The present review aimed to examine the association of eating frequency with body weight or body composition in adults of both sexes.

PubMed, EMBASE and Scopus databases were searched. PRISMA and MOOSE protocols were followed. Observational studies published up to August 2016 were included. The methodological quality of the studies was assessed with the Downs and Black checklist.

A systematic review of the literature.

Adults (n 136 052); the majority of studies were developed in the USA and Europe.

Thirty-one articles were included in the review: two prospective and twenty-nine cross-sectional studies. Thirteen per cent of the studies received quality scores above 80 %. The assessment of eating frequency and body composition or body weight varied widely across the studies. Potential confounders were included in 73 % of the studies. Fourteen studies reported an inverse association between eating frequency and body weight or body composition, and seven studies found a positive association. The majority of studies applied multiple analyses adjusted for potential confounders, such as sex, age, education, income, smoking, physical activity and alcohol intake. Six studies took into account under-reporting of eating frequency and/or energy intake in the analysis, and one investigated the mediation effect of energy intake.

There is not sufficient evidence confirming the association between eating frequency and body weight or body composition when misreporting bias is taken into account. However, in men, a potential protective effect of high eating frequency was observed on BMI and visceral obesity.

To investigate the association between sensory-based food education implemented in early childhood education and care (ECEC) centres and children’s willingness to choose and eat vegetables, berries and fruit, and whether the mother’s education level and children’s food neophobia moderate the linkage.

The cross-sectional study involved six ECEC centres that provide sensory-based food education and three reference centres. A snack buffet containing eleven different vegetables, berries and fruit was used to assess children’s willingness to choose and eat the food items. The children’s parents completed the Food Neophobia Scale questionnaire to assess their children’s food neophobia.

ECEC centres that provide sensory-based food education and reference ECEC centres in Finland.

Children aged 3–5 years in ECEC (n 130) and their parents.

Sensory-based food education was associated with children’s willingness to choose and eat vegetables, berries and fruit. This association was stronger among the children of mothers with a low education level. A high average level of neophobia in the child group reduced the children’s willingness to choose vegetables, berries and fruit. No similar tendency was observed in the group that had received sensory-based food education. Children’s individual food neophobia had a negative association with their willingness to choose and eat the vegetables, berries and fruit.

Child-oriented sensory-based food education seems to provide a promising method for promoting children’s adoption of vegetables, berries and fruit in their diets. In future sensory food education research, more focus should be placed on the effects of the education at the group level.

To evaluate the association between eating away from home and BMI and to examine whether dietary intake differs based on the consumption of away-from-home food (AFHF).

Data were obtained from the first Brazilian National Dietary Survey, using food records. The association between the percentage of energy provided by foods consumed away from home and BMI status was tested using logistic regression models. The mean percentages of energy provided by protein, fat, saturated fat and free sugars were calculated based on the consumption of foods away from home among AFHF consumers.

Urban areas of Brazil.

Adults (n 13 736) between 25 and 65 years old.

AFHF was not associated with BMI status. Individuals who consumed AFHF had higher intakes of free sugars away from home than at home and had higher intakes of energy-dense foods than AFHF non-consumers.

Although AFHF consumption was not related to overweight or obesity status, individuals who consumed foods away from home had higher intakes of energy-dense foods. Public health policies should be implemented to help people make healthier food choices away from home.

To investigate the differential effects of dietary diversity (DD) and maternal characteristics on child linear growth at different points of the conditional distribution of height-for-age Z-score (HAZ) in sub-Saharan Africa.

Secondary analysis of data from nationally representative cross-sectional samples of singleton children aged 0–59 months, born to mothers aged 15–49 years. The outcome variable was child HAZ. Quantile regression was used to perform the multivariate analysis.

The most recent Demographic and Health Surveys from Ghana, Nigeria, Kenya, Mozambique and Democratic Republic of Congo (DRC).

The present analysis was restricted to children aged 6–59 months (n 31 604).

DD was associated positively with HAZ in the first four quantiles (5th, 10th, 25th and 50th) and the highest quantile (90th) in Nigeria. The largest effect occurred at the very bottom (5th quantile) and the very top (90th quantile) of the conditional HAZ distribution. In DRC, DD was significantly and positively associated with HAZ in the two lower quantiles (5th, 10th). The largest effects of maternal education occurred at the lower end of the conditional HAZ distribution in Ghana, Nigeria and DRC. Maternal BMI and height also had positive effects on HAZ at different points of the conditional distribution of HAZ.

Our analysis shows that the association between DD and maternal factors and HAZ differs along the conditional HAZ distribution. Intervention measures need to take into account the heterogeneous effect of the determinants of child nutritional status along the different percentiles of the HAZ distribution.

To describe the relationship between specific levels of nitrite intake from cured meat consumption during pregnancy and the relative risk of paediatric brain tumours in the offspring.

Exposure data were previously collected for a population-based case–control study of paediatric brain tumours; data on nitrite content were obtained by a comprehensive literature review of surveys of residual nitrite content in cured meats published in the USA and Canada. The level of nitrite intake for each mother was predicted by year of pregnancy based on survey results. Dose–response was evaluated both categorically and continuously using polynomial and quadratic spline regression.

The US west coast: Los Angeles County, the San Francisco–Oakland Bay Area and the Seattle–Puget Sound area.

There were 540 cases diagnosed between 1984 and 1990 at ages varying from 0 to 19 years, and 801 controls frequency-matched by geographic area, age and birth year.

In general, survey results suggest a trend of decreasing nitrite levels in cured meats over time. We observed a moderate increase in brain tumour risk in the offspring of mothers with relatively low levels of nitrite consumption from cured meats during pregnancy, and a two- to three-fold risk increase in offspring of mothers who consumed 3 mg day−1 nitrite from cured meats (about 125 g day−1 of cured meat consumption throughout the pregnancy).

A substantial risk of paediatric brain tumour appears to be associated with relatively high levels of maternal cured meat consumption during pregnancy. A more scientifically valid approach than a literature review to estimate nitrite intake from cured meats and data from a large group of highly exposed subjects would be useful in determining potentially harmful levels.

To compare infant and young child feeding practices in children aged 0–23 months across nine East and Southeast Asian countries.

Secondary analyses of cross-sectional data from available Demographic and Health Surveys (DHS; Indonesia, Philippines, Timor-Leste, Cambodia and Vietnam), Multiple Indicator Country Surveys (Lao People's Democratic Republic (Lao PDR) and Myanmar) and national nutrition surveys (Democratic People’s Republic of Korea (DPR Korea) and Mongolia) conducted between 2000 and 2005.

Seven countries from Southeast Asia and two from East Asia.

Children aged 0–23 months with samples ranging from 826 to 5610 for DHS, and from 477 to 5860 for non-DHS data.

More than 93 % of infants were ever breast-fed, and over 75 % were currently breast-fed except in the Philippines. Timely initiation of breast-feeding varied from 32 % in Indonesia to 46 % in Timor-Leste. Exclusive breast-feeding (EBF) rate in infants under 6 months of age ranged from 11 % in Myanmar to 60 % in Cambodia. EBF rates were also low in Vietnam (15·5 %) and Lao PDR (23 %), and varied between 30 % and 40 % in Indonesia, Philippines and Timor-Leste. The proportion of infants under 6 months of age who were given breast milk with non-milk liquids was high except in Indonesia and Timor-Leste. Bottle-feeding rates were lower in DPR Korea (3 %), Lao PDR (6 %) and Myanmar (6 %) and higher in the Philippines (49 %) and Mongolia (31 %). Timely complementary-feeding rate varied widely across countries (6–99 %).

All the countries studied should make greater efforts to improve timely initiation of breast-feeding and EBF for 6 months. Measures should be taken to reduce high bottle-feeding rate in the Philippines, Mongolia, Indonesia and Vietnam, and improve complementary-feeding rate in Lao PDR, Myanmar, DPR Korea and Philippines.

To examine the risk factors of prelacteal feeding (PLF) among mothers in sub-Saharan Africa (SSA).

We pooled data from Demographic and Health Surveys in twenty-two SSA countries. The key outcome variable was PLF. A multilevel logistic regression model was used to explore factors associated with PLF.

Demographic and Health Surveys in twenty-two SSA countries.

Mother–baby pairs (n 95348).

Prevalence of PLF in SSA was 32·2 %. Plain water (22·1 %), milk other than breast milk (5·0 %) and sugar or glucose water (4·1 %) were the predominant prelacteal feeds. In the multivariable analysis, mothers who had caesarean section delivery had 2·25 times the odds of giving prelacteal feeds compared with mothers who had spontaneous vaginal delivery (adjusted OR=2·25; 95 % CI 2·06, 2·46). Other factors that were significantly associated with increased likelihood of PLF were mother’s lower educational status, first birth rank, fourth or above birth rank with preceding birth interval less than or equal to 24 months, lower number of antenatal care visits, home delivery, multiple birth, male infant, as well as having an average or small sized baby at birth. Mothers aged 20–34 years were less likely to give prelacteal feeds compared with mothers aged ≤19 years. Belonging to the second, middle or fourth wealth quintile was associated with lower likelihood of PLF compared with the highest quintile.

To achieve optimal breast-feeding, there is a need to discourage breast-feeding practices such as PLF. Breast-feeding promotion programmes should target the at-risk sub-population groups discovered in our study.

To investigate factors influencing the practices of partial breast-feeding (PBF) and exclusive breast-feeding (EBF).

A national, cross-sectional survey was conducted among married women aged 15–49 years from May to August 2003.

South Korea.

A total of 865 mothers answered questions regarding the feeding practices of their youngest baby, born between January 2001 and May 2003.

The initiation rates of PBF and EBF were 81% and 63%, respectively. However, the median durations of PBF and EBF were very short: 12 and 8 weeks, respectively. According to stepwise logistic and Cox regression analyses, the more prenatal care women received, the more likely they were to initiate PBF and EBF but the less likely to continue EBF. Delivery by Caesarean section decreased the initiation of PBF and EBF. The mother’s education level and employment status before marriage, the amount of prenatal care, delivery method and baby’s status at birth affected breast-feeding initiation, whereas the amount of prenatal care influenced breast-feeding duration.

To promote breast-feeding, education and campaigning on the importance of continued breast-feeding should be provided to the general public, particularly to health workers in maternity units.

To compare the Household Food Insecurity Access Scale (HFIAS), the US Food Security Survey Module (US FSSM) and a modified version of the US FSSM in which references to buying food were changed to references to getting food, in terms of their classification of food security levels among homeless individuals, and to determine which of these instruments was most preferred by homeless individuals.

A cross-sectional survey.

Recruitment of participants took place at seven shelters and from three drop-in programmes that serve homeless individuals in Toronto, Canada.

Fifty individuals who were ≥18 years of age, able to communicate in English and currently homeless.

The modified US FSSM assigned 20 % of participants to a lower ordinal food security category compared with the US FSSM, and only 8 % to a higher food security category. The HFIAS assigned 30 % of participants to a lower food security category compared with either the US FSSM or the modified US FSSM, and only 10–16 % of participants to a higher food security category. When asked to compare all three instruments, the majority of respondents (62 %) selected the HFIAS as the best instrument for people who are homeless.

A majority of homeless individuals selected the HFIAS as the best food security instrument for people who are homeless. Our findings suggest that the HFIAS is a more appropriate instrument than the US FSSM for measuring food security in the homeless population.

The purpose of conducting this survey was to identify data on consumer attitudes towards and beliefs about physical activity, body weight and health among the 15 countries of the EU.

A cross-sectional study to get a picture of the attitudes to physical activity, body weight and health in the EU. For this, it was considered important that samples be nationally representative so that inferences drawn from the data could be applied to the population in each country as well as to the EU population as a whole. Using a non-probability sampling method employing quota controls (and the national weight) we obtained large sample sizes from each country which were nationally representative in terms of the variables age, sex and regional distribution. To ensure samples were truly nationally representative a national weight was used when analysing the data using the same characteristics as those used to define quotas. When examining pooled estimates for the total EU sample a population weight was applied.

In total, 15 239 subjects aged 15 years and upwards in the EU completed the survey. This article gives details on the methods used in carrying out the survey from design of the questionnaire to sample selection, questionnaire administration and analysis of the data. The methods and their limitations are discussed.

To examine the association between obesity and food group intakes, physical activity and socio-economic status in adolescents.

A cross-sectional study was carried out in 2008. Cole's cut-off points were used to categorize BMI. Abdominal obesity was defined by a waist circumference at or above the 90th percentile, as well as a waist-to-height ratio at or above 0·500. Diet was evaluated using an FFQ, and the food group consumption was categorized using sex-specific tertiles of each food group amount. Physical activity was assessed via a self-report questionnaire. Socio-economic status was assessed referring to parental education and employment status. Data were analysed separately for girls and boys and the associations among food consumption, physical activity, socio-economic status and BMI, waist circumference and waist-to-height ratio were evaluated using logistic regression analysis, adjusting the results for potential confounders.

Public schools in the Azorean Archipelago, Portugal.

Adolescents (n 1209) aged 15–18 years.

After adjustment, in boys, higher intake of ready-to-eat cereals was a negative predictor while vegetables were a positive predictor of overweight/obesity and abdominal obesity. Active boys had lower odds of abdominal obesity compared with inactive boys. Boys whose mother showed a low education level had higher odds of abdominal obesity compared with boys whose mother presented a high education level. Concerning girls, higher intake of sweets and pastries was a negative predictor of overweight/obesity and abdominal obesity. Girls in tertile 2 of milk intake had lower odds of abdominal obesity than those in tertile 1. Girls whose father had no relationship with employment displayed higher odds of abdominal obesity compared with girls whose father had high employment status.

We have found that different measures of obesity have distinct associations with food group intakes, physical activity and socio-economic status.

To meet some of the UN’s seventeen Sustainable Development Goals by 2030, there is a need for more effective policy to reduce food insecurity in low-income and lower-middle-income countries (LMIC). Measuring progress towards these goals requires reliable indicators of food security in these countries. Routinely conducted household consumption and expenditure surveys (HCES) provide potentially valuable and nationally representative data sets for this purpose. The present study aimed to assess methods used to determine national food security status using proxy measures from HCES data in LMIC globally.

A scoping literature review was conducted using electronic databases. Of the 929 abstracts identified, a total of twenty articles were reviewed against strict inclusion and exclusion criteria and included for further analysis.

Fourteen LMIC globally were represented in the twenty articles. The simplest metric used to indicate food insecurity compared household food expenditure against a level of expenditure considered to be below the poverty line. Data on acquisition of food was commonly converted to available energy for the household using local food composition tables and expressed as a proportion of household total energy requirements. Dietary diversity was also assessed in some studies as well as experience of food insecurity.

The review demonstrated that routinely collected HCES data sets provide a useful resource for the measurement of household food security in often resource-limited LMIC. Standardisation of methods used to assess food security is needed to allow for more useful comparisons between countries, as well as to assess temporal trends.

To investigate the prevalence of anaemia and iron deficiency and vitamin A status among school-aged children in rural Kazakhstan and identify factors associated with anaemia in this population.

A cross-sectional design.

School-aged children in rural Kazakhstan.

Socio-economic and anthropometric information was collected from 159 school-aged children living in the Kzyl-Orda region of Kazakhstan. Blood samples were collected and the concentrations of haemoglobin (Hb), serum iron, serum ferritin (SF), erythrocyte protoporphyrin (EP), serum retinol and β-carotene, total iron binding capacity (TIBC), transferrin saturation (TS) and other haematological indices were measured.

Among the 159 children, the prevalence of anaemia and iron deficiency defined by the multiple criteria model (SF, TS and EP) was 27% and 13%, respectively. Nine per cent had iron-deficiency anaemia and 21% had serum retinol value <1.05 μmol l−1. Mean SF and serum iron concentrations and TS were significantly lower in anaemic children than in their non-anaemic peers, while TIBC and EP were significantly higher in children with anaemia. Hb was significantly correlated with serum iron and retinol concentrations. Serum retinol and SF concentrations and mean corpuscular volume were significantly correlated with Hb by multiple regression analysis.

Anaemia among school-aged children in rural Kazakhstan appears to be related to iron indices and vitamin A status.

The present paper aims at describing the current status of nutrition policyin the WHO European Region and to discuss the implications for publichealth. The stages of policy development in the Region are illustrated andachievements in specific aspects of food and nutrition policy arehighlighted.

The analysis is based on a WHO survey on nutrition policies in the WHOEuropean Region in 2005 with information from forty-eight out of fifty-threecountries in the Region. Based on the findings, countries were categorizedaccording to their stage in policy development. Additionally, fifty policydocuments related to nutrition and published by a national body wereanalysed according to certain criteria of food and nutrition policy.

Most Member States (n 46) have available apolicy document related to nutrition and forty have a mechanism to implementit. Collaboration between sectors is taking place in thirty-one countries.Implementation tools, such as food-based dietary guidelines and monitoringand surveillance systems, are in place in twenty-seven countries. Theanalysis of policy documents revealed that actions addressing the individualwith information or education are well developed. Actions addressingenvironmental determinants, such as food availability, affordability andaccessibility, are indicated in only a few policies.

Food and nutrition policies appear to have developed successfully in the pastdecade. However, implementation of the policies seems to be a majorchallenge due to lack of funds, political commitment and coordination. Moresupport should be given to the implementation and evaluation of policies anda shift towards stronger environmental approaches is needed.

To identify factors influencing dietary behaviours in urban food environments in Africa and identify areas for future research.

We systematically reviewed published/grey literature (protocol CRD4201706893). Findings were compiled into a map using a socio-ecological model on four environmental levels: individual, social, physical and macro.

Urban food environments in Africa.

Studies involving adolescents and adults (11–70 years, male/female).

Thirty-nine studies were included (six adolescent, fifteen adolescent/adult combined and eighteen adult). Quantitative methods were most common (twenty-eight quantitative, nine qualitative and two mixed methods). Studies were from fifteen African countries. Seventy-seven factors influencing dietary behaviours were identified, with two-thirds at the individual level (45/77). Factors in the social (11/77), physical (12/77) and macro (9/77) environments were investigated less. Individual-level factors that specifically emerged for adolescents included self-esteem, body satisfaction, dieting, spoken language, school attendance, gender, body composition, pubertal development, BMI and fat mass. Studies involving adolescents investigated social environment-level factors more, for example, sharing food with friends. The physical food environment was more commonly explored in adults, for example, convenience/availability of food. Macro-level factors associated with dietary behaviours were food/drink advertising, religion and food prices. Factors associated with dietary behaviour were broadly similar for men and women.

The dominance of studies exploring individual-level factors suggests a need for research to explore how social, physical and macro-level environments drive dietary behaviours of adolescents and adults in urban Africa. More studies are needed for adolescents and men, and studies widening the geographical scope to encompass all African countries.

To illustrate the effect of common mistakes when using 24-hour national dietary survey data to estimate the prevalence of inadequate nutrient intakes.

Raw data on nutrient intake from the Australian 1995 National Nutrition Survey were adjusted for within-person variance using standard techniques and corrected for underreporting using the criteria of Goldberg et al. The distributions for six nutrients were compared with current dietary reference values from the UK, USA and Australia.

A national sample of the Australian population with a 61.4% response rate.

Adjusting for within-person variance reduced the range of nutrient intakes to 66–80% of the raw data range and the proportion with intakes below the estimated average requirement (EAR) by up to 20%. Excluding underreporters further reduced the proportion below the EAR by up to 10%. Using the dietary reference values from different countries also resulted in some markedly different estimates. For example, the prevalence of low folate intakes ranged from <1 to 92% for adult women depending on the reference used. Except for vitamin A and protein, the prevalence of low intakes was invariably higher for women than for men.

Estimates of the prevalence of low nutrient intakes based on raw 24-hour survey data are invariably misleading. However, even after adjustment for within-person variance and underreporting, estimates of the prevalence of low nutrient intakes may still be misleading unless interpreted in the light of the reference criteria used and supported by relevant biochemical and physiological measures of nutritional status.

To examine mothers’ experience of support received from fathers for breast-feeding.

We conducted in-depth in-person interviews with women with recent breast-feeding experience. Interview transcripts were analysed by qualitative content analysis. Interviews were designed to explore the mothers’ perception of role of fathers in breast-feeding, education on breast-feeding that fathers received and their perception of the fathers’ view on breast-feeding.

Urban and suburban community.

Nineteen women from a metropolitan area in the north-eastern USA.

Ten themes emerged, these involved practical and emotional support provided by fathers, especially during times of unexpected breast-feeding challenges. In addition, mothers perceived fathers may benefit from more peer and professional support, lactation consultant service and breast-feeding education.

Mothers appreciated the support from fathers for breast-feeding continuation, including encouragement and understanding. These results may be useful for health-care practitioners to promote breast-feeding continuation by supporting fathers in their role in the breast-feeding process.

To investigate the frequency of vitamin D deficiency in relation to demographics, clinical diagnosis, season of measurement and laboratory parameters in adult out-patients.

Descriptive, retrospective study concerning evaluation of the initial 25-hydroxyvitamin D (25(OH)D) levels determined at admission in relation to demographics, clinical diagnosis, season of measurement and laboratory parameters. 25(OH)D levels <20 ng/ml were classified as deficiency, 20–30 ng/ml as insufficiency and >30 ng/ml as sufficiency.

Out-patient clinics at a tertiary care centre.

A total of 2488 adult patients (mean age: 53·3 (sd 15·2) years; 85·2 % were females) admitted to out-patient clinics at Baskent University Istanbul Hospital were included.

Mean level of 25(OH)D in the overall population was 17·4 (sd 11·5) ng/ml while insufficiency and deficiency were evident in 24 % and 66 % of patients, respectively. Mean 25(OH)D levels in males >45 years old were higher than in their female counterparts (19·4 (sd 11·3) ng/ml v. 17·8 (sd 12·2) ng/ml; P < 0·05). Mean 25(OH)D levels obtained in summer (18·6 (sd 11·1) ng/ml) and autumn (23·3 (sd 13·6) ng/ml) were significantly higher than levels in spring (16·1 (sd 10·3) ng/ml) and winter (14·6 (sd 10·2) ng/ml; P < 0·01). Mean 25(OH)D levels were determined to be significantly lower in obese patients compared with non-obese patients (15·6 (sd 10·4) ng/ml v. 17·6 (sd 11·6) ng/ml; P < 0·05). Levels of 25(OH)D were significantly negatively correlated with serum parathyroid hormone levels (r = −0·194; P < 0·001) while significantly positively correlated with phosphorus (r = 0·059; P < 0·01) and HDL cholesterol (r = 0·070; P < 0·01) levels.

Our findings indicate that vitamin D deficiency is very common among out-patients in Turkey, regardless of gender and age, especially among obese people and during winter and spring.

To estimate the dietary intake of total polycyclic aromatic hydrocarbons (PAH) and benzo(a)pyrene (BaP), and to characterise factors associated with higher intake during pregnancy. Recent studies suggest that prenatal exposure to PAH is associated with adverse reproductive outcomes. Other than tobacco smoke and occupational exposures, diet is the main source of human PAH exposure.

Prospective birth cohort study. Dietary exposure to total PAH and BaP was calculated combining food consumption data and estimated PAH concentrations in foods. One-way ANOVA was used to assess differences in intake among non-smokers, passive or active smokers. Linear regression was used to assess factors related to higher intake, and associations between dietary PAH and birth weight.

Sabadell, Spain, 2004–2006.

Women (n 657) recruited during the first trimester of pregnancy.

The mean dietary intake of BaP and total PAH was significantly higher among active (0·199 and 10·207 μg/d, respectively) and passive smokers (0·196 and 9·458 μg/d) than among non-smokers (0·181 and 8·757 μg/d; P value < 0·005). Maternal age, educational level and region of origin were also associated with higher BaP intake. In all women, major contributors to PAH intake were processed/cured meats, cereals/potatoes and shellfish. Elevated first trimester dietary BaP was associated with a significant reduction in birth weight (fourth v. first quartile: β = −142·73 g, P value < 0·05).

Active and passive smokers had higher dietary PAH exposure during pregnancy because of higher intake of processed meats and shellfish. As tobacco smoke is an additional route of PAH exposure, the added dietary burden in these women is of concern.

Findings from cohort studies investigating the association between rice consumption and risk of chronic diseases or mortality have been inconsistent. We performed a comprehensive systematic review and meta-analysis on all published cohort studies examining white rice consumption in relation to incidence of chronic diseases or risk of mortality.

A systematic literature search of MEDLINE, Embase, Cochrane review, Google Scholar and Scopus databases for relevant cohort studies published until July 2014. For systematic review, we found nineteen studies examining the association between rice intake and risk of chronic diseases (obesity, hypertension, metabolic syndrome, diabetes, CVD and cancers) or mortality. Cohort studies which reported relative risk (RR) or odds ratio for highest v. lowest intake of rice and chronic diseases or mortality were included in the meta-analysis.

In a meta-analysis on seventeen risk estimates for highest v. lowest category of rice intake, provided from twelve studies, we found a trend towards a positive association (RR; 95 % CI) between rice consumption and risk of all chronic diseases (1·11; 0·96, 1·29); however, significant between-study heterogeneity was found (I2=70·3 %, P<0·001). Stratified analysis by gender showed a significant positive association between rice consumption and risk of chronic diseases in women (1·40; 1·13, 1·73), but not in men (0·95; 0·72, 1·24). Combining ten effect sizes from five studies showed that high consumption of rice was not significantly associated with mortality (0·97; 0·88, 1·06). Subgroup analysis by gender indicated an inverse association between rice consumption and mortality in men (0·87; 0·81, 0·94), but a trend towards a positive association in women (1·08; 0·97, 1·19).

Although white rice consumption was not found to be associated with individual chronic conditions, we observed a positive association between white rice intake and risk of all overall chronic diseases in women. High rice consumption was related to a modest reduction in risk of mortality in men but not in women. Further studies of these relationships, in different populations, are needed.