In women, the risk for non-communicable diseases increases after menopause. We aimed to identify major dietary patterns and study their associations with nutrient intake, sociodemographic factors and risk factors for non-communicable diseases among women aged 50–69 years.

A cross-sectional study. Food intake was recorded by a 253-item FFQ. Dietary patterns were identified using principal component analysis. The associations between the dietary patterns and nutrients were described by Pearson’s correlation coefficients and multiple regression analysis was used to examine the associations between the dietary patterns and age, education, BMI, physical activity and smoking.

The Norwegian Breast Cancer Screening Programme.

Women (n 6298) aged 50–69 years.

Three dietary patterns were identified: ‘Prudent’, ‘Western’ and ‘Continental’. Adherence to the ‘Prudent’ pattern was related to older age, higher education, higher BMI, more physical activity (Ptrend<0·001) and being a non-smoker (P<0·001). Adherence to the ‘Western’ pattern was related to older age, lower education, higher BMI, less physical activity (0·001≤Ptrend≤0·006) and lower alcohol intake (r =−0·28). Adherence to the ‘Continental’ pattern was related to younger age, higher education, higher BMI, less physical activity, (Ptrend<0·001), being a smoker (P<0·001) and higher alcohol intake (r=0·36).

Three distinct dietary patterns were identified. High adherence to a ‘Prudent’ pattern was associated with a healthy lifestyle, while high adherence to a ‘Western’ or ‘Continental’ pattern was associated with an unhealthy lifestyle. These findings are valuable knowledge for health authorities when forming strategies to promote a healthier lifestyle among women.

To evaluate the validity and reproducibility of a 122-item interviewer-administered quantitative FFQ developed to determine food and nutrient intakes of adults in Botswana.

Relative validity of the FFQ was evaluated by comparing nutrient and food group intakes against four non-consecutive 24 h recalls administered over 12 months. The FFQ was repeated after 1 year to assess reproducibility.

Kanye, Botswana.

Seventy-nine adults aged 18–75 years.

Spearman correlation coefficients for the validity of energy-adjusted nutrients ranged from 0·42 (carbohydrate) to 0·49 (protein) for macronutrients and from 0·23 (Fe) to 0·44 (PUFA) for micronutrients. Exact agreement of quartile distribution for nutrients between the FFQ and recalls ranged from 27 % to 72 %. Weighted kappa values were lowest for retinol (0·13), Fe (0·22) and β-carotene (0·25) and ranged from 0·33 (SFA) to 0·59 (folate) for other nutrients (energy, carbohydrate, protein, fat, Ca and vitamin E). Spearman correlation coefficients between the recalls and FFQ for food groups ranged from 0·18 (dark green leafy and yellow vegetables) to 0·58 (poultry). Reproducibility correlation coefficients (energy-adjusted) varied between 0·39 for retinol and 0·66 for vitamin E, with most values falling between 0·50 and 0·60.

The FFQ had good relative validity for estimating habitual food group and nutrient intakes, but was poor for some micronutrients (Fe, retinol and β-carotene) and foods (fruits and dark green leafy vegetables).

To determine the prevalence of metabolic syndrome (MetS) in schoolchildren from 6 to 16 years old, while considering their socio-economic status and other potential risk factors.

A cross-sectional study was conducted between April and November of 2005 in a semi-rural city with a total population of 13 000 inhabitants.

The study was conducted in Maracai city, located in the Brazilian state of Sao Paulo.

Schoolchildren (n 2170) of both genders, corresponding to approximately 82 % of all Maracai schoolchildren, were evaluated for components of MetS, as defined by the National Cholesterol Education Program; reference values for children and adolescents were adjusted for age and sex.

Overall, MetS prevalence was 3·6 % (95 % CI 2·9, 4·5) and did not differ statistically between genders, skin colour, between children and adolescents. However, when we analysed groups of subjects by weight, MetS prevalence progressively increased from 0·3 % (95 % CI 0·1, 0·8) in normal-weight subjects to 10·7 % (95 % CI 7·4, 14·8) and 34·5 % (95 % CI 25·9, 43·9) in overweight and obese subjects, respectively (both P < 0·001 compared to normal-weight controls). When socio-economic classes were considered, 4·7 % high-income students (95 % CI 3·5, 6·2) had MetS, which was significantly greater than low-income students (2·7 %; 95 % CI 1·9, 3·9; P = 0·023).

MetS prevalence was high in overweight and obese schoolchildren and these risk factors were present during childhood and adolescence. Changes in lifestyle and alimentary safety should be encouraged to avoid future cardiovascular morbidity and type 2 diabetes mellitus.

To determine the nutritional and health status of urban infants in two disadvantaged communities in the Western Cape, South Africa with special reference to micronutrient status. The results of this study will serve to plan an intervention study in these communities in the same age group.

Cross-sectional study.

Two disadvantaged urban black and ‘coloured’ communities in the Western Cape, South Africa.

Sixty infants aged 6–12 months from each community.

Dietary intake, anthropometric measurements, micronutrient status and psychomotor development.

Stunting and underweight were more prevalent in coloured infants (18% and 7%, respectively) than in black infants (8% and 2%, respectively). Anaemia (haemoglobin (Hb)<11 g dl−1 ) was prevalent in 64% of coloured and 83% of black infants. Iron-deficiency anaemia ( Hb<11 g dl−1 and ferritin < 10 ng ml−1) was found in 32% of coloured infants and in 46% of black infants. Zinc deficiency was prevalent in 35% and 33% of the coloured and black infants, respectively. Marginal vitamin A deficiency (serum retinol < 20 μg dl−1) was observed in 23% of black infants compared with 2% of coloured infants. Of black infants, 43% and of coloured infants 6% were deficient in two or more micronutrients. Six per cent of coloured infants had C-reactive protein concentrations above 5 mg l−1 compared with 38% of the black infants. The dietary intake of micronutrients was in general lower in black infants than in coloured infants. The overall psychomotor development, assessed by the Denver Developmental Screening Test, was different between the two groups. The coloured infants scored higher in three out of the four categories as well as in their overall score.

This study shows that information on stunting and wasting only in urban disadvantaged infants is not sufficient to make recommendations about specific community intervention programmes. Information on the micronutrient status, independent of wasting and stunting, is necessary to design nutrition programmes for different communities. The study also showed a substantially higher prevalence of micronutrient deficiencies among black infants.

We examined the association between unhealthy snacking at school and academic outcomes in students from the Santiago Metropolitan Region (Chile).

Cross-sectional population-based study.

We measured the nutritional quality of snacks at school using an FFQ, and accounting for the amounts of saturated fat, fibre, sugar and salt in the foods, and academic outcomes using national standardized test scores in Language and Mathematics. Multivariate regression analyses modelled the relationship between unhealthy snacking at school (exposure), potential confounders and performance in Mathematics and Language (outcomes).

Random sample of 1073 students (13·1 (sd 2·3) years old) attending public, partially subsidized and private schools.

Fifty-six per cent of students ate items at snack time that were high in fat, sugar, salt and energy, and thus were considered to have unhealthy snaking. Thirty-six per cent and 8 % were considered to have poor-to-fair and healthy snacking, respectively. Unhealthy snacking significantly lowered the odds of good academic performance in both domains. Students having unhealthy snacks were 56 % less likely to pass in Language (fully adjusted OR=0·44; 95 % CI 0·23, 0·85) and 66 % less likely to pass in Mathematics (fully adjusted OR=0·34; 95 % CI 0·19, 0·64) compared with students having healthy snack items.

Schoolchildren eating unhealthy foods at snack time had worse academic performance in Language and Mathematics, as measured by a standardized test. Although association does not imply causation, these findings support the notion that academic and health-related behaviours are linked. More research is needed on the effect of school health programmes on educational outcomes.

The majority of groceries purchased by US households are industrially processed, yet it is unclear how processing level influences diet quality. We sought to determine if processing level is associated with diet quality of grocery purchases.

We analysed grocery purchasing data from the National Household Food Acquisition and Purchase Survey 2012–2013. Household grocery purchases were categorized by the NOVA framework as minimally processed, processed culinary ingredients, processed foods or ultra-processed foods. The energy share of each processing level (percentage of energy; %E) and Healthy Eating Index-2015 (HEI-2015) component and total scores were calculated for each household’s purchases. The association between %E from processed foods and ultra-processed foods, respectively, and HEI-2015 total score was determined by multivariable linear regression. Foods purchased by households with the highest v. lowest ultra-processed food purchases and HEI-2015 total score <40 v. ≥60 were compared using linear regression.

USA.

Nationally representative sample of 3961 households.

Processed foods and ultra-processed foods provided 9·2 (se 0·3) % and 55·8 (se 0·6) % of purchased energy, respectively. Mean HEI-2015 score was 54·7 (se 0·4). Substituting 10 %E from minimally processed foods and processed culinary ingredients for ultra-processed foods decreased total HEI-2015 score by 1·8 points (β = −1·8; 95 % CI −2·0, −1·5). Processed food purchases were not associated with diet quality. Among households with high ultra-processed food purchases, those with HEI-2015 score <40 purchased less minimally processed plant-foods than households with HEI-2015 score ≥60.

Increasing purchases of minimally processed foods, decreasing purchases of ultra-processed foods and selecting healthier foods at each processing level may improve diet quality.

To evaluate the effect on decrease in blood pressure of modifying risk factors for stroke, such as blood lipid profiles, diet habits and indices of body weight, through a family-based nutrition health education programme among hypertensive patients and pre-hypertensive subjects without taking any antihypertensive drugs.

This was a community-based prospective study. The study population was randomly selected from communities in Taipei; potential subjects were invited by telephone to participate.

After excluding subjects whose blood pressure was normal and those using antihypertensive drugs, there were 390 participants included in the study. Subjects in the intervention group (n 293) received nutrition health education on blood pressure control and stroke-related risk factor modification at each visit. Non-intervention subjects (n 97) only acquired a general education sheet available in clinics. The blood pressure of study subjects was measured at baseline and 6-month follow-up to evaluate the intervention’s effect on decrease in blood pressure.

Significant decreases of 2·0 mmHg and 5·9 mmHg in systolic blood pressure were observed both in pre-hypertensive and hypertensive subjects in the intervention group. Additionally, intervention subjects with improvement of total cholesterol and LDL cholesterol, decrease in indices of body weight and increase in consumption of fruit and vegetables also had significant lowering of blood pressure.

The present study provided evidence that the blood pressure of pre-hypertensive and hypertensive subjects could decrease significantly, without taking antihypertensive drugs, after modifying blood lipid profiles and waist by dietary habits changed through a family-based nutrition heath education programme, resulting in a significant effect on stroke risk reduction.

To examine food and nutrient availability in New Zealand using supermarket sales data in conjunction with a brand-specific supermarket food composition database (SFD).

The SFD was developed by selecting the top-selling supermarket food products and linking them to food composition data from a variety of sources, before merging with individualised sales data. Supermarket food and nutrient data were then compared with data from national nutrition and household budget/economic surveys.

A supermarket in Wellington, New Zealand.

Eight hundred and eighty-two customers (73% female; mean age 38 years) who shopped regularly at the participating supermarket store and for whom electronic sales data were available for the period February 2004–January 2005.

Top-selling supermarket food products included full-fat milk, white bread, sugary soft drinks and butter. Key food sources of macronutrients were similar between the supermarket sales database and national nutrition surveys. For example, bread was the major source of energy and contributed 12–13% of energy in all three data sources. Proportional expenditure on fruit, vegetables, meat, poultry, fish, farm products and oils, and cereal products recorded in the Household Economic Survey and supermarket sales data were within 2% of each other.

Electronic supermarket sales data can be used to evaluate a number of important aspects of food and nutrient availability. Many of our findings were broadly comparable with national nutrition and food expenditure survey data, and supermarket sales have the advantage of being an objective, convenient, up-to-date and cost-effective measure of household food purchases.

Women (especially mothers) are theorized as critical to reducing household food insecurity through their work and caregiver roles. The present study tests these assumptions, assessing how maternal economic and social resources are associated with food insecurity in households with young children.

Data from a population-based sample of households was collected in León, Nicaragua (n 443). Data include a newly validated measure of household food insecurity (ELCSA), maternal resource measures, and household economic status and demographics. Regression analysis tests the statistical associations (P<0·05) of maternal resources with household, adult-specific and child-specific food insecurity.

Municipality of León, Nicaragua.

Households with children aged 3–11 years in rural and urban León.

Only 25 % of households with young children were food secure, with 50 % mildly food insecure and 25 % moderately/severely food insecure. When mothers contributed substantially to household income, the odds of moderate/severe household food insecurity were 34 % lower than when their spouse/partner was the main provider. The odds of food insecurity were 60 % lower when mothers managed household money, 48 % lower when mothers had a secondary (v. primary) education, 65 % higher among single mothers and 16 % lower with each indicator of social support. Results were similar for adult- and child-specific food insecurity.

This research provides new evidence that maternal economic and social resources are important for reducing household food insecurity and adult- and child-specific food insecurity. Women’s social status, social support and access to economic resources need to be enhanced as a part of policies aimed to reduce food insecurity in high-poverty settings.

A social network is a valuable resource in later life. Therefore, the current study aims to investigate whether social networks within homes and neighbourhoods are associated with older adults’ daily fruit and vegetable consumption.

Cross-sectional secondary data analysis.

USA.

A nationally representative sample of 6865 community-dwelling older adults over age 53 in the Health and Retirement Study – Health Care and Nutrition Survey.

Older adults who lived alone with no children or friends nearby had the lowest fruit and vegetable consumption. However, the daily fruit and vegetable consumption of respondents who lived alone and had children or friends nearby or those who lived with someone and had no children or friends nearby was not statistically different from those who lived with someone and had children or friends nearby. This suggests that having a social network either at home or in the neighbourhood complements the absence of living with someone or having children or friends nearby and attenuates the negative association between limited social networks and daily fruit and vegetable consumption. A greater decrease in the number of fruits and vegetables consumed was observed among men when they lived alone with no children or friends nearby.

Special attention should be given to older adults with limited social networks, especially older adults living alone with no children or friends nearby. Provision of help with grocery shopping and meal preparation as well as social support networks and more opportunities that can improve social engagement appear to be necessary.

Suboptimal nutrition among children remains a problem among South Asian (SA) families. Appropriate complementary feeding (CF) practices can greatly reduce this risk. Thus, we undertook a systematic review of studies assessing CF (timing, dietary diversity, meal frequency and influencing factors) in children aged <2 years in Pakistan.

Searches between January 2000 and June 2016 in MEDLINE, EMBASE, Global Health, Web of Science, OVID Maternity & Infant Care, CINAHL, Cochrane Library, BanglaJOL, POPLINE and WHO Global Health Library. Eligibility criteria: primary research on CF practices in SA children aged 0–2 years and/or their families. Search terms: ‘children’, ‘feeding’ and ‘Asians’ with their derivatives. Two researchers undertook study selection, data extraction and quality appraisal (EPPI-Centre Weight of Evidence).

From 45 712 results, seventeen studies were included. Despite adopting the WHO Infant and Young Child Feeding guidelines, suboptimal CF was found in all studies. Nine of fifteen studies assessing timing recorded CF introduced between 6 and 9 months. Five of nine observed dietary diversity across four of seven food groups; and two of four, minimum meal frequency in over 50 % of participants. Influencing factors included lack of CF knowledge, low maternal education, socio-economic status and cultural beliefs.

This is the first systematic review to evaluate CF practices in Pakistan. Campaigns to change health and nutrition behaviour are needed to meet the substantial unmet needs of these children.

The present study investigated how trans-fat is reported on the packaging of foods sold in a Brazilian supermarket.

The present descriptive, cross-sectional study analysed the ingredient list, nutrition facts label and claims of no trans-fat on the packaging.

A large supermarket in Florianópolis, Brazil.

All food products available at the supermarket.

Of the 2327 study products, more than half had components containing trans-fat in the ingredient list, especially hydrogenated vegetable fat and its alternative names. A small percentage of food products reported some trans-fat content on the nutrition facts label and roughly a quarter of the food products claimed to contain no trans-fat on the front of the packaging. There was very low agreement among the trans-fat content reported in the nutrition facts label, claims of no trans-fat made on the packaging and the ingredient list.

There was low agreement among the different ways of reporting trans-fat, suggesting that it is not possible to rely on the nutrition facts label or no trans-fat claims printed on the packaging of Brazilian food products. Hence, the Brazilian legislation on food labels needs to change to improve the reliability of food labels and to help control the trans-fat intake of the population.

To assess the nutrition knowledge levels and dietary intake pattern of schoolchildren belonging to two groups of different socio-economic status (SES; high income/high SES and low income/low SES).

A purposive sampling method was employed. A validated food-frequency questionnaire was administered to assess the dietary intake of schoolchildren in four schools from two different socio-economic strata in the month of January 2001. The children were divided into two groups, one serving as the experimental group and the other as the control group.

Two hundred and seventy-two children aged between 12 and 14 years.

There was a significant improvement (P < 0.001) in the knowledge levels of high-SES schoolchildren as compared with low-SES schoolchildren. A significant difference was observed in the intake of protective foods like milk and milk products, green leafy vegetables and fruits between the two income groups. However, children from the high SES background preferred fast foods such as noodles and corn flakes to traditional foods. Irrespective of income group, most of the children consumed carbonated beverages.

There was a significant difference in the intakes of protective foods and fast foods between the different income groups. However, the increased intake of fast foods and carbonated beverages by the children irrespective of SES needs to be discouraged as a part of nutrition education. The study indicated the need for repeated interventions for improvement of nutrition knowledge levels in low-SES children.

We explore the association between a neighbourhood’s ethnic composition and the foods and nutrients consumed by Mexican-Americans.

Cross-sectional survey of a large national sample, from the Third National Health and Nutrition Examination Survey (1988–94), was linked to the 1990 Census. The outcomes were food frequencies and serum levels of micronutrients. The variable of interest was percentage of Mexican-Americans at the census tract level.

United States.

A total of 5306 Mexican-American men and women aged 17–90 years.

Increased percentage of Mexican-Americans at the census tract level was associated with less consumption of fruits, carrots, spinach/greens and broccoli and with lower serum levels of Se, lycopene, α-carotene, vitamin C and folate. By contrast, increased percentage of Mexican-Americans at the census tract level was associated with more consumption of corn, tomatoes, hot red chilli peppers and legumes such as beans, lentils or chickpeas.

An increased percentage of Mexican-Americans at the census tract level was associated with less consumption of selective foods (e.g. some fruits, broccoli) and low levels of serum Se or vitamin C, but it was associated with more consumption of other foods (e.g. legumes, tomatoes, corn products) that may have positive effects on health in this population.

To investigate how socio-economic position, demographic factors, degree of integration and dietary indicators are related to BMI/waist:hip ratio (WHR) and to weight dissatisfaction and slimming among South Asians in Oslo, Norway.

Cross-sectional study consisting of a health check including anthropometric measures and two self-administered questionnaires.

Oslo, Norway.

Pakistanis and Sri Lankans (n 629), aged 30–60 years, residing in Oslo.

BMI was positively associated with female gender (P = 0·004) and Pakistani origin (P < 0·001), and inversely associated with years of education (P = 0·011) and eating more hot meals (P = 0·016). WHR was positively associated with male gender (P < 0·001), age (P < 0·001) and a dietary pattern with high-fat foods (P = 0·005), and inversely associated with degree of integration (measured by a composite index, independent of duration of residence; P = 0·017). One-third of those with normal weight and most of those obese were dissatisfied with their weight. Among these, about 40 % had attempted to slim during the past year. Dissatisfaction with weight was positively associated with education in women (P = 0·006) and with integration in men (P = 0·026), and inversely associated with physical activity (P = 0·044) in men. Women who had made slimming attempts had breakfast and other meals less frequently than others (P < 0·05).

Weight dissatisfaction exists among South Asian immigrants. More research is needed regarding bodily dissatisfaction and the relationship between perception of weight and weight-change attempts among immigrants in Norway, in order to prevent and treat both obesity and eating disorders.

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.

To verify associations of income and education with nutrient intakes in Brazilian adults.

Data from the population-based National Dietary Survey conducted in 2008–2009. Family per capita income and education levels were categorized into quartiles. Prevalences of inadequate nutrient intakes and excessive intakes of saturated fat and Na were calculated by using the method prescribed by the National Cancer Institute. The Estimated Average Requirement was used as a reference for micronutrient intake. Linear regression models for both the independent and the mutually adjusted associations of education and income with nutrient intakes were tested. Interaction between education and income was tested.

Households (n 13 569) selected using a two-stage cluster sampling design.

Food records for two non-consecutive days were obtained for 21 003 Brazilian adults (aged 20–59 years).

For most of eleven nutrients, the prevalence of inadequate intake declined with increasing income and education levels; however, it remained high across all income and education quartiles. Excessive intake of saturated fat and low fibre intake increased with both variables. Most nutrients were independently associated with income and education in both sexes. Fe, vitamin B12 and Na intakes among women were associated only with education. There was an interaction between income and education for Na intake in men, P intake in women and Ca intake in both sexes.

Education is one important step to improve nutrient intakes in Brazil. Emphasis should be laid on enhancing dietary knowledge and formulating economic strategies that would allow lower-income individuals to adopt a healthy diet.

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

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

The state of Veracruz, Mexico.

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

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

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