To characterise consumption of ultra-processed foods and drinks (UPF) across a range of socio-demographic characteristics of Canadians.

Cross-sectional study. The national-level 2015 Canadian Community Health Survey–Nutrition provided data on all foods and drinks consumed on the previous day via a 24-hour dietary recall. All food items were classified according to the type of industrial processing using the NOVA system. Multivariable linear regression models examined associations between a range of socio-demographic characteristics and the mean energy contribution (% of total daily energy intake) from total UPF and UPF subgroups.

The ten Canadian provinces.

Canadians aged 2 or older (n 20 103).

UPF contributed, on average, nearly half (44·9 %) of total daily energy intake of Canadians. Children aged 6–12 and adolescents aged 13–18 consumed over half of total daily energy from UPF (adjusted means of 51·9 % and 50·7 %, respectively). Recent and long-term immigrants consumed a significantly lower share of energy from UPF (adjusted means of 42·2 % and 45·1 %, respectively) compared with non-immigrants (54·4 %), as did the food secure (42·8 %) v. those in moderately (48·1 %) or severely food-insecure households (50·8 %). More modest differences were observed for intake of total UPF and UPF subgroups by sex, education, income adequacy and region of residence.

Levels of UPF consumption in 2015 in Canada were pervasive in all socio-demographic groups and highest among children and adolescents, non-immigrants and those living in food-insecure households. These findings can inform public health interventions to reduce UPF consumption and promote healthier diets in various socio-demographic groups.

To assess the nutritional status, growth parameters and lifestyle behaviours of children between 0·5 and 12 years in nationally representative samples in Malaysia, Indonesia, Thailand and Vietnam.

A cross-sectional study was conducted in the four countries, between May 2019 and April 2021. Data collected can be categorised into four categories: (1) Growth – anthropometry, body composition, development disorder, (2) nutrient intake and dietary habits – 24-h dietary recall, child food habits, breast-feeding and complementary feeding, (3) socio-economic status – food insecurity and child health status/environmental and (4) lifestyle behaviours – physical activity patterns, fitness, sunlight exposure, sleep patterns, body image and behavioural problems. Blood samples were also collected for biochemical and metabolomic analyses. With the pandemic emerging during the study, a COVID-19 questionnaire was developed and implemented.

Both rural and urban areas in Malaysia, Indonesia, Thailand and Vietnam.

Children who were well, with no physical disability or serious infections/injuries and between the age of 0·5 and 12 years old, were recruited.

The South East Asian Nutrition Surveys II recruited 13 933 children. Depending on the country, data collection from children was conducted in schools and commune health centres, or temples, or sub-district administrative organisations.

The results will provide up-to-date insights into nutritional status and lifestyle behaviours of children in the four countries. Subsequently, these data will facilitate exploration of potential gaps in dietary intake among Southeast Asian children and enable local authorities to plan future nutrition and lifestyle intervention strategies.

To investigate the extent, quality and challenges of dietetic counselling during the pandemic.

A cross-sectional online thirty-six-item Google Survey. The survey queried demographics and information on usage and perceived telemedicine quality.

The survey was distributed to Israeli Dietetic Association (ATID) mailing list between 31 March and 5 May 2020.

Clinical dietitians, members of ATID, who consented to participated in the survey.

Three hundred dietitians (12 % of ATID members; 95 % women; mean age 4·41 (sd 10·2) years) replied to the survey. Most dietitians reported a significant ∼30 % decrease in work hours due to the pandemic. The most prevalent form of alternative nutrition counselling (ANC) was over the phone (72 %); 53·5 % used online platforms. Nearly 45 % had no former ANC experience. Both ANC formats were reported inferior to face-to-face nutritional consultation (consultation quality median scores 8 and 7, on a 1–10 scale, for online and phone, respectively). ANC difficulties on either phone or online platforms were technical (56 and 47 %, respectively), lack of anthropometric measurements (28 and 25 %, respectively) and interpersonal communication (19 and 14·6 %, respectively). Older age and former phone counselling experience were associated with higher quality scores, respectively (OR = 1·046, 95 % CI 1·01, 1·08, P = 0·005), (95 % CI 1·38, 4·52, P = 0·02). Those who continued to work full time had five-time greater odds for a higher quality score using online platforms (OR = 5·33, 95 % CI 1·091, 14·89, P = 0·001).

Our findings suggest telemedicine holds considerable promise for dietary consultation; however, additional tools and training are needed to optimise remote ANC, especially in light of potential crisis-induced lockdown.

To assess the prevalence of metabolic syndrome (MetS) in Chinese adults living in Ningbo and to examine the association between alcohol consumption and MetS and its medical components.

A representative survey in Ningbo was conducted in 2015 covering socio-demography. A FFQ together with additional questionnaires was used to collect information on alcohol consumption, diet, demography, lifestyle and medical information. Multivariable logistic regression and generalised linear models were used to examine the association between alcohol consumption and both MetS and its medical components, respectively.

Ningbo, China.

A total of 2853 adults ≥ 20 years (44 % men) in this final analysis.

The prevalence of frequent alcohol drinkers and MetS was 29·9 % and 28·0 %, respectively. Significantly higher prevalence of MetS and mean values of medical components were found in the group of frequent alcohol drinkers with an exception for HDL-cholesterol, compared with less or non-alcohol drinkers. Frequent alcohol consumption was associated with higher odds of developing MetS and positively associated with medical components excepting waist circumference.

Frequent alcohol consumption contributed to a higher prevalence of MetS and unfavourable influence on MetS and its medical components among Chinese adults. A public health intervention on alcohol restriction is necessary for the prevention and control of the ongoing epidemic MetS.

To develop and test a scale for healthy eating practices measurement according to the Dietary Guidelines for the Brazilian Population recommendations.

Methodological study. The current Brazilian food-based dietary guideline highlights the importance of choosing foods, combining foods to create meals and modes of eating. These recommendations formed the main domains of the scale and served as a basis for the development of ninety-six items, each with a 4-point Likert response option. Content and face validity were tested. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to determine construct validity. Internal consistency was determined using α and ω coefficients, and reproducibility was tested using test–retest.

Brazil.

A ten-member expert panel was used to assess content validity. Adults aged 18–60 years were included in the face validity (n 20), EFA (n 352), CFA and reliability tests (n 900).

Of the ninety-six initial items, twenty-four were excluded and fifty-five were reworded following the content and face validations. EFA detected a four-domain structure (Food choices, Modes of eating, Planning and Domestic organization), which explained 41 % of the variance. CFA led to a final twenty-four-item model with acceptable goodness-of-fit indices and good reliability measures (α=0·77; ω=0·83). Intraclass correlation coefficient for the total score (0·82) and analysis of the Bland–Altman plot suggested good reproducibility of the scale.

The scale presents good evidence of validity and reliability. This innovative study created a useful tool for evaluation of the impact of the Dietary Guidelines for the Brazilian Population.

To update the data on food consumption and practices in children under 3 years of age in metropolitan France.

The Nutri-Bébé 2013 cross-sectional study selected a random sample, according to the quota sampling method. After giving their informed consent, parents had to record the food consumption during three non-consecutive days framed by two face-to-face interviews, using for quantitative information different portion size measurement aids.

One thousand one hundred and eighty-four children were enrolled. Mothers’ mean age was 30·8 (sd 5·4) years; 38 % were primiparous; 89 % lived with a partner; 60 % had an occupation. Of the infants younger than 4 months, 31 % were breast-fed. One thousand and thirty-five children consumed infant formula followed by growing-up milk in 63 % of them; solid foods were introduced at a mean age of 5·4 (sd 2·13) months. From 8 months onwards, 25 % of children consumed the same foods as their parents on a more or less regular basis; 29 % ate in front of a screen, with a daily average screen time of 43·0 (sd 40·4) min.

This robust survey highlights the low prevalence and duration of breast-feeding in France and shows a modest improvement since the previous survey of 2005 in the observance of recommendations concerning other feeding practices. The frequent consumption of adult foods and the screen time are of concern.

(i) To determine the Na content of commonly consumed fast foods in New Zealand and (ii) to estimate Na intake from savoury fast foods for the New Zealand adult population.

Commonly consumed fast foods were identified from the 2008/09 New Zealand Adult Nutrition Survey. Na values from all savoury fast foods from chain restaurants (n 471) were obtained from nutrition information on company websites, while the twelve most popular fast-food types from independent outlets (n 52) were determined using laboratory analysis. Results were compared with the UK Food Standards Agency 2012 sodium targets. Nutrient analysis was completed to estimate Na intake from savoury fast foods for the New Zealand population using the 2008/09 New Zealand Adult Nutrition Survey.

New Zealand.

Adults aged 15 years and above.

From chain restaurants, sauces/salad dressings and fried chicken had the highest Na content (per 100 g) and from independent outlets, sausage rolls, battered hotdogs and mince and cheese pies were highest in Na (per 100 g). The majority of fast foods exceeded the UK Food Standards Agency 2012 sodium targets. The mean daily Na intake from savoury fast foods was 283 mg/d for the total adult population and 1229 mg/d for fast-food consumers.

Taking into account the Na content and frequency of consumption, potato dishes, filled rolls, hamburgers and battered fish contributed substantially to Na intake for fast-food consumers in New Zealand. These foods should be targeted for Na reduction reformulation.

The aims of the present study were to examine the Zn intake and characteristics of Zn supplement users and non-users and to survey Zn supplements that are commercially available.

Cross-sectional national nutrition survey (2007 Australian Children’s Nutrition and Physical Activity Survey) and a review of commercially available Zn supplements.

Australia.

Children (n 4834) aged 2–16 years.

Zn supplement use was associated with younger age, being female, having a lower BMI and consuming a vegetarian or modified diet. Supplement users had significantly higher intakes of Zn than non-users in all age and gender subgroups. Adolescent boys aged 14–16 years who did not use Zn supplements were at highest risk of inadequate Zn intake (15 % compared with 1 % of users). Conversely, children aged 2–3 years were at highest risk of exceeding the recommended upper limit of Zn intake (86–87 % of users and 64–71 % of non-users), followed by children aged 4–8 years (9–29 % of users and 3–12 % of non-users). The most common sources of Zn supplements consumed by children were multi-vitamin and mineral preparations (92 %), followed by Zn-only supplements (5 %) and Zn-containing cold and flu, or cold sore supplements (3 %). A survey of commercially available Zn supplements revealed that the median elemental Zn content was 2 and 25 mg for multi-vitamin and mineral preparations and Zn-only supplements, respectively.

Based on these data, widespread Zn supplement use among young children is unlikely to be warranted. The impact of exceeding the upper limit of Zn intake on biomarkers of Zn toxicity requires further investigation.

To estimate the impact of choosing food products labelled either as low or high in salt on salt intake in the Finnish adult population.

The National FINDIET 2002 survey with 48-hour recalls from 2007 subjects aged 25–64 years. Sodium intake was calculated based on the Fineli® food composition database including the sodium content of natural and processed foods as well as the salt content of recipes. The distribution of salt intake was calculated in different ways: the present situation; assuming that all breads, cheeses, processed meat and fish, breakfast cereals and fat spreads consumed would be either ‘lightly salted’ or ‘heavily salted’ based on the current labelling practice; and, in addition, assuming that all foods would be prepared with 50% less or more salt.

Excluding underreporters, the mean salt intake would be reduced by 1.8 g in men and by 1.0 g in women if the entire population were to choose lightly salted products and further by 2.5 and 1.8 g, respectively, if also salt used in cooking were halved. Choosing heavily salted products would increase salt intake by 2.1 g in men and by 1.4 g in women. In the worst scenarios, salt intake would be further increased by 2.3 g in men and by 1.6 g in women.

These calculations show that the potential impact of labelling and giving consumers the possibility to choose products with less salt is of public health importance. In addition, strategies to reduce the salt content of all food groups are needed.

To evaluate the current clinical attitude in enteral nutrition support and motility disorders in adult critically ill patients on German intensive care units.

A total of 1493 questionnaires, including 25 items on the medical environment, treatment of motility disorders and enteral nutrition, were sent to German intensive care units in September 2005. Responses were collected during a 2-month period.

A total of 593 questionnaires were returned (response rate 41%). The intensive care units were mainly led by anaesthesiologists (63%) or internists (17%). Standard nutrition protocols were used in 44%. Feeding was mainly started as a combined enteral–parenteral regimen (70%). Early enteral nutrition was performed in 58% using a volume of 250–500 mL (66%) and increased by 200–400 mL day−1 (55%). It was mainly delivered by gastric tube (76%) via continuous pump systems (72%) with short interruption intervals of <4 h (86%). Enteral nutrition solutions were mainly standard polymeric formulae (86%). Modified solutions for diabetics and those with renal or liver failure were uncommonly used; immunonutrition did not play a role. Prokinetic agents, especially metoclopramide, laxatives and neostigmine, were routinely used (39%). Further therapeutic options in motility dysfunction included purgative enemas (96%), gastrografin (72%) and colon massage (39%).

The concept of early enteral nutrition has been well established and approved in German intensive care units, though the recommendations only meet level C criteria in the current ESPEN guidelines. The current survey may serve for further updates on practical nutrition support in intensive care medicine.

To analyse the degree of compliance with the nutrition objectives and population-based food guides and to indicate possible recommendations for their development within the framework of a Nutrition and Health Policy in Catalonia.

Using data derived from the latest Catalan Nutrition Survey (ENCAT 2002–03) conducted by the Department of Health, compliance was analysed with respect to the recommendations derived as a result of a previously conducted Survey. In addition, compliance to the recommendations elaborated by the Spanish Society of Community Nutrition (SENC) was also evaluated.

Catalonian region located in the Northeast of Spain.

Analysis is based on a total of 2160 individuals (996 males and 1164 females) aged 10–80 years interviewed in 2002–03.

The analysis of compliance with the recommendations established in 1995 showed: (a) recommendation to maintain and increase consumption of fruits and vegetables was not achieved; (b) continued use of olive oil as the dietary fat of choice was met; (c) incomplete compliance with maintaining the Mediterranean diet traditions, especially in the younger cohorts; (d) compliance with the recommendation to decrease consumption of red meat and sausages, but non-compliance with guidance to maintain or increase fish consumption and (e) compliance with partially substituting whole milk and dairy for low-fat products.

Compliance with the SENC Healthy Eating Guide revealed that those food groups with the worst results were meat and sausages (excessive), pulses (below recommendations) and fruits and vegetables (below recommendations).

Compliance with dietary guidelines is low in Catalonia, and reflects the need for an effective nutrition policy in the region defined by the Autonomous Government as the Plan for the Promotion of Physical Activity and Healthy Eating (PAAS).

To evaluate the reliability of alcohol consumption measured by five different dietary methods in the Catalan Nutrition Survey (1992–1993).

The different questionnaires used were: (1) two 7-day food records, (2) five items addressing alcoholic beverages in a 76-item food-frequency questionnaire, (3) a 1-week recall of 13 alcoholic beverages, (4) a 13-item alcoholic beverages frequency questionnaire and (5) two 24-hour recalls.

Ninety-three of the 120 adults (aged 20 to 70 years) initially recruited completed the questionnaires and provided a peripheral blood sample.

Mean daily alcohol intakes as assessed by the questionnaires were very similar. Beer was the alcoholic beverage most frequently consumed, followed by wine and liquor. Eighty-two per cent of the study population consumed less than 20 g of alcohol per day. No biochemical parameters were significantly correlated with alcohol intake estimated from the questionnaires.

We found a satisfactory level of reproducibility and validity in the pattern of alcohol consumption across different levels and types of alcoholic beverage intake. We also found that the self-administered 13-item questionnaire and the 1-week recall were the best techniques to measure moderate or low alcohol consumption, suggesting that the two methods are the most suitable to assess overall alcohol intake in the general population.

To assess the dietary habits of Balearic Islands' consumers who are successful in meeting current nutritional recommendations, to find clues for the development of future food-based dietary guidelines (FBDG) that would be relevant to this population.

Cross-sectional nutritional survey carried out in the Balearic Islands between 1999 and 2000.

Dietary habits were assessed by means of 24-hour recall (two non-consecutive days: warm and cold season) and a food-frequency questionnaire in a random sample (n = 1200, aged 16–65 years) living in private households. Differences in percentage of compliers with the intermediate nutritional objectives for the Spanish population and differences in food consumption patterns between genders and between high (above the upper quartile of intake) and low (below the lower quartile of intake) consumers of fat, saturated fatty acids (SFA), fibre, and fruit and vegetables were analysed.

Gender differences were observed in nutrient and energy intakes, as well as in attainment of the recommendations. Less than 25% of the population reached the intermediate nutritional recommendations for iodine, fruit, carbohydrates, SFA, fibre and vegetables. Low fat/SFA and high fruit and vegetables/fibre consumers kept a diet in line with the traditional Balearic diet and prevailing dietary pyramids, which ensured better compliance with the nutritional goals.

The intermediate nutritional objectives for the Spanish population could be achieved through maintenance of the traditional Balearic diet, a Mediterranean-type diet in the Balearic population. Therefore, this dietary model could be used to develop FBDG relevant to this population.

To analyse the dietary behaviour of persons engaging in different levels of sport activity.

A cross-sectional survey analysis.

A population-based sample of German adults.

A total of 1756 men and 2254 women participating in the German National Health Interview and Examination Survey and the integrated German Nutrition Survey 1998.

Among both genders, the median micronutrient intakes of active persons were more preferable than those of sedentary persons when German current reference values were used as a criterion. The median nutrient densities were also higher in the diet of active persons, especially those of vitamin E, calcium, magnesium, and among women also those of folate and vitamin C. On average, active persons consumed higher amounts of fruit/vegetable juice, drinking water, milk products (including cheese) and fruits. Active men additionally consumed higher amounts of vegetables and vegetable fat. The contribution of dietary supplements to the total nutrient intake was 3%, on average, for active men and women. Compared with sedentary persons, this contribution was significantly higher for vitamins, and among men also for calcium and magnesium.

There was no indication of an impaired micronutrient intake of active and moderately active persons compared with sedentary persons.

The primary objective of this study was to generate a reference table of food items and average amounts of these items consumed by South Africans, for the Department of Health. The reference table was required to be representative of foods and beverages eaten frequently by children and adults from all age and ethnic groups in order for the Department of Health to test for contaminants in these foods.

The National Food Consumption Survey (NFCS) served as a framework for compiling data on children since this was a national representative survey of 1–9-year-old children undertaken in South Africa in 1999. However, there has never been a national dietary survey on adults in South Africa. Consequently the data had to be extrapolated from existing isolated surveys on adults. Secondary data analysis was conducted on existing dietary databases (raw data) obtained from surveys undertaken on adults in South Africa between 1983 and 2000. Available datasets were regional and independent, and were not individually representative of the South African diet. It was therefore necessary to use different statistical methods, including factor analyses, weighting and correlations, to generate ethnic and geographic representative data for adults. Two methods were used: Method 1, which corresponded with results of the NFCS (over-sampled for low socio-economic status), and Method 2, which was based on ethnic proportions of the population.

The secondary data analyses generated food items most commonly consumed by the South African adult population (Method 1) in descending frequency of usage and average (mean) amount per day: maize porridge (78%/848 g), white sugar (77%/27 g), tea (68%/456 g), brown bread (55%/165 g), white bread (28%/163 g), non-dairy creamer (25%/6 g), brick margarine (21%/19 g), chicken meat (19%/111 g), full-cream milk (19%/204 g) and green leaves (17%/182 g). In 6–9-year-olds, maize porridge (72%/426 g), sugar (76%/23 g), tea (51%/258 g), full-cream milk (35%/171 g) and white bread (33%/119 g) were eaten most frequently. Similarly, in 1–5-year-olds, the foods consumed most frequently were maize porridge (80%/426 g), sugar (76%/21 g), tea (44%/224 g), full-cream milk (39%/186 g) and white bread (24%/83 g). In order to evaluate the validity of the adult data generated, kilojoule values of the individual food items (per capita) were compared with food balance sheets (FBSs). The comparison was favourable except that the FBSs had a higher overall energy intake per capita of between 22 and 28%.

Reference tables of commonly consumed foods and beverages were generated at minimal cost based on secondary data analyses of past dietary surveys in different South African populations.