The aims of the present work were to study beverage consumption among obese women from rural communities in Mexico and to estimate daily polyphenol intake and dietary antioxidant capacity from beverages.

A cross-sectional study was used to analyse the beverage intake of 139 premenopausal obese women estimated through repeated 24 h food recalls. Total polyphenol content and antioxidant capacity were determined in eighteen beverages, representing 71 % of total beverage consumption, in order to estimate the intake of polyphenols (mg/person per d) and the dietary antioxidant capacity (μmol Trolox equivalents/person per d) from beverages.

Five rural communities located in Queretaro State, Mexico, in 2008.

A total of 139 premenopausal women identified as obese (BMI 35·0 (se 0·4) kg/m2), aged 25–45 years.

The contribution of beverages to dietary energy was 1369 kJ/d (18 % of total energy intake). Soft drinks were consumed the most (283 (se 17) ml/d), followed by coffee and fresh fruit beverages. Polyphenol intake and dietary antioxidant capacity from beverages was 180·9 (se 12·5) mg/person per d and >1000 μmol Trolox equivalents/person per d, respectively. The items that contributed most to this intake were coffee, roselle drink, peach and guava juices and infusions.

There is an urgent need to reduce the consumption of sugar-sweetened beverages among obese women from rural Mexico. Low-sugar beverages rich in polyphenols and antioxidants may be healthier options to replace sweetened drinks and increase the intake of bioactive compounds. Nutritional advice on this topic could be a viable strategy to tackle obesity in rural areas in Mexico.

There are no percentile curves for BMI, waist circumference (WC) or waist-to-height ratio (WHtR) available for Portuguese children and adolescents. The purpose of the present study was to develop age- and sex-specific BMI, WC and WHtR percentile curves for a representative sample of adolescents living in the Portuguese islands of Azores, one of the poorest regions of Europe, and to compare them with those from other countries.

Cross-sectional school-based study. Weight, height and WC were objectively measured according to standard procedures. Smoothed percentile curves were estimated using Cole's LMS method.

Azores, Portugal.

Proportionate stratified random sample of 1500 adolescents, aged 15–18 years.

Results showed some sex differences in the shape of the BMI curves: in girls, the upper percentile values tend to decrease by the age of 16 and 17 years; whereas in boys, the upper percentiles tend to be flat between 15 and 16 years and then increase until the age of 18 years. In both sexes, the upper percentile values of both WC and WHtR decreased slightly by the age of 16 years and then increased steeply. In both sexes, the Azorean values for the 50th and 90th WC percentiles were higher than those reported for adolescents from the majority of other countries.

The reference curves presented herein provide baseline data for the long-term surveillance of Azorean adolescents, as well as for national and international comparisons.

Epidemiological studies have shown that adults tend to underestimate their weight and overestimate their height. This may lead to a misclassification of their BMI in studies based on self-reported data. The aim of the present study was to assess the validity of self-reported weight and height in Austrian adults.

Data on weight, height, health behaviour and sociodemographic characteristics of adults were collected in a standardized procedure via a self-filling questionnaire and a medical examination including measurements of weight and height.

A publicly accessible out-patient clinic in southern Austria.

Austrian residents (n 473) aged 18 years and older who attended a health check participated in the study.

The mean difference between reported and measured BMI was not significant in younger adults (<35 years: mean difference −0·21 kg/m2; P < 0·08) but increased significantly with age (≥55 years: mean difference −0·68 kg/m2; P < 0·001). The prevalence of normal weight (BMI = 18·5–24·9 kg/m2) and overweight (BMI = 25·0–29·9 kg/m2) was overestimated based on the self-reported data on BMI, while that for underweight (BMI < 18·5 kg/m2) and obesity (BMI ≥ 30·0 kg/m2) was underestimated (P < 0·001). The self-reported data showed an obesity prevalence of 12·5 %, while measurement showed a prevalence of 15·4 % (P < 0·001).

Our results indicate that prevalence rates of obesity are probably underestimated for Austrian adults when using self-reported weight and height information. The deviations from the measured data clearly increased with age. Analyses based on self-reported data should therefore be adjusted for the age dependency of the validity.

To evaluate the first phase of a specialist weight management programme provided entirely within the UK National Health Service.

Prospective cohort study using multiple logistic regression analysis to report odds of ≥5 kg weight loss in all referrals and completers, and odds of completion, with 95 % confidence intervals. Anxiety and depression ‘caseness’ were measured by the Hospital Anxiety and Depression Scale.

Glasgow and Clyde Weight Management Service (GCWMS) is a specialist multidisciplinary service, with clinical psychology support, for patients with BMI ≥35 kg/m2 or BMI ≥30 kg/m2 with co-morbidities.

All patients referred to GCWMS between 2004 and 2006.

Of 2976 patients referred to GCWMS, 2156 (72·4 %) opted into the service and 809 completed phase 1. Among 809 completers, 35·5 % (n 287) lost ≥5 kg. Age ≥40 years, male sex (OR = 1·39, 95 % CI 1·05, 1·82), BMI ≥ 50 kg/m2 (OR = 1·70, 95 % CI 1·14, 2·54) and depression (OR = 1·81, 95 % CI 1·35, 2·44) increased the likelihood of losing ≥5 kg. Diabetes mellitus (OR = 0·55, 95 % CI 0·38, 0·81) and socio-economic deprivation were associated with poorer outcomes. Success in patients aged ≥40 years and with BMI ≥50 kg/m2 was associated with higher completion rates of the programme. Patients from the most deprived areas were less likely to lose ≥5 kg because of non-completion of the programme.

Further improvements in overall effectiveness might be achieved through targeting improvements in appropriateness of referrals, retention and effective interventions at specific populations of patients.

To examine food concern (FC) and its associations with obesity and diabetes in a racially diverse, urban population.

Cross-sectional population-based survey.

Five boroughs of New York City.

Lower-income adults (n 5981) in the 2004 New York City Community Health Survey.

The overall prevalence of obesity was 24 % and was higher among FC than non-FC white men and women, black women, US- and foreign-born whites and foreign-born blacks. In multivariable analysis, FC was marginally associated with obesity (OR = 1·18, 95 % CI 0·98, 1·42) among all lower-income New Yorkers, after controlling for socio-economic factors. The association of FC and obesity varied by race/ethnicity, with FC being positively associated with obesity only among white New Yorkers. FC whites had 80 % higher odds of obesity than whites without FC (OR = 1·80; 95 % CI 1·21, 2·68), with a model-adjusted obesity prevalence of 20 % among non-FC whites v. 31 % among FC whites. FC was not associated with diabetes after controlling for obesity and socio-economic factors.

The prevalence of obesity was significantly higher among FC whites and certain subgroups of blacks. FC was positively associated with obesity risk among lower-income white New Yorkers. Programmes designed to alleviate FC and poverty should promote the purchase and consumption of nutritious, lower-energy foods to help address the burden of obesity in lower-income urban populations.

The present study aimed to define the complexity of the relationships between the family environment, health behaviours and obesity. A conceptual model that quantifies the relationships and interactions between parent factors, family environment, and certain aspects of children's behaviour and weight status is presented.

Exploratory structural equation modelling was used to quantitatively model the relationships between parent, child and family environmental factors.

Adelaide, South Australia.

Families (n 157) with children aged 5–10 years completed self-reported questionnaires, providing data on parents’ knowledge, diet quality and activity habits; child feeding and general parenting styles; and the food and physical activity environments. Outcome variables included children's fruit and vegetable intake, activity and sedentary habits and weight status.

The proposed model was an acceptable fit (normed fit index = 0·457; comparative fit index = 0·746; root-mean-squared error associated = 0·044). Parents’ BMI (β = 0·32) and nutrition and physical activity knowledge (β = 0·17) had the strongest direct associations with children's BMI Z-score. Parents’ dietary intake and energy expenditure behaviours were indirectly associated with children's behaviour through the creation of the home environment. The physical activity and food environments were associated with children's sedentary (β = −0·44) and activity habits (β = 0·29), and fruit and vegetable intake (β = 0·47), respectively.

A conceptual model that quantifies the complex network of family environment factors influencing children's behaviour and weight status is presented. The model provides a basis for future research on larger representative samples with a view to guiding obesity prevention interventions.

Patterns of socio-economic inequalities in obesity and overweight have not been documented for Turkey. The present study aimed to describe educational and wealth-related inequalities for overweight in Turkey, taking a regional perspective.

Cross-sectional self-reported data of the World Health Survey 2002 for Turkey were used. BMI ≥ 25·00 kg/m2 was considered as overweight. Respondents were classified according to education years and a wealth score derived from the availability of household assets. Logistic regression analysis was applied to assess the relationship between overweight and socio-economic factors. Analyses were stratified by sex and region (West, Mediterranean, Middle, Black Sea and East).

Turkey.

Among the respondents 20 years and older, 3790 women and 4057 men had data on self-reported height and weight.

Age-adjusted overweight prevalence was 48·4 % for women and 46·1 % for men. For men, education was not systematically related to overweight while overweight was significantly increased among the highest wealth groups. For women, the prevalence of overweight was highest for low-educated and middle-wealth groups. The size of the inequalities in overweight showed only small regional variations. In the East, however, overweight prevalence was more related to higher socio-economic position than in the other regions.

Socio-economic inequalities for overweight in Turkey are at a similar level as in most European countries, and especially comparable to Southern Europe. The smaller inequalities in the East correspond to the low level of socio-economic development in this part of the country. Prevention of overweight should focus on lower educational groups throughout the entire country and especially on low-educated women.

To investigate the long-term effects of duration of postpartum lactation on maternal body composition and risk for cardio-metabolic disorders in later life.

Retrospective study. Body composition was measured using dual-energy X-ray absorptiometry and serum glucose, insulin and lipids were analysed using enzymatic photometric methods 16–20 years after the last pregnancy. Medical history and lifestyle factors were collected via a self-administered questionnaire. Detailed information regarding weight change patterns during each pregnancy was obtained from personal maternity tracking records.

City of Jyväskylä and surroundings in Central Finland.

Two hundred and twelve women (mean age 48, range 36–60 years).

At 16–20 years after their last pregnancy, women who had breast-fed for less than 6 months had higher total body fat mass and fat mass percentage, particularly in the android region (46·5 (sd 8·2) %) than mothers who had breast-fed for longer than 6 months (39·0 (sd 10·2) %) or for longer than 10 months (38·4 (sd 10·9) %, P < 0·01). These differences were independent of pre-pregnancy weight and BMI, menopausal status, smoking status, level of education, participation in past and present leisure-time physical activity, and current dietary energy intake. Higher body fat mass was also associated with higher fasting serum glucose concentration and insulin resistance, TAG, LDL cholesterol and total cholesterol concentrations, as well as higher systolic and diastolic blood pressure (P < 0·05 for all).

Short duration of breast-feeding may induce weight retention and fat mass accumulation, resulting in increased risk of cardio-metabolic disorders in later life.

To assess how diet quality, physical activity and body weight are related to health-related quality of life (HRQOL) among children in the Canadian province of Alberta.

In 2008, we surveyed 3421 grade 5 students and their parents from 148 randomly selected schools. Students completed the Harvard Food Frequency Questionnaire, questions on physical activities, and had their height and weight measured. The HRQOL of the students was assessed using the EQ-5D-Y. Parents completed questions on socio-economic background and children's lifestyle. We applied multilevel regression methods to examine the importance of children's diet quality, physical activity and weight status for the EQ-5D-Y Visual Analogue Scale and for the EQ-5D-Y dimensions.

The province of Alberta, Canada.

Grade 5 students.

Students with better diet quality, higher physical activity levels and normal body weights were statistically significantly more likely to report better HRQOL than students who ate less healthily, were less active or were overweight or obese.

The importance of diet quality, physical activity and body weight status for HRQOL may help justify broader implementation of school health programmes that promote healthy eating and active living, as these programmes will help reduce the burden of childhood obesity and improve quality of life.

To estimate the association between food intake and metabolic syndrome (MetS).

Cross-sectional design conducted from July 2006 to December 2007.

Adolescents assisted by the Family Doctor Program (FDP) in Niterói, a metropolitan area in Rio de Janeiro State, Brazil.

Survey of 210 adolescents. Individuals with three or more of the following components of MetS were classified as having this syndrome: TAG ≥ 110 mg/dl; HDL cholesterol < 50 mg/dl for girls aged 12–19 years and boys aged 12–14 years or <45 mg/dl for boys aged 15–19 years; waist circumference ≥75th percentile; serum glucose >100 mg/dl; and blood pressure ≥90th percentile. A semi-quantitative FFQ was used, and foods were grouped as: unprocessed or minimally processed foods (Group 1), processed culinary and food industry ingredients (Group 2) and ultra-processed foods (Group 3). The associations between food consumption and MetS were adjusted for sociodemographic, behavioural and family history covariates and were estimated using generalized estimation equations with the Poisson regression model.

MetS was diagnosed in 6·7 % of the adolescents; the most frequent diagnostic criteria included the reduction of HDL cholesterol (46·7 %), elevated serum glucose (17·1 %) and the elevation of waist circumference (16·7 %). Crude analysis showed higher average daily intakes of energy, carbohydrates and ultra-processed foods among adolescents with MetS. After statistical adjustment, the intake of ultra-processed foods (≥3rd quartile) remained associated with MetS (prevalence ratio = 2·5; P = 0·012).

High consumption of ultra-processed foods was associated with the prevalence of MetS in this adolescents group.

To simultaneously identify consumer segments based on individual-level consumption and community-level food retail environment data and to investigate whether the segments are associated with BMI and dietary knowledge in China.

A multilevel latent class cluster model was applied to identify consumer segments based not only on their individual preferences for fast food, salty snack foods, and soft drinks and sugared fruit drinks, but also on the food retail environment at the community level.

The data came from the China Health and Nutrition Survey (CHNS) conducted in 2006 and two questionnaires for adults and communities were used.

A total sample of 9788 adults living in 218 communities participated in the CHNS.

We successfully identified four consumer segments. These four segments were embedded in two types of food retail environment: the saturated food retail environment and the deprived food retail environment. A three-factor solution was found for consumers’ dietary knowledge. The four consumer segments were highly associated with consumers’ dietary knowledge and a number of sociodemographic variables.

The widespread discussion about the relationships between fast-food consumption and overweight/obesity is irrelevant for Chinese segments that do not have access to fast food. Factors that are most associated with segments with a higher BMI are consumers’ (incorrect) dietary knowledge, the food retail environment and sociodemographics. The results provide valuable insight for policy interventions on reducing overweight/obesity in China. This study also indicates that despite the breathtaking changes in modern China, the impact of ‘obesogenic’ environments should not be assessed too strictly from a ‘Western’ perspective.

Due to a proliferation of measures for different components of the home environment related to childhood obesity, the purpose of the present systematic review was to examine these tools and the degree to which they can validly and reliably assess the home environment.

Relevant manuscripts published between 1998 and 2010 were obtained through electronic database searches and manual searches of reference lists. Manuscripts were included if the researchers reported on a measure of the home environment related to child eating and physical activity (PA) and childhood obesity and reported on at least one psychometric property.

Of the forty papers reviewed, 48 % discussed some aspect of parenting specific to food. Fifty-per cent of the manuscripts measured food availability/accessibility, 18 % measured PA availability/accessibility, 20 % measured media availability/accessibility, 30 % focused on feeding style, 23 % focused on parenting related to PA and 20 % focused on parenting related to screen time.

Many researchers chose to design new measures for their studies but often the items employed were brief and there was a lack of transparency in the psychometric properties. Many of the current measures of the home food and PA environment focus on one or two constructs; more comprehensive measures as well as short screeners guided by theoretical models are necessary to capture influences in the home on food and PA behaviours of children. Finally, the current measures of the home environment do not necessarily translate to specific sub-populations. Recommendations were made for future validation of measures in terms of appropriate psychometric testing.

To systematically review weight and cardiovascular risk reduction in blacks by diet and lifestyle changes.

Randomised and non-randomised controlled trials of diet with/without lifestyle changes with duration of intervention ≥3 months, and published between January 1990 and December 2009, were searched in electronic databases including MEDLINE, EMBASE, CINAHL and CCTR (Cochrane Controlled Trials Register). Studies were included if they reported weight/BMI changes with changes in at least one of the following: systolic and diastolic blood pressure, fasting plasma lipids and glucose, and glycated haemoglobin.

Clinical, community and church-based interventions.

Study participants were of African ancestry (blacks).

Eighteen studies met the inclusion criteria. Average mean difference in weight loss was −2·66 kg, with improvements in all outcomes except total cholesterol. No significant difference was observed in outcome measures between all studies and studies that recruited only healthy participants or patients with type 2 diabetes.

Diet and lifestyle changes result in weight loss with improvements in cardiovascular risk factors in blacks. However, more culturally tailored programmes have been suggested to motivate and encourage blacks to participate in intervention trials.

To investigate the relationship between dietary patterns and self-perceived body shape silhouette and BMI in a sample of Mexican women.

A cross-sectional analysis of dietary habits from baseline data of a large cohort study (EsMaestra) conducted in 2006–2008.

The state of Veracruz, Mexico.

Mexican teachers (n 20 330) provided information on body shape silhouette at baseline, changes in body shape silhouette and BMI, as well as information on sociodemographic variables and lifestyle.

The median BMI was 26·8 kg/m2; 43 % of women were overweight and 24 % were obese. The carbohydrates, sweet drinks and refined foods pattern was associated with a greater risk of having a large silhouette and a large BMI (BMI ≥ 30·0 kg/m2v. BMI < 25·0 kg/m2; ORT1−3 = 1·86, 95 % CI 1·56, 2·22 and 1·47, 95 % CI 1·28, 1·69, respectively) with a significant trend when comparing the first and third tertiles of intake. The fruit and vegetable pattern was associated with a lower risk of having a large silhouette and a large BMI (ORT1−3 = 0·68, 95 % CI 0·57, 0·82 and ORT1−3 = 0·77, 95 % CI 0·67, 0·88, respectively) with a significant decreasing trend. Similar results were observed when change in silhouette (from 18 years of age to current silhouette) was considered.

High intakes of carbohydrates, sweet drinks and refined foods are related to larger silhouettes. Public health intervention improving access to healthy dietary guidelines, healthy food choice in the work place, promotion of physical activity and regulation of beverages with a high sugar content and of refined foods should be considered.

To quantify the prevalence and trends of stunting among children using the WHO growth standards.

Five hundred and seventy-six nationally representative surveys, including anthropometric data, were analysed. Stunting was defined as the proportion of children below −2sd from the WHO length- or height-for-age standards median. Linear mixed-effects modelling was used to estimate rates and numbers of affected children from 1990 to 2010, and projections to 2020.

One hundred and forty-eight developed and developing countries.

Boys and girls from birth to 60 months.

In 2010, it is estimated that 171 million children (167 million in developing countries) were stunted. Globally, childhood stunting decreased from 39·7 (95 % CI 38·1, 41·4) % in 1990 to 26·7 (95 % CI 24·8, 28·7) % in 2010. This trend is expected to reach 21·8 (95 % CI 19·8, 23·8) %, or 142 million, in 2020. While in Africa stunting has stagnated since 1990 at about 40 % and little improvement is anticipated, Asia showed a dramatic decrease from 49 % in 1990 to 28 % in 2010, nearly halving the number of stunted children from 190 million to 100 million. It is anticipated that this trend will continue and that in 2020 Asia and Africa will have similar numbers of stunted children (68 million and 64 million, respectively). Rates are much lower (14 % or 7 million in 2010) in Latin America.

Despite an overall decrease in developing countries, stunting remains a major public health problem in many of them. The data summarize progress achieved in the last two decades and help identify regions needing effective interventions.

To assess the validity of a locally adapted Household Food Insecurity Access Scale (HFIAS) in the measurement of household food insecurity (FI) in the city of Tehran.

A cross-sectional study.

Urban households were selected through a systematic cluster sampling method from six different districts of Tehran. The socio-economic status of households was evaluated using a questionnaire by means of interviews. An adapted HFIAS was used to measure FI. Content validity was assessed by an expert panel, and the questionnaire was then tested among ten households for clarity. Criterion validity was assessed by comparing the measure with a number of determinants and consequences of FI. Internal consistency was evaluated by Cronbach's α and exploratory factor analysis. For repeatability, the questionnaire was administered twice to twenty-five households at an interval of 20 d and Pearson's correlation coefficient was calculated.

A total of 416 households.

In all, 11·8 %, 14·4 % and 17·5 % of the households were severely, moderately and mildly food insecure, respectively. Cronbach's α was 0·855. A significant correlation was observed between the two administrations of the questionnaire (r = 0·895, P < 0·001). Factor analysis of HFIAS items revealed two factors: the first five items as factor 1 (mild-to-moderate FI) and the last four as factor 2 (severe FI). Heads of food-secure households had higher education and higher job position compared with heads of food-insecure households (P < 0·001). Income and expenditure were lower in food-insecure households compared with food-secure households.

Adapted HFIAS showed acceptable levels of internal consistency, criterion validity and reliability in assessing household FI among Tehranians.

Rapid economic development and subsequent changes in lifestyle and disease burdens (‘health transition’) is associated with increasing prevalence of obesity among both adults and children. However, because of continued infectious diseases and undernutrition during the early stages of transition, monitoring childhood obesity has not been prioritized in many countries and the scope of the problem is unknown. Therefore we sought to characterize patterns of childhood overweight and obesity in an early transitional area, the South Pacific archipelago of Vanuatu.

We completed an anthropometric survey among children from three islands with varying levels of economic development, from rural areas (where adult obesity prevalence is low) to urban areas (where adult obesity prevalence is high).

The islands of Ambae (rural), Aneityum (rural with tourism) and Efate (urban).

Boys and girls (n 513) aged 6–17 years.

Height-, weight- and BMI-for-age did not vary among islands, and prevalence of overweight/obesity based on BMI was low. However, girls from Aneityum – a rural island where the tourism industry increased rapidly after malaria eradication – had increased central adiposity compared with girls from the other islands. This is contrary to adult patterns, which indicate higher obesity prevalence in urban areas. Multiple factors might contribute, including stunting, biological responses after malaria control, sleeping patterns, diet and physical activity levels.

Measures of central adiposity highlight an emerging obesity risk among girls in Vanuatu. The data highlight the synergistic relationship among infectious diseases, undernutrition and obesity during the early stages of health transition.