We examined the association between dietary patterns and diabetes using the strengths of two methods: principal component analysis (PCA) to identify the eating patterns of the population and reduced rank regression (RRR) to derive a pattern that explains the variation in glycated Hb (HbA1c), homeostasis model assessment of insulin resistance (HOMA-IR) and fasting glucose.

We measured diet over a 3 d period with 24 h recalls and a household food inventory in 2006 and used it to derive PCA and RRR dietary patterns. The outcomes were measured in 2009.

Adults (n 4316) from the China Health and Nutrition Survey.

The adjusted odds ratio for diabetes prevalence (HbA1c≥6·5 %), comparing the highest dietary pattern score quartile with the lowest, was 1·26 (95 % CI 0·76, 2·08) for a modern high-wheat pattern (PCA; wheat products, fruits, eggs, milk, instant noodles and frozen dumplings), 0·76 (95 % CI 0·49, 1·17) for a traditional southern pattern (PCA; rice, meat, poultry and fish) and 2·37 (95 % CI 1·56, 3·60) for the pattern derived with RRR. By comparing the dietary pattern structures of RRR and PCA, we found that the RRR pattern was also behaviourally meaningful. It combined the deleterious effects of the modern high-wheat pattern (high intakes of wheat buns and breads, deep-fried wheat and soya milk) with the deleterious effects of consuming the opposite of the traditional southern pattern (low intakes of rice, poultry and game, fish and seafood).

Our findings suggest that using both PCA and RRR provided useful insights when studying the association of dietary patterns with diabetes.

Psychological disorders are highly prevalent worldwide. The present study aimed to investigate the relationship between major dietary patterns and prevalence of psychological disorders in a large sample of Iranian adults.

A cross-sectional study was done to identify dietary patterns derived from factor analysis. Dietary data were collected through the use of a validated dish-based semi-quantitative FFQ. Psychological health was examined by use of the Hospital Anxiety and Depression Scale and the General Health Questionnaire.

The study was conducted in Isfahan, Iran, within the framework of the Study on Epidemiology of Psychological, Alimentary Health and Nutrition (SEPAHAN).

Iranian adults (n 3846) aged 20–55 years.

After adjustment for potential confounders, greater adherence to the lacto-vegetarian dietary pattern was protectively associated with depression in women (OR=0·65; 95 % CI 0·46, 0·91). Normal-weight participants in the top quintile of this dietary pattern tended to have decreased odds of anxiety compared with those in the bottom quintile (OR=0·61; 95 % CI 0·38, 1·00). In addition, the traditional dietary pattern was associated with increased odds of depression (OR=1·42; 95 % CI 1·01, 1·99) and anxiety (OR=1·56; 95 % CI 1·00, 2·42) in women. Normal-weight participants in the highest quintile of the traditional dietary pattern had greater odds for anxiety (OR=1·89; 95 % CI 1·12, 3·08) compared with those in the lowest quintile. The Western dietary pattern was associated with increased odds of depression in men (OR=1·73; 95 % CI 1·07, 2·81) and anxiety in normal-weight participants (OR=2·05; 95 % CI 1·22, 3·46). There was a significant increasing trend in the odds of psychological distress across increasing quintiles of the fast food dietary pattern in women (P-trend=0·02).

Recommendation to increase the intake of fruits, citrus fruits, vegetables, tomato and low-fat dairy products and to reduce the intakes of snacks, high-fat dairy products, chocolate, carbonated drinks, sweets and desserts might be associated with lower chance of psychological disorders.

Carotid intima-media thickness (IMT) is a validated surrogate marker of preclinical atherosclerosis and is predictive of cardiovascular morbidity and mortality. Research on the association between IMT and diet, however, is lacking, especially in low-income countries or low-BMI populations.

Cross-sectional analysis. Dietary intakes were measured using a validated, thirty-nine-item FFQ at baseline cohort recruitment. IMT measurements were obtained from 2010–2011.

Rural Bangladesh.

Participants (n 1149) randomly selected from the Health Effects of Arsenic Longitudinal Study, an ongoing, population-based, prospective cohort study established in 2000. Average age at IMT measurement was 45·5 years.

Principal component analysis of reported food items yielded a ‘balanced’ diet, an ‘animal protein’ diet and a ‘gourd and root vegetable’ diet. We observed a positive association between the gourd/root vegetable diet and IMT, as each 1 sd increase in pattern adherence was related to a difference of 7·74 (95 % CI 2·86, 12·62) μm in IMT (P<0·01), controlling for age, sex, total energy intake, smoking status, BMI, systolic blood pressure and diabetes mellitus diagnoses. The balanced pattern was associated with lower IMT (−4·95 (95 % CI −9·78, −0·11) μm for each 1sd increase of adherence; P=0·045).

A gourd/root vegetable diet in this Bangladeshi population positively correlated with carotid IMT, while a balanced diet was associated with decreased IMT.

To systematically review prospective cohort studies about the association between dietary patterns and type 2 diabetes mellitus (T2DM) incidence, and to quantify the effects using a meta-analysis.

Databases such as PubMed, ISI Web of Science, SCOPUS and Google Scholar were searched up to 15 January 2015. Cohort studies which tried to examine the association between empirically derived dietary patterns and incident T2DM were selected. The relative risks (RR) and their 95 % confidence intervals for diabetes among participants with highest v. lowest adherence to derived dietary patterns were incorporated into meta-analysis using random-effects models.

Ten studies (n 404 528) were enrolled in the systematic review and meta-analysis; our analysis revealed that adherence to the ‘healthy’ dietary patterns significantly reduced the risk of T2DM (RR=0·86; 95 % CI 0·82, 0·90), while the ‘unhealthy’ dietary patterns adversely affected diabetes risk (RR=1·30; 95 % CI 1·18, 1·43). Subgroup analysis showed that unhealthy dietary patterns in which foods with high phytochemical content were also loaded did not significantly increase T2DM risk (RR=1·06; 95 % CI 0·87, 1·30).

‘Healthy’ dietary patterns containing vegetables, fruits and whole grains can lower diabetes risk by 14 %. Consuming higher amounts of red and processed meats, high-fat dairy and refined grains in the context of ‘unhealthy’ dietary patterns will increase diabetes risk by 30 %; while including foods with high phytochemical content in these patterns can modify this effect.

Pattern analysis has emerged as a tool to depict the role of multiple nutrients/foods in relation to health outcomes. The present study aimed at extracting nutrient patterns with respect to breast cancer (BC) aetiology.

Nutrient patterns were derived with treelet transform (TT) and related to BC risk. TT was applied to twenty-three log-transformed nutrient densities from dietary questionnaires. Hazard ratios (HR) and 95 % confidence intervals computed using Cox proportional hazards models quantified the association between quintiles of nutrient pattern scores and risk of overall BC, and by hormonal receptor and menopausal status. Principal component analysis was applied for comparison.

The European Prospective Investigation into Cancer and Nutrition (EPIC).

Women (n 334 850) from the EPIC study.

The first TT component (TC1) highlighted a pattern rich in nutrients found in animal foods loading on cholesterol, protein, retinol, vitamins B12 and D, while the second TT component (TC2) reflected a diet rich in β-carotene, riboflavin, thiamin, vitamins C and B6, fibre, Fe, Ca, K, Mg, P and folate. While TC1 was not associated with BC risk, TC2 was inversely associated with BC risk overall (HRQ5 v. Q1=0·89, 95 % CI 0·83, 0·95, Ptrend<0·01) and showed a significantly lower risk in oestrogen receptor-positive (HRQ5 v. Q1=0·89, 95 % CI 0·81, 0·98, Ptrend=0·02) and progesterone receptor-positive tumours (HRQ5 v. Q1=0·87, 95 % CI 0·77, 0·98, Ptrend<0·01).

TT produces readily interpretable sparse components explaining similar amounts of variation as principal component analysis. Our results suggest that participants with a nutrient pattern high in micronutrients found in vegetables, fruits and cereals had a lower risk of BC.

Cluster analysis is widely applied to identify dietary patterns. A new method based on Gaussian mixture models (GMM) seems to be more flexible compared with the commonly applied k-means and Ward’s method. In the present paper, these clustering approaches are compared to find the most appropriate one for clustering dietary data.

The clustering methods were applied to simulated data sets with different cluster structures to compare their performance knowing the true cluster membership of observations. Furthermore, the three methods were applied to FFQ data assessed in 1791 children participating in the IDEFICS (Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants) Study to explore their performance in practice.

The GMM outperformed the other methods in the simulation study in 72 % up to 100 % of cases, depending on the simulated cluster structure. Comparing the computationally less complex k-means and Ward’s methods, the performance of k-means was better in 64–100 % of cases. Applied to real data, all methods identified three similar dietary patterns which may be roughly characterized as a ‘non-processed’ cluster with a high consumption of fruits, vegetables and wholemeal bread, a ‘balanced’ cluster with only slight preferences of single foods and a ‘junk food’ cluster.

The simulation study suggests that clustering via GMM should be preferred due to its higher flexibility regarding cluster volume, shape and orientation. The k-means seems to be a good alternative, being easier to use while giving similar results when applied to real data.

To examine gender-specific associations of weight perception and appearance satisfaction with slimming attempts and eating patterns among young Norwegian adolescents.

Cross-sectional study. Adolescent dietary data were reported by parents using a retrospective FFQ. Eating patterns were identified using principal component analysis. Adolescents’ reported weight perception, appearance satisfaction and slimming attempts were analysed using cross-tabulation and Pearson’s χ2 test. Associations between perceived weight, appearance satisfaction and slimming attempts/eating patterns were examined using multiple logistic regression analysis.

Primary schools, Telemark, Norway.

Children (n 469), mean age 12·7 (sd 0·3) years, and parents.

Gender differences were observed in self-perceived weight and appearance satisfaction. Girls were most satisfied with appearance when feeling thin, boys when feeling just the right weight. Perceived overweight was the main predictor of slimming attempts across genders (adjusted OR=15·3; 95 % CI 6·0, 39·1 for girls; adjusted OR=18·2; 95 % CI 5·8, 57·3 for boys). Low appearance satisfaction was associated with slimming attempts (adjusted OR=3·3; 95 % CI 1·0, 10·5) and a dieting eating pattern (adjusted OR=2·8; 95 % CI 1·5, 5·2) in girls. Perceived underweight was associated with a junk/convenience eating pattern in boys (adjusted OR=2·8; 95 % CI 1·2, 6·4).

Gender differences were observed in subjective body concerns. Perceived overweight was the main predictor of slimming attempts by both genders. Different aspects of body dissatisfaction were related to different food behaviours in boys and girls. Health professionals should be aware of these gender differences when planning health promotion programmes targeting young adolescents.

To examine young Australian women’s weight expectations, motivations for weight change and perceived factors influencing weight management, and to determine if these factors differ by age, BMI, marital status, education or income.

Cross-sectional study. An online survey captured respondents’ weight, height, ideal weight, main reasons for wanting to change their weight and challenges to managing their weight.

Online survey in Australia.

Six hundred and twenty women aged 18–30 years currently living in Australia who completed the survey between 31 July and 30 September 2012.

Approximately half of participants (53·1 %) were a healthy weight, 25·2 % overweight and 19·0 % obese. Women unhappy at their current weight (78·1 %) reported a median ideal weight −12·3 % less than their current weight. The key motivators for weight change were to improve health (24·4 %, ranked 1), feel better in oneself (22·3 %) and improve self-confidence (21·5 %). Lack of motivation, time constraints because of job commitments and cost were the most commonly reported factors influencing weight management. Age, BMI, marital status, education and income were found to influence weight expectations, motivations for weight change and/or factors perceived to influence weight management.

The findings suggest potential implications for weight management interventions and public health messaging targeting young women, to improve long-term health outcomes. Strategies that promote the health benefits of physical activity and healthy eating, feeling better about oneself and improved self-confidence, and address the main factors influencing weight management including lack of motivation, time constraints and cost, may be used to engage this target group.

Parental body image dissatisfaction (BID) is associated with children’s weight in cross-sectional studies; however, it is unknown whether BID predicts development of adiposity. The objective of the present study was to investigate the associations between maternal dissatisfaction with her or her child’s body and children’s BMI trajectories.

Longitudinal study. Maternal dissatisfaction (BID) with her and her child’s body was calculated based on ratings of Stunkard scales obtained at recruitment, as current minus desired body image. Children’s height and weight were measured at baseline and annually for a median of 2·5 years. Mixed-effects models with restricted cubic splines were used to construct sex- and weight-specific BMI-for-age curves according to maternal BID levels.

Public primary schools in Bogotá, Colombia.

Children (n 1523) aged 5–12 years and their mothers.

After multivariable adjustment, heavy boys and thin girls whose mothers desired a thinner child gained an estimated 1·7 kg/m2 more BMI (P=0·04) and 2·4 kg/m2 less BMI (P=0·004), respectively, between the age 6 and 14 years, than children of mothers without BID. Normal-weight boys whose mothers desired a thinner child’s body gained an estimated 1·8 kg/m2 less BMI than normal-weight boys of mothers without BID (P=0·02). Maternal BID with herself was positively related to children’s BMI gain during follow-up.

Maternal BID is associated with child’s BMI trajectories in a sex- and weight-specific manner.

To summarize the best available evidence regarding the short- and long-term health effects of cow’s milk intake in healthy, full-term infants up to 3 years of age.

We conducted a systematic review and meta-analysis.

We searched MEDLINE (via PubMed), EMBASE and the Cochrane Library between 1960 and July 2013 and manually reviewed reference lists of pertinent articles. Two researchers independently reviewed abstracts and full-text articles and extracted relevant data.

We included (randomized/non-randomized) controlled trials and observational studies.

We included data from twenty-three studies (one randomized controlled trial, four non-randomized controlled trials, eight case–control studies and ten cohort studies) for the evidence synthesis. Pooled results of four studies revealed a higher risk of Fe-deficiency anaemia for infants consuming cow’s milk compared with those consuming follow-on formula (relative risk=3·76; 95 % CI 2·73, 5·19). For type 1 diabetes mellitus, six out of seven case–control studies did not show a difference in the risk of developing this disease based on the age of introduction of cow’s milk. We did not find negative associations for other health effects.

Cow’s milk consumption in infancy is associated with an increased risk of developing Fe-deficiency anaemia. Limiting cow’s milk consumption may be important to ensure an adequate Fe intake for infants and toddlers. High-quality patient information for caregivers is needed on how infants’ Fe requirements can be met.

Colorectal cancer shows large incidence variations worldwide that have been attributed to different dietary factors. We conducted a meta-analysis on the relationship between garlic consumption and colorectal cancer risk.

We systematically reviewed publications obtained by searching ISI Web of Knowledge, MEDLINE and EMBASE literature databases. We extracted the risk estimate of the highest and the lowest reported categories of intake from each study and conducted meta-analysis using a random-effects model.

The pooled analysis of all fourteen studies, seven cohort and seven case–control, indicated that garlic consumption was not associated with colorectal cancer risk (OR=0·93; 95 % CI 0·82, 1·06, P=0·281; I2=83·6 %, P≤0·001). Separate analyses on the basis of cancer sites and sex also revealed no statistically significant effects on cancer risk. However, when separately analysed on the basis of study type, we found that garlic was associated with an approximately 37 % reduction in colorectal cancer risk in the case–control studies (combined risk estimate=0·63, 95 % CI 0·48, 0·82, P=0·001; I2=75·6 %, P≤0·001).

Our results suggest that consumption of garlic is not associated with a reduced colorectal cancer risk. Further investigations are necessary to clarify the discrepancy between results obtained from different types of epidemiological studies.

To study the association of fish and fish-liver oil consumption across the lifespan with CHD later in life among Icelandic women, with special emphasis on the effects of consumption in adolescence.

Prevalence association study. Logistic regression was used to estimate odds ratios and 95 % confidence intervals of CHD according to fish or fish-liver oil exposure. Models were adjusted for age, education, concurrent diet and other known risk factors.

The study was nested within the AGES-Reykjavik Study, conducted in Reykjavik, Iceland.

Participants were 3326 women aged 66–96 years, with available information on CHD status at entry to the study and information on fish and fish-liver oil consumption during midlife and adolescence. Dietary habits were assessed retrospectively using a validated FFQ.

CHD was identified in 234 (7·9 %) women. Compared with women with no intake of fish-liver oil in adolescence or midlife, women who consumed fish-liver oil at least three times weekly in adolescence or in midlife had a decreased risk of CHD (OR=0·62; 95 % CI 0·45, 0·85 and OR=0·68; 95 % CI 0·50, 0·94, respectively). No associations were observed between fish intake (>2 portions/week v. ≤2 portions/week) in adolescence or midlife and CHD in this population with high fish intake.

Fish-liver oil consumption, from early life, may reduce the risk of CHD in older women. Lifelong nutrition may be of importance in the prevention of CHD in older women.

The objective of the present study was to examine the relationship between plasma alkyresorcinol (AR) concentrations, which are biomarkers of whole-grain intake, and atherosclerotic progression over 3 years in postmenopausal women with coronary artery disease.

Plasma AR concentrations were measured by a validated GC–MS method in fasting plasma samples. Atherosclerosis progression was assessed using change in mean minimal coronary artery diameter (MCAD) and percentage diameter stenosis (%ST), based on mean proximal vessel diameter across up to ten coronary segments. Dietary intake was estimated using a 126-item interviewer-administered FFQ.

A prospective study of postmenopausal women participating in the Estrogen Replacement and Atherosclerosis trial.

For the analysis of plasma AR concentrations and atherosclerotic progression, plasma samples and follow-up data on angiography were available for 182 women.

Mean whole-grain intake was 9·6 (se 0·6) servings per week. After multivariate adjustment, no significant associations were observed between plasma AR concentrations and change in mean MCAD or progression of %ST. Plasma AR concentrations were significantly correlated with dietary whole grains (r=0·35, P<0·001), cereal fibre (r=0·33, P<0·001), bran (r=0·15, P=0·05), total fibre (r=0·22, P=0·003) and legume fibre (r=0·15, P=0·04), but not refined grains, fruit fibre or vegetable fibre.

Plasma AR concentrations were not significantly associated with coronary artery progression over a 3-year period in postmenopausal women with coronary artery disease. A moderate association was observed between plasma AR concentrations and dietary whole grains and cereal fibre, suggesting it may be a useful biomarker in observational studies.

To examine pre-conception dietary patterns in pregnant asthmatic women and to identify associations between maternal diet and asthma control during pregnancy.

Cross-sectional study. Pre-conception food frequency data were collected retrospectively. Asthma control was assessed using the Global Initiative for Asthma guidelines. Dietary patterns were derived using factor analysis. Binary logistic regression analyses were used to test the association between uncontrolled asthma and each dietary pattern (Z-score), with values presented as odds ratio and 95 % confidence interval.

Antenatal clinic in a tertiary hospital, Adelaide, Australia, May 2009–July 2013.

One hundred and fifty-eight asthmatic pregnant women.

Three dietary patterns were identified: (i) ‘high protein/fruit’ (strong food group loadings for fish, meat, chicken, fruit); (ii) ‘high fat/sugar/takeaway’ (takeaway foods, crisps, refined grains); and (iii) ‘vegetarian-type’ (vegetables, fruit, soya milk, whole grains). A 1 sd increase in score on the high fat/sugar/takeaway pattern was associated with increased likelihood of uncontrolled asthma (adjusted OR=1·54; 95 % CI 1·07, 2·23; P=0·022). Women with uncontrolled asthma (n 115) had higher energy-adjusted intakes of saturated fat, monounsaturated fat, carbohydrate, sugar and fibre compared with women with controlled asthma (n 43, all P≤0·05).

Pre-pregnancy dietary patterns may influence maternal asthma control. Our work highlights the importance of achieving a healthy diet before pregnancy that is low in saturated fat, sugar and takeaway foods, and therefore higher in lean meats, poultry and fish, as well as fruits, vegetables and whole grains. A healthy dietary pattern should be encouraged in all asthmatic women who are of childbearing age, and should additionally be promoted before pregnancy and beyond.

To explore factors affecting children’s and adolescents’ diet quality, in the framework of a food aid and promotion of healthy nutrition programme implemented in areas of low socio-economic status of Greece, during the current financial crisis.

From a total of 162 schools participating in the programme during 2012–2013, we gathered 15 897 questionnaires recording sociodemographic characteristics, lifestyle parameters and dietary habits of children and their families. As a measure of socio-economic status, the Family Affluence Scale (FAS) was used; whereas for the assessment of diet quality, the KIDMED score was computed. Associations between KIDMED and FAS, physical activity and socio-economic parameters were examined using regression and classification–regression tree analysis (CART).

The higher the FAS score, the greater the percentage of children and adolescents who reported to consume, on a daily basis, fruits and vegetables, dairy products and breakfast (P<0·001). Results from CART showed that children and adolescents in the medium or high FAS groups had higher KIDMED score, compared with those in the low FAS group. For those in the low FAS group, KIDMED score is expected to increase by 12·4 % when they spend more than 0·25 h/week in sports activities. The respective threshold for the medium and high FAS groups is 1·75 h/week, while education of the mother and father affected KIDMED score significantly as well.

Diet quality is strongly influenced by socio-economic parameters in children and adolescents living in economically disadvantaged areas of Greece, so that lower family affluence is associated with worse diet quality.

To examine whether nutrient and food intakes among South Asian adult immigrants differ by length of residence in the USA.

Cross-sectional analysis to examine differences in nutrient and food intakes by length of residence in the USA. Dietary data were collected using an interviewer-administered, culturally appropriate FFQ, while self-reported length of residence was assessed using a questionnaire and modelled as tertiles.

The Mediators of Atherosclerosis in South Asians Living in America (MASALA) study.

Eight hundred and seventy-four South Asians (mean age=55 (sd 9) years; 47 % women; range of length of residence in the USA=2–58 years), part of the baseline examination of the MASALA study.

Intakes of fat, including saturated and trans fats, dietary cholesterol and n-6 fatty acids, were directly associated with length of residence, while intakes of energy, carbohydrate, glycaemic index and load, protein, dietary fibre, folate and K were inversely associated with length of residence (P trend <0·05). A longer length of residence in the USA was also associated with higher intakes of alcoholic beverages, mixed dishes including pizza and pasta, fats and oils, and lower intakes of beans and lentils, breads, grains and flour products, milk and dairy products, rice, starchy vegetables and sugar, candy and jam (P for differences across groups <0·05).

Length of residence in the USA influences diet and nutrient intakes among South Asian adult immigrants and should be considered when investigating and planning dietary interventions to mitigate chronic disease risk.

Cash transfer programmes targeting children are considered an effective strategy for addressing child poverty and for improving child health outcomes in developing countries. In South Africa, the Child Support Grant (CSG) is the largest cash transfer programme targeting children from poor households. The present paper investigates the association of the duration of CSG receipt with child growth at 2 years in three diverse areas of South Africa.

The study analysed data on CSG receipt and anthropometric measurements from children. Predictors of stunting were assessed using a backward regression model.

Paarl (peri-urban), Rietvlei (rural) and Umlazi (urban township), South Africa, 2008.

Children (n 746), median age 22 months.

High rates of stunting were observed in Umlazi (28 %), Rietvlei (20 %) and Paarl (17 %). Duration of CSG receipt had no effect on stunting. HIV exposure (adjusted OR=2·30; 95 % CI 1·31, 4·03) and low birth weight (adjusted=OR 2·01, 95 % CI 1·02, 3·96) were associated with stunting, and maternal education had a protective effect on stunting.

Our findings suggest that, despite the presence of the CSG, high rates of stunting among poor children continue unabated in South Africa. We argue that the effect of the CSG on nutritional status may have been eroded by food price inflation and limited progress in the provision of other important interventions and social services.

To compare an improved corn–soya blend (CSB+) with a ready-to-use supplementary food (RUSF) to test the hypothesis that satisfactory recovery rate will be achieved with CSB+ or RUSF when these foods provide 50 % of the child’s energy requirement, the 50 % remaining coming from usual diet.

A comparative efficacy trial study was conducted with moderately wasted children, using a controlled randomized design, with parallel assignment for RUSF or CSB+. Every child received a daily ration of 167 kJ (40 kcal)/kg body weight during 56 d with a follow-up performed every 14 d. Every caregiver received nutrition counselling at enrolment and at each follow-up visit.

Health districts of Mvog-Beti and Evodoula in the Centre region of Cameroon.

Eight hundred and thirty-three children aged 6–59 months were screened and eighty-one malnourished children (weight-for-height Z-score between −3 and −2) aged 25–59 months were selected.

Of children treated with CSB+ and RUSF, 73 % (95 % CI 59 %, 87 %) and 85 % (95 % CI 73 %, 97 %), respectively, recovered from moderate acute malnutrition, with no significant difference between groups. The mean duration of treatment required to achieve recovery was 44 d in the RUSF group and 51 d in the CSB+ group (log-rank test, P=0·0048).

There was no significant difference in recovery rate between the groups. Both CSB+ and RUSF were relatively successful for the treatment of moderate acute malnutrition in children. Despite the relatively low ration size provided, the recovery rates observed for both groups were comparable to or higher than those reported in previous studies, a probable effect of nutrition education.

Weight management appears to be multidimensional and complex, and registered nutritionists might work to educate, promote and provide weight-management services to communities, groups and individuals. However, nutrition education might not adequately reflect the weight-management requirements of individuals and groups. The aim of the present study was to investigate if the Association for Nutrition’s undergraduate core competency framework for accredited Nutrition degrees sufficiently reflects the weight-management needs and experiences of individuals.

A qualitative investigation, conducted within critical realist ontology, was performed to understand the weight-management experiences of dieters and compare these with the Association for Nutrition’s accreditation criteria for undergraduate Nutrition degrees.

Framework analysis was used to identify and explain participants’ experiences thematically and to compare these with the Association for Nutrition’s core competency criteria.

Participants (n 8) with weight-loss (n 4) and weight-maintenance experiences (n 4) were interviewed using semi-structured interviews to understand weight management at the agential level.

Participants described knowledge, exercise, planning, psychological constructs and behaviour-change techniques, determinants of eating and social support as features of weight management. The competency criteria provided clear guidance on all aspects discussed by the group, apart from psychological constructs and behaviour-change techniques and social support.

Accredited Nutrition courses might not fully reflect the weight-management needs and experiences of individuals. Nutritionists might require greater knowledge of psychology and behaviour change to better understand and accommodate their clients’ weight-management needs.