The objective of this study was to describe the evolution of household purchase of added sugars and their main food sources in Brazil. Nationally representative data from the Household Budget Surveys from 2002–2003, 2008–2009 and 2017–2018 were used. Energy and added sugar quantities were estimated by means of per capita food quantities. The items considered as food sources were: (1) table sugar: refined sugar and other energetic sweeteners and (2) processed and ultra-processed foods with added sugar: soft drinks; other drinks; sweets, candies and chocolates; cookies; cakes and pies and other foods. The parameters estimated were: mean share of added sugar in total energy and, for food sources, the share of added sugar in total sugar intake and the impact of variations in sources of added sugar between 2008 and 2017. There was a regular share of energy from added sugar to total energy intake between 2002 and 2008 but a reduced share in 2017. Between 2008 and 2017, there was a decrease in the share of refined sugar and other sweeteners and soft drinks to total sugar intake and an increased share of all other items. High-income households had a lower share of refined sugar and other energetic sweeteners, but a higher share of soft drinks, sweets, candies and chocolates. The decrease in added sugar in 2017 was mainly due to the lower share of soft drinks. In conclusion, Brazilians’ total intake of added sugar was decreased, mostly owing to reduced consumption of sugar from soft drinks.

This study evaluated changes in the use of sweeteners over one decade and the relationship between socio-demographics, diet and weight status with the type of sweetener. Data came from the Brazilian National Dietary Surveys of 2008–2009 and 2017–2018, including ≥ 10-year-old individuals (n 32 749; n 44 744, respectively, after excluding pregnant and lactating women). The use of table sugar, non-caloric sweeteners (NCS), both or none was reported through a specific question. Food consumption was assessed using two non-consecutive food records (2008–2009) and 24-h recalls (2017–2018). For the last survey, means of energy, macro and micronutrient intake, food groups’ contribution (%) to daily energy intake and age- and energy-adjusted nutrient intake were estimated according to the type of sweetener used. Differences in means and proportions across the categories of sweeteners used were evaluated based on the 95 % CI. All analyses were stratified by sex and considered sample design and weights. Over 10 years, the use of table sugar decreased by 8 %, while the habit of not using any sweetener increased almost three times, and the use of NCS remained stable. Larger reductions in the use of table sugar were observed in the highest income level and among men. Regardless of sex, compared with NCS users, table sugar users had greater mean intake of energy, carbohydrates and added sugar and lower micronutrient intake means. Although table sugar is still the most used sweetener, the increased choice of ‘no sweetener’ is noteworthy in Brazil.

It is commonly asserted that Chinese diets before the market and production reforms of the 1980s contained little or no meat. Yet this nearly universal assumption remains untested: Unlike other forms of material consumption, the question of meat in Chinese diets has received almost no systematic attention from historians. Focusing on the early twentieth century, this article examines who in China ate meat, and how meat consumption was shaped by regional and household patterns. It combines insights from three sorts of data. First, Japanese price surveys from the 1920s show a high degree of variation in the preference for one type of meat over others, and the price availability of meat versus wages or other food products. Second, production data, including slaughterhouse tallies and industry estimates of animal by-products show the seasonality of animal slaughter and the vast scale and dispersed geography of China’s livestock production. Finally, nutrition and diet studies from the 1920 to the late 1940s examine actual household consumption, emphasizing how social forces and cyclical fortunes shaped individual choices. The composite picture from these three perspectives confirms that China’s meat consumption was hardly inconsequential. But more than simply triangulating a result, the exercise of comparing perspectives of price, production, and nutrition also highlights the collection of survey data as a series of historical moments.

Currently, there is considerable emphasis on the relationship between dietary sugar consumption and various health outcomes, with some countries and regions implementing national sugar reduction campaigns. This has resulted in significant efforts to quantify dietary sugar intakes, to agree on terms to describe dietary sugars and to establish associated recommendations. However, this information is infrequently collated on a global basis and in a regularised manner. The present review provides context regarding sugar definitions and recommendations. It provides a global review of the available data regarding dietary sugar intake, considering forms such as total, free and added sugars. A comprehensive breakdown of intakes is provided by age group, country and sugar form. This analysis shows that free sugar intakes as a percentage of total energy (%E) are the highest for children and adolescents (12–14%E) and the lowest for older adults (8%E). This trend across lifecycle stages has also been observed for added sugars. The available data also suggest that, while some reductions in sugar intake are observed in a few individual studies, overall intakes of free/added sugars remain above recommendations. However, any wider conclusions are hampered by a lack of detailed high-quality data on sugar intake, especially in developing countries. Furthermore, there is a need for harmonisation of terms describing sugars (ideally driven by public health objectives) and for collaborative efforts to ensure that the most up-to-date food composition data are used to underpin recommendations and any estimates of intake or modelling scenarios.

Monitoring nutritional status of the population is essential in the development and evaluation of national or local health policies. In this study, we aimed to demonstrate analysis on the trends in dietary intake of energy and macronutrients, as well as Na, in Japanese population using the data of series of cross-sectional national surveys – the National Nutrition Survey (NNS) and the National Health Nutrition Survey (NHNS) – during the period from 1995 to 2016. The NNS and NHNS participants aged 20–79 years were included in the analysis. Dietary intake was estimated using 1-d household-based dietary record. The trend in total energy intake, energy intake from macronutrients (fat and protein), Na intake and energy-adjusted Na intake were analysed using regression models adjusted to 2010 age distribution and anthropometry status. A total of 94 270 men and 107 890 women were included the analysis. Total energy intake showed a decreasing trend in both men and women. Similarly, energy intake from protein decreased, but energy intake (%) from fat increased in both sexes. Energy-adjusted Na intake showed a decreasing trend in both men and women. This study identified the decrease in total energy intake and energy intake from protein, whereas there were inverse trends in energy intake from fat among Japanese adults. Continued monitoring of trends in dietary intake will be needed, and there should be efforts to increase the accuracy of current survey procedures.

Dietary under-reporting is a common problem when using self-reported dietary assessment tools. However, there are few studies regarding under-reporting during pregnancy. This study aimed to explore the demographic and psychosocial characteristics related to dietary under-reporting in pregnant Japanese women. A cross-sectional study was conducted between 2010 and 2011 at a university hospital in Tokyo, Japan. Nutrient intake was assessed using a self-administered Diet History Questionnaire (DHQ), which had questions about the consumption frequency and portion size of selected food items. The 24-h urinary excretion levels of urea N and K were used as the dietary protein and K intake reference values, respectively. Under-reporting of protein and K was defined as the bottom 25 % of the reporting accuracy (the ratio of reported intake on the DHQ to the estimated intake based on urinary excretion). Under-reporters were defined as participants who under-reported both protein and K intake. Multiple logistic regression analysis was performed to examine the factors associated with under-reporters. Of 271 healthy women at 19–23 weeks of gestation, thirty-five participants (12·9 %) were identified as under-reporters. Under-reporters had a lower pre-pregnancy BMI (adjusted OR (AOR) = 0·81) and lower gestational weight gain (AOR = 0·82); they also reported managing their gestational weight gain with the aim to return to their pre-pregnancy weight soon after childbirth (AOR = 2·99). Healthcare professionals should consider the potential for dietary under-reporting and the possible related factors when assessing the dietary intakes of pregnant Japanese women using self-administered questionnaires.

Nutrition in the second year is important as this is a period of rapid growth and development. Milk is a major food for young children and this analysis evaluated the impact of the type of milk consumed on nutrient intakes and nutritional status. Data from the Diet and Nutrition Survey of Infants and Young Children were used to investigate the intakes of key nutrients, and Fe and vitamin D status, of children aged 12–18 months, not breastfed, and consuming >400 g/d fortified milk (n 139) or >400 g/d of whole cows’ milk (n 404). Blood samples from eligible children for measurement of Hb (n 113), serum ferritin and plasma 25-hydroxyvitamin D (25(OH)D) concentrations (n 105) were available for approximately 20 % of children. Unpaired Mann–Whitney tests were used to compare nutrient intakes and status between consumers of fortified and cows’ milk. Mean daily total dietary intakes of Fe, Zn, vitamin A and vitamin D were significantly higher in the fortified milk group. Mean daily total dietary intakes of energy, protein, Ca, iodine, Na and saturated fat were significantly higher in the cows’ milk group. Hb was not different between groups. The fortified milk group had significantly higher serum ferritin (P = 0·049) and plasma 25(OH)D (P = 0·014). This analysis demonstrates significantly different nutrient intakes and status between infants consuming >400 g/d fortified milk v. those consuming >400 g/d whole cows’ milk. These results indicate that fortified milks can play a significant role in improving the quality of young children's diets in their second year of life.

Because of the discretionary nature of voluntary food fortification in the European Union, there is a need to monitor fortification practices and consumption of fortified foods in order to assess the efficacy and safety of such additions on an ongoing basis. The present study aimed to investigate the nutritional impact of changes in voluntary fortification practices in adults aged 18–64 years using dietary intake data from two nationally representative cross-sectional food consumption surveys, the North/South Ireland Food Consumption Survey (NSIFCS) (1997–9) and the National Adult Nutrition Survey (NANS) (2008–10). The supply of fortified foods increased between 1997–9 and 2008–10, resulting in a higher proportion of adults consuming fortified foods (from 67 to 82 %) and a greater contribution to mean daily energy intake (from 4·6 to 8·4 %). The overall nutrient profile of fortified foods consumed remained favourable, i.e. higher in starch and dietary fibre and lower in fat and saturated fat, with polyunsaturated fat, sugars and Na in proportion to energy. Women, particularly those of childbearing age, remained the key beneficiaries of voluntary fortification practices in Ireland. Continued voluntary fortification of foods has increased protection against neural tube defect-affected pregnancy by folic acid and maintained the beneficial impact on the adequacy of Fe intake. Increased consumption of fortified foods did not contribute to an increased risk of intakes exceeding the tolerable upper intake level for any micronutrient. Recent increases in voluntary fortification of foods in Ireland have made a favourable nutritional impact on the diets of adults and have not contributed to an increased risk of adverse effects.

The consumption of whole grain foods is associated with many nutritional, health and weight control benefits. The present study assessed whole grain intake in France on the basis of a 7 d dietary survey in a representative sample of children, adolescents and adults (Comportements et Consommations Alimentaires en France 2010 survey). Special care was taken to identify and assess the intake of all whole grains. All foods consumed were considered, with no lower limit on whole grain content. For the majority of foods, details regarding the whole grain contents were obtained from brand information and quantitative nutrient declarations on food labels. Over half of the respondents reported never consuming any whole grain. In participants who did, consumption levels were very low (about 9·1 g/d in children and 14·4 g/d in adults). The main food sources of whole grains were breakfast cereals in children and adolescents and bread in adults. Consumers of whole grains had higher daily intakes of fibre and several vitamins and minerals than non-consumers. In adults but not in children, the OR for overweight/obesity decreased significantly as the level of whole grain consumption increased. Although a majority of French consumers comply with the national recommendation to consume a starchy food with each meal, they do so with minimal consumption of whole grain foods.

Although breakfast is associated with more favourable nutrient intake profiles in children, limited data exist on the impact of breakfast on nutrient adequacy and the potential risk of excessive intakes. Accordingly, we assessed differences in nutrient intake and adequacy among breakfast non-consumers, consumers of breakfasts with ready-to-eat cereal (RTEC) and consumers of other types of breakfasts. We used cross-sectional data from 12 281 children and adolescents aged 4–18 years who took part in the nationally representative Canadian Community Health Survey, 2004. Mean nutrient intakes (obtained using a multiple-pass 24 h recall method) were compared among the breakfast groups using covariate-adjusted regression analysis. Usual nutrient intake distributions, generated using the National Cancer Institute method, were used to determine the prevalence of nutrient inadequacy or the potential risk of excessive intakes from food sources alone and from the combination of food plus supplements. Of these Canadian children, 10 % were breakfast non-consumers, 33 % were consumers of RTEC breakfasts and 57 % were consumers of other types of breakfasts. Non-consumption of breakfast increased with age (4–8 years: 2 %; 9–13 years: 9 %; 14–18 years: 18 %). Breakfast consumers had higher covariate-adjusted intakes of energy, many nutrients and fibre, and lower fat intakes. The prevalence of nutrient inadequacy for vitamin D, Ca, Fe and Mg (from food alone or from the combination of food plus supplements) was highest in breakfast non-consumers, intermediate in consumers of other types of breakfasts and lowest in consumers of RTEC breakfast. For vitamin A, P and Zn, breakfast non-consumers had a higher prevalence of nutrient inadequacy than both breakfast groups. The potential risk of excessive nutrient intakes was low in all groups. Efforts to encourage and maintain breakfast consumption in children and adolescents are warranted.

Childhood obesity is an issue of public health concern globally. This review reports on levels of overweight and obesity in Irish children and examines some aspects of their diet and lifestyle proposed to promote or protect against increasing body fatness in children. While there is still some debate with regard to the most appropriate cut-off points to use when assessing body fatness in children, approximately one in five Irish children (aged 2–17 years) have been classified as overweight (including obese) according to two generally accepted approaches. Furthermore, comparison with previous data has shown an increase in mean body weight and BMI over time. On examining dietary patterns for Irish children, there was a noticeable transition from a less energy dense diet in pre-school children to a more energy dense diet in older children and teenagers, associated with a change to less favourable dietary intakes for fibre, fat, fruit and vegetables, confectionery and snacks and sugar-sweetened beverages as children got older. A significant proportion of school-aged children and teenagers reported watching more than 2 h television per day (35 % on school-days and 65 % on week-ends) compared with 13 % of pre-school children. For children aged 5–12 years, eating out of the home contributed just 9 % of energy intake but food eaten from outside the home was shown to contribute a higher proportion of energy from fat and to be less fibre-dense than food prepared at home. Improvements in dietary lifestyle are needed to control increasing levels of overweight and obesity in children in Ireland.

Energy intake under-reporting (UR) is a concern in nutritional epidemiological studies, as it may distort the relationships between dietary habits and health. Although UR is known to be associated with certain characteristics, few studies have investigated them in France. Therefore, the goal of the present study was to assess the prevalence and characteristics of UR in French adults. UR was defined according to Goldberg's classification. A sample of 1567 adults was drawn from the nationally representative French dietary survey (Individuelle Nationale des Consommations Alimentaires 2 2006–7). Food intake (7 d record), dietary habits, socio-economic status, region of residence, sedentary behaviour and weight perception variables were assessed. Multivariate logistic regression was used to investigate the associations between UR and a number of covariates. The overall prevalence of UR was 22·5 %, similar in men and women. In both sexes, UR was positively associated with overweight and protein intake and inversely associated with age. In women, UR was associated with eating lunch in the office, poor perception of diet quality and sedentary behaviour and was inversely associated with educational level, residence in the Paris region, cereal product intake and eating lunch in a friend's or family member's home. In men, UR was positively associated with a history of slimming and inversely associated with dairy product intake and eating lunch at a staff canteen. In conclusion, UR is prevalent in French adults and is associated with several different characteristics. It is important to take account of UR when investigating diet–disease associations in adults.

The aim of the present study was to validate thirty-eight picture series of six pictures each developed within the PANCAKE (Pilot study for the Assessment of Nutrient intake and food Consumption Among Kids in Europe) project for portion size estimation of foods consumed by infants, toddlers and children for future pan-European and national dietary surveys. Identical validation sessions were conducted in three European countries. In each country, forty-five foods were evaluated; thirty-eight foods were the same as the depicted foods, and seven foods were different, but meant to be quantified by the use of one of the thirty-eight picture series. Each single picture within a picture series was evaluated six times by means of predefined portions. Therefore, thirty-six pre-weighed portions of each food were evaluated by convenience samples of parents having children aged from 3 months to 10 years. The percentages of participants choosing the correct picture, the picture adjacent to the correct picture or a distant picture were calculated, and the performance of individual pictures within the series was assessed. For twenty foods, the picture series performed acceptably (mean difference between the estimated portion number and the served portion number less than 0·4 (sd < 1·1)). In addition, twelve foods were rated acceptable after adjustment for density differences. Some other series became acceptable after analyses at the country level. In conclusion, all picture series were acceptable for inclusion in the PANCAKE picture book. However, the picture series of baby food, salads and cakes either can only be used for foods that are very similar to those depicted or need to be substituted by another quantification tool.

Achieving an understanding of the extent of micronutrient adequacy across Europe is a major challenge. The main objective of the present study was to collect and evaluate the prevalence of low micronutrient intakes of different European countries by comparing recent nationally representative dietary survey data from Belgium, Denmark, France, Germany, The Netherlands, Poland, Spain and the United Kingdom. Dietary intake information was evaluated for intakes of Ca, Cu, I, Fe, Mg, K, Se, Zn and the vitamins A, B1, B2, B6, B12, C, D, E and folate. The mean and 5th percentile of the intake distributions were estimated for these countries, for a number of defined sex and age groups. The percentages of those with intakes below the lower reference nutrient intake and the estimated average requirement were calculated. Reference intakes were derived from the UK and Nordic Nutrition Recommendations. The impact of dietary supplement intake as well as inclusion of apparently low energy reporters on the estimates was evaluated. Except for vitamin D, the present study suggests that the current intakes of vitamins from foods lead to low risk of low intakes in all age and sex groups. For current minerals, the study suggests that the risk of low intakes is likely to appear more often in specific age groups. In spite of the limitations of the data, the present study provides valuable new information about micronutrient intakes across Europe and the likelihood of inadequacy country by country.

The objectives of the present study were to estimate the dietary contribution of away-from-home food consumption, to describe the contribution of away-from-home foods to energy intake, and to investigate the association between eating away from home and total energy intake in Brazilian urban areas. In the first Brazilian Nationwide Dietary Survey, conducted in 2008–9, food records were collected from 25 753 individuals aged 10 years or older, living in urban areas of Brazil. Foods were grouped into thirty-three food groups, and the mean energy intake provided by away-from-home food consumption was estimated. Linear regression models were used to evaluate the association between away-from-home food consumption and total energy intake. All analyses considered the sample design effect. Of the total population, 43 % consumed at least one food item away from home. The mean energy intake from foods consumed away from home was 1408 kJ (337 kcal), averaging 18 % of total energy intake. Eating away from home was associated with increased total energy intake, except for men in the highest income level. The highest percentage of away-from-home energy sources was for food with a high content of energy, such as alcoholic beverages (59 %), baked and deep-fried snacks (54 %), pizza (42 %), soft drinks (40 %), sandwiches (40 %), and sweets and desserts (30 %). The consumption of foods away from home was related to a greater energy intake. The characterisation of away-from-home food habits is necessary in order to properly design strategies to promote healthy food consumption in the away-from-home environment.

Vitamins play a crucial role in health, but modern lifestyles may lead to suboptimal intakes even in affluent countries. The aim of the present study is to review vitamin intakes in Germany, the UK, The Netherlands and the USA and to compare them with respective national recommendations. Data on adults from the most recently published national dietary intake surveys for the first three countries and data for adults from the US National Health and Nutrition Examination Survey from 2003 to 2008 for the USA were used as a basis for the analysis. The proportions of the populations with intakes below recommendations were categorised as < 5, 5–25, >25–50, >50–75 and >75 % for each vitamin. The data generated are presented in a ‘traffic light display’, using colours from green to red to indicate degrees of sufficiency. The trends found were compared with the results from the European Nutrition and Health Report 2009, even though in that report, only information on mean intakes in the different countries was available. We showed that, although inter-country differences exist, intakes of several vitamins are below recommendations in a significant part of the population in all these countries. The most critical vitamin appears to be vitamin D and the least critical niacin. The variation between the countries is most probably due to differences in recommendations, levels of fortification and local dietary habits. We show that a gap exists between vitamin intakes and requirements for a significant proportion of the population, even though diverse foods are available. Ways to correct this gap need to be investigated.

Accurate dietary assessment is an essential foundation of research in nutritional epidemiology. Due to the weaknesses in current methodology, attention is turning to strategies that automate the dietary assessment process to improve accuracy and reduce the costs and burden to participants and researchers. ‘My Meal Mate’ (MMM) is a smartphone application designed to support weight loss. The present study aimed to validate the diet measures recorded on MMM against a reference measure of 24 h dietary recalls. A sample of fifty volunteers recorded their food and drink intake on MMM for 7 d. During this period, they were contacted twice at random to conduct 24 h telephone recalls. Daily totals for energy (kJ) and macronutrients recorded on MMM were compared against the corresponding day of recall using t tests for group means and Pearson's correlations. Bland–Altman analysis was used to assess the agreement between the methods. Energy (kJ) recorded on MMM correlated well with the recalls (day 1: r 0·77 (95 % CI 0·62, 0·86), day 2: r 0·85 (95 % CI 0·74, 0·91)) and had a small mean difference (day 1 (MMM −  recall): − 68 kJ/d (95 % CI − 553, 418 kJ) ( − 16 kcal/d, 95 % CI − 127, 100 kcal); day 2 (MMM −  recall): − 441 kJ/d (95 % CI − 854, − 29 kJ) ( − 105 kcal/d, 95 % CI − 204, − 7 kcal)). Bland–Altman analysis showed wide limits of agreement between the methods: − 3378 to 3243 kJ/d ( − 807 to 775 kcal/d) on day 1. At the individual level, the limits of agreement between MMM and the 24 h recall were wide; however, at the group level, MMM appears to have potential as a dietary assessment tool.