results to a pilot of a personal trainer (Maori Community Health Worker, MCHW) approach among Maori in New Zealand.

A randomised cluster-controlled trial of intensive lifestyle change was commenced among 5240 non-pregnant Maori family members without diabetes from 106 rural and 106 urban geographical clusters. Baseline assessments included lifestyle questionnaires, anthropometric measurements and venesection. A pilot study (Vanguard Study) cohort of 160 participants were weighed before and during MCHW intervention, and compared with fifty-two participants weighed immediately before intervention and with 1143 participants from the same geographical area. Interactions between participants and the MCHW were reported using personal digital assistants with a programmed detailed structured approach to each interview.

During the Vanguard Study, participants and MCHW found the messages, toolkit and delivery approach acceptable. Those with IGT/IFG diagnosed (n 27) experienced significant weight loss after screening and during the Vanguard Study (5·2 (sd 6·6) kg, paired t test P < 0·01). Significant weight loss occurred during the Vanguard Study among all participants (−1·3 (sd 3·6) kg, P < 0·001).

Comparable initial weight loss was shown among those with IGT/IFG and those from existing trials. Community-wide prevention programmes are feasible among Maori and are likely to result in significant reductions in the incidence of diabetes.

To investigate the prevalence of vitamin A deficiency (VAD) among pregnant women in rural Bangladesh, and examine the relationship between various factors and vitamin A status.

Community Nutrition Promoter (CNP) centres in Kapasia sub-district of Gazipur district, Bangladesh.

A cross-sectional study.

Two hundred women, aged 18–39 years, in their second or third trimester of pregnancy were selected from seventeen CNP centres in four unions of Kapasia sub-district where they usually visit for antenatal care. Various socio-economic, personal and pregnancy-related information, dietary intake of vitamin A and mid-upper arm circumference (MUAC) data were collected. Serum retinol (vitamin A) concentration was determined.

More than half (51 %) of the pregnant women had low vitamin A status (serum retinol <1·05 μmol/l) with 18·5 % having VAD (serum retinol <0·70 μmol/l). Fifty-three per cent of the women’s vitamin A intake was less than the recommended dietary allowance. By multiple regression analysis, MUAC, per-capita expenditure on food and wealth index were found to have significant independent positive relationship with serum retinol concentration, while gestational age of the pregnant women had a negative relationship. The overall F-ratio (10·3) was highly significant (P = 0·0001), the adjusted R2 was 0·18 (multiple R = 0·45).

VAD is highly prevalent among rural pregnant women in Bangladesh. Gestational age, nutritional status, per-capita expenditure on food and wealth index appear to be important in influencing the vitamin A status of these women. An appropriate intervention is warranted in order to improve the vitamin A status.

The aim of the present study was to determine the impact of food advertising in primary and secondary schools on the food purchasing habits of children.

All forty-four primary and secondary schools in Rzeszow, Poland were included in the investigation; 15 000 children attend primary and secondary schools in the region. Schools were visited by members of the research team, who filled in a questionnaire regarding the type of food products displayed or advertised in the school shop window and recorded the presence of direct corporate advertising in the proximity of the school shop. Shop owners were asked to fill in a form describing food purchases by students within the week preceding the visit. The school principal (or one of teachers) completed a form describing the school’s policy regarding food advertising and the sponsorship of school activities by food companies.

Recommended foods like milk, yoghurts and fruit were offered by only 40·9 % of shops. There was a correlation between foods offered in the shop and foods purchased by students. In schools, 40·9 % (95 % CI 25·8, 56·0 %) of shop windows displayed or advertised ‘healthy’ foods while 9·1 % (95 % CI 0·0, 17·9 %) of shops displayed advertisements of food companies. The difference between display of ‘healthy’ food in shop windows and display of food on company advertisements was significant (likelihood ratio χ2 test, P < 0·04). Type of school (primary v. secondary) was not significant factor in advertising or purchasing pattern.

Educational programmes should be introduced in schools with the aim of improving the understanding of nutritional principles among pupils, teachers and parents.

To evaluate body size preference, body weight perception and their relationship with actual weight in two migrant groups of non-Western origin, Turks and Moroccans; additionally, to study the association between body size preference and acculturation.

Cross-sectional study.

Amsterdam, The Netherlands.

Males and females (18–30 years) were randomly selected from the population registry (n 451); participants, or at least one of their parents, were born in Turkey or Morocco. Body size preference was assessed using seven silhouette drawings and body weight perception was assessed by asking participants’ opinion of own weight. Acculturation variables were generation status and two scale measures, cultural orientation and social contacts.

Participants showed preference for a thin body size. The discrepancy between ideal and current size was significant in women but not men (P < 0·001). Perceived current body size was correlated with BMI (Spearman’s correlation coefficient 0·60, P < 0·001 (men) and 0·73, P < 0·001 (women)). Among overweight participants (BMI = 25·0–29·9 kg/m2), 63–82 % of men and 35 % of women perceived themselves as ‘average’. Paying attention to own body weight was associated with a discrepancy between ideal and current size among women and with perceiving oneself as ‘overweight’ among men. Body size preference was not significantly associated with the three acculturation variables.

We did not observe a preference for large body sizes in these two non-Western migrant groups. Similar to Western populations, most women wished to be thinner than they were. This was not the case among men, the majority of whom were also unaware of being overweight.

The aims of the present work were to investigate whether dietary habits are associated with socio-economic status (SES), and if they modify the relationship between SES and CVD risk factors, in a sample of men and women free from known CVD.

This population-based study was carried out in the province of Attica, where Athens is a major metropolis. During 2001–2002, information from 1528 men (18–87 years old) and 1514 women (18–89 years old) was collected (75 % participation rate). Among several sociodemographic, clinical and biological factors, adherence to the Mediterranean diet was assessed by a special diet score (Mediterranean Diet Score, MDS) that incorporated the inherent characteristics of this traditional diet. CVD risk factors were examined across the participants’ educational level and annual income that defined their SES.

Low SES groups exhibited higher prevalence of CVD risk factors, such as obesity, hypertension, diabetes mellitus and hypercholesterolaemia (all P < 0·001). Low SES groups also showed less adherence to the Mediterranean diet than high SES groups (MDS: 23·6 (sd 8·1) v. 25·6 (sd 5·6), P < 0·001). Higher SES index was associated with lower likelihood of having hypercholesterolaemia (OR = 0·91; 95 % CI 0·83, 1·00) and diabetes (OR = 0·83; 95 % CI 0·72, 0·95), after adjusting for various potential confounders. However, the previously mentioned inverse relationship observed between SES and prevalence of CVD risk factors was mainly explained by the dietary habits of the participants.

Low SES groups showed less adherence to the Mediterranean diet compared with high SES groups. This finding may, in part, explain the higher CVD risk factors profile observed among low SES participants.

Data on the prevalence and predictors of breast-feeding remain scarce in Lebanon. Moreover, no study has previously addressed the effect of the paediatrician’s sex on breast-feeding. The present study aimed to assess the prevalence and predictors of breast-feeding at 1 and 4 months of infant age while exploring the potential role of the sex of the paediatrician.

Prospective cohort study. Predictors of breast-feeding significant at the bivariate level were tested at 1 and 4 months through two stepwise regression models.

Infants were enrolled through the clinics and dispensaries of 117 paediatricians located in Beirut, Lebanon, and its suburbs.

A total of 1320 healthy newborn infants born between August 2001 and February 2002 were prospectively followed during the first year.

Breast-feeding rates at 1 and 4 months were 56·3 % and 24·7 %, respectively. Early discharge, high parity and religion were significantly associated with higher breast-feeding rates at 1 and 4 months of age. Maternal age proved significant only at 1 month, while maternal working status and sex of the paediatrician were significant at 4 months. A novel finding of our study was the positive effect of female paediatricians on breast-feeding continuation until 4 months of age (OR = 1·49; 95 % CI 1·03, 2·15).

Breast-feeding rates are low at 1 and 4 months of infant age in Beirut. Further research to investigate the interactions between female physicians and lactating mothers in maintaining breast-feeding in other populations is warranted. The results constitute the basis for designing interventions targeting policy makers, health professionals and mothers.

To determine (i) the extent of malnutrition and the risk factors for severe malnutrition in Guinea Bissau, a post-conflict country experiencing long-term consequences of civil war; and (ii) the feasibility and effectiveness of a short-term intervention characterized by outpatient treatment with locally produced food for the treatment of severe malnutrition during the rainy season.

Social, clinical, nutritional information were collected for children reaching the paediatric outpatient clinic of the Hospital ‘Comunità di Sant’Egidio’ in Bissau, Guinea Bissau, from 1 July to 12 August 2003. Severely malnourished children (weight-for-age <−3sd) in poor health status were admitted for daily nutritional and pharmacological treatment until complete recovery. Social and health indicators were analysed to define risk factors of severe malnutrition.

In total, 2642 children were visited (age range: 1 month–17 years). Fever, cough and dermatological problems were the main reasons for access. Social data outlined poor housing conditions: 86·4 % used water from unprotected wells, 97·3 % did not have a bathroom at home, 78·2 % lived in a mud house. Weight-for-age was <−2sd in 23·0 % of the children and <−3sd in 10·3 %; thirty-seven children (1·4 %) were severely malnourished and admitted for day care. All recovered with a weight gain of 4·45 g/kg per d, none died or relapsed after 1 year. Severely malnourished children were mainly infants, part of large families and had illiterate mothers.

Short-term interventions performed in post-conflict countries during seasons of high burden of disease and malnutrition are feasible and successful at low cost; day-care treatment of severe malnutrition with locally produced food is an option that can be tested in other settings.

Explore the level of general nutrition knowledge and demographic influences of knowledge levels in a community sample.

A sample of volunteers, recruited from community centres in two suburbs of differing socio-economic status, in Adelaide, South Australia.

Two hundred and one people, aged 18 years and older, completed a modified and validated version of the General Nutrition Knowledge Questionnaire (113 items). The questionnaire was self-administered and completed under supervision.

Basic messages about eating more fruit, vegetables and fibre, and less fatty and salty foods were best understood. Confusion was evident with more detailed nutrition information. For example, 90 % of the people were aware of the recommendations to eat more fruit and vegetables, but 56 % and 62 % knew the recommended number of servings of fruit and vegetables, respectively. Descriptive statistics showed significant demographic variation in nutrition knowledge levels; multiple regression analysis confirmed the significant independent effects of gender, age, highest level of education and employment status on nutrition knowledge level (P < 0·01 level). The model accounted for 40 % of the variance in nutrition knowledge scores.

There is demographic variation in nutrition knowledge levels and a broad lack of awareness of some public health nutrition recommendations. Having a detailed understanding of the deficiencies in community knowledge should allow for future nutrition education programmes to target subgroups of the population or particular areas of nutrition education, to more efficiently improve knowledge and influence dietary behaviour.

To investigate the sociodemographic risk factors associated with metabolic syndrome (MetS) in the Mediterranean population of Catalonia, Spain.

Data from the cross-sectional, population-based 2002–2003 Health Survey of Catalonia were analysed. The survey used a structured questionnaire to collect information on demographics, lifestyle and medical history. In a sub-sample of the original survey population anthropometrics and blood pressure were measured and blood samples were taken to determine HDL cholesterol, TAG and fasting glucose.

The analysis included the 1104 individuals aged 18–74 years from this sub-sample who had complete information on all variables necessary to define MetS using the National Cholesterol Education Program’s Adult Treatment Panel III (ATP III) and the International Diabetes Federation (IDF) criteria.

MetS prevalence was 28·5 % and 24·8 % according to IDF and ATP III criteria, respectively. MetS was significantly (P = 0·05) more common in males than females. MetS prevalence increased significantly (P<0·001) with age and degree of adiposity and as social class decreased. In general, MetS prevalence decreased as physical activity increased, which was significant (P = 0·0253) when applying ATP III criteria. After taking into account important confounders, MetS prevalence was significantly positively associated with male gender, age, BMI, physical inactivity and lower social class. Smoking status, marital status and working situation were not independently associated with MetS.

Age, sex, degree of adiposity, physical activity and social class are the sociodemographic risk factors independently associated with MetS in this Mediterranean population. Understanding which factors predict MetS is important considering likely increasing MetS trends, and is useful for determining public health strategies.

To analyse the associations of selected sociodemographic and lifestyle factors with the intake of antioxidant nutrients and consumption of their main dietary sources among pregnant women.

A population-based cohort study. Dietary intake during pregnancy was assessed by a self-administered FFQ one to three months after the delivery.

Type 1 Diabetes Prediction and Prevention (DIPP) Project.

Subjects comprised 3730 women (70·1 % of those invited) who entered the DIPP Nutrition Study after delivering a child at increased genetic risk for type 1 diabetes at the university hospitals in Oulu and Tampere, Finland, 1997–2002.

All sociodemographic and lifestyle factors studied showed significant associations with antioxidant intake in multiple regression models adjusting for all other factors. Older and more educated women tended to have higher intake of most antioxidants. Parity was positively associated with retinol intake and inversely with vitamin C intake. Smokers had lower intakes of most antioxidants. Only the partner’s education was positively associated with high intake of fruits, whereas own education was positively associated with berry consumption. Vegetable consumption was positively associated with partner’s education except for women with academic education, who tended to have high vegetable consumption irrespective of partner’s education.

Young women, smokers and those with a low education are at risk for low antioxidant intake and non-optimal food choices during pregnancy.