To determine risk factors for consumption of soda and other sugar-sweetened beverages (SSB) among 2-year-old children.

The analysis was performed using three linked data sets: the 2004–2005 Oregon Pregnancy Risk Assessment Monitoring Survey (PRAMS); its longitudinal follow-up, 2006–2007 Oregon PRAMS-2; and 2004–2005 Oregon birth certificates.

PRAMS is a surveillance programme supported by the federal Centers for Disease Control and Prevention and implemented by participating state health departments. Using mixed methods, PRAMS surveys women 2–6 months after a live birth. Oregon PRAMS-2 re-interviews respondents shortly after the index child's second birthday. Oregon PRAMS oversamples minority women.

Using monthly cohorts, we randomly selected 5851 women from the 2004–2005 birth certificates. In total 1911 women completed both PRAMS and PRAMS-2. The weighted response rate of PRAMS-2 was 43·5 %.

Almost half of mothers (49·9 %) reported that their child drank SSB on at least 1 d/week. Mothers whose children drank SSB at least once weekly were more likely to have low income (adjusted OR = 2·83, 95 % CI 2·09, 3·83) and to eat out on ≥2 d/week (OR = 2·11 %, 95 % CI 1·66, 2·70). Hispanic and non-Hispanic black women were most likely to report that their child drank SSB at least once weekly.

Half of mothers reported that their 2-year-old children drank SSB at least once weekly. Public health interventions and policies should address childhood SSB consumption including educating health-care providers and parents.

Childhood cancer survivors (CCS) have been shown to practise suboptimal dietary intake and may benefit from nutrition interventions during and after treatment. Cooking classes have become popular for encouraging healthy eating behaviours in community-based programming and academic research; however, literature on teaching cooking classes in CCS is limited. The purpose of the present study was to address the development and implementation of classes for CCS based on a recently developed framework of healthy cooking behaviour.

A conceptual framework was developed from a systematic literature review and used to guide healthy cooking classes for CCS in different settings.

One paediatric cancer hospital inpatient unit, one paediatric cancer in-hospital camp programme and two off-site paediatric cancer summer camp programmes.

One hundred and eighty-nine CCS of varying ages and thirteen parents of CCS.

Seventeen classes were taught at camps and seven classes in the hospital inpatient unit. Healthy cooking classes based on the conceptual framework are feasible and were well received by CCS.

Cooking classes for CCS, both at the hospital and at camp, reinforced the principles of the conceptual framework. Future trials should assess the dietary and anthropometric impact of evidence-based healthy cooking classes in CCS.

The present study examined the energy (kilojoule) content of Australian fast-food menu items over seven years, before and after introduction of menu board labelling, to determine the impact of the introduction of the legislation.

Analysis of the median energy contents per serving and per 100g of fast-food menu items. Change in energy content of menu items across the years surveyed and differences in energy content of standard and limited-time only menu items were analysed.

Five of Australia’s largest fast food chains: Hungry Jack’s, KFC, McDonald’s, Oporto and Red Rooster.

All standard and limited-time only menu items available at each fast-food chain, collected annually for seven years, 2009–2015.

Although some fast-food chains/menu item categories had significant increases in the energy contents of their menus at some time points during the 7-year period, overall there were no significant or systematic decreases in energy following the introduction of menu labelling (P=0·19 by +17 kJ/100 g, P=0·83 by +8 kJ/serving). Limited-time only items were significantly higher in median energy content per 100 g than standard menu items (+74 kJ/100 g, P=0·002).

While reformulation across the entire Australian fast-food supply has the potential to positively influence population nutrient intake, the introduction of menu labelling legislation in New South Wales, Australia did not lead to reduced energy contents across the five fast-food chains. To encourage widespread reformulation by the fast-food industry and enhance the impact of labelling legislation, the government should work with industry to set targets for reformulation of nutrient content.

In post-transitional countries, obesity disproportionally affects women. Longitudinal studies can detect high-risk groups in whom to target actions. We investigated the magnitude and velocity of BMI changes in Chilean women of reproductive age and evaluated whether these trends vary in specific groups.

Longitudinal study. We measured weight and height in 2007 (baseline) and again in 2010 (follow-up); we estimated change in BMI (weight/height2) within the 3-year period and assessed its relationship with age, years of education and parity, collected at baseline and follow-up using a questionnaire.

Population-based cohort of low- to middle-income Chilean women.

Seven hundred and sixty-one women of reproductive age (mean 32·0 (sd 7·0) years), mothers of children who participate in the Growth and Obesity Cohort Study (GOCS).

At baseline, 61 % of women had BMI ≥ 25·0 kg/m2. After 3 years, women gained on average 2·6 kg and obesity (BMI ≥ 30·0 kg/m2) increased by 23 % (12 % new obesity cases). Women with normal nutritional status gained more BMI than obese women (1·4 v. 0·6 kg/m2, P < 0·001). An increase in parity was positively associated with BMI change, independently of age, nutritional status and education (P < 0·05). Age and education were not associated with BMI change after controlling for other factors (P > 0·05).

In Chile, a post-transitional country, we observed an alarming increase in obesity among women of reproductive age. Our results indicate that in this population actions need to be targeted at all women irrespective of their nutritional status. A key component of these policies should be avoiding excessive weight gain during pregnancy.

Transition from a low-fat vegetable-rich rural diet to a high-fat Westernised diet is considered a factor in the escalating occurrence of vascular-related diseases and type 2 diabetes in urban black South Africans. Consumption of morogo is a distinguishing feature of rural African diets.

To determine fatty acid profiles and folate contents of three widely consumed, wild-growing, African dark green leafy vegetables (morogo).

GC–MS was applied for analysis of fatty acid composition and a validated microbiological assay conducted to determine folic acid contents of wild-growing morogo sampled from deep rural villages in three different geographical regions of South Africa.

Measured fatty acids ranged from 1610·2 to 2941·6 mg/100 g dry mass, with PUFA concentrations 1·4 to 2·8 times those of SFA. Calculated from the relative percentages of linoleic acid (18:2n-6) and linolenic acid (18:3n-3), the ratio of 18:2n-6 to 18:3n-3 PUFA was 1·0:3·4 to 1·0:8·9. The only MUFA was palmitoleic acid (16:1), measured at 34·7 (sd 0·3) to 79·0 (sd 9·3) mg/100 g dry mass, and the predominant SFA was palmitic acid (16:0), measured at 420·6 (sd 83·3) to 662·0 (sd 21·2) mg/100 g dry mass. Folic acid concentration varied from 72 to 217 μg/100 g fresh sample.

Morogo is low-fat food item high in folate and with 18:3n-3 in excess of 18:2n-6, the proposed anti-inflammatory effects of which may lower risks of vascular-related chronic diseases and type 2 diabetes.

Few studies have considered the combined effects of home-related determinants on children's diet. The present study investigated independent associations between sociodemographic and food practice (SFP) characteristics and fruit and vegetable consumption in UK children and the combined effects of SFP on consumption using pattern analysis.

Diet was assessed using 4 d food diaries, SFP were collected using computer-assisted personal interview. Linear regressions were used to test associations; principal component analysis was used to identify patterns of SFP characteristics. Regression of fruit (g/d) and vegetables (g/d) v. component scores of each pattern were performed.

UK National Diet and Nutrition Survey Rolling Programme (2008–2010).

Children aged 1·5–10 years (n 642).

Significant associations were found between fruit and vegetable consumption and household socio-economic status. Pattern 1, which was positively correlated with household structure characteristics, was associated with increased fruit consumption (P < 0·001). Pattern 2, characterised by positive correlations for socio-economic status, fruit availability and organic food purchase, and negatively correlated with household size and the number of children per household, was associated with higher fruit and vegetable consumption (both P < 0·001). Pattern 3, characterised by high frequency of eating out and eating takeaway, was associated with a lower consumption of both fruit (P < 0·012) and vegetables (P < 0·023).

Patterns of SFP determinants may be more informative than individual characteristics in relation to dietary outcomes. Results have public health implications on the healthfulness of meals eaten out of home and in takeaways, as well as the need to reduce diet inequality in larger households with lower socio-economic status.

To compare estimates from one day with usual intake estimates to evaluate how the adjustment for within-person variability affected nutrient intake and adequacy in Mexican children.

In order to obtain usual nutrient intakes, the National Cancer Institute’s method was used to correct the first 24 h dietary recall collected in the entire sample (n 2045) with a second 24 h recall collected in a sub-sample (n 178). We computed estimates of one-day and usual intakes of total energy, fat, Fe, Zn and Na.

2012 Mexican National Health and Nutrition Survey.

A total of 2045 children were included: 0–5·9 months old (n 182), 6–11·9 months old (n 228), 12–23·9 months old (n 537) and 24–47·9 months old (n 1098). From these, 178 provided an additional dietary recall.

Although we found small or no differences in energy intake (kJ/d and kcal/d) between one-day v. usual intake means, the prevalence of inadequate and excessive energy intake decreased somewhat when using measures of usual intake relative to one day. Mean fat intake (g/d) was not different between one-day and usual intake among children >6 months old, but the prevalence of inadequate and excessive fat intake was overestimated among toddlers and pre-schoolers when using one-day intake (P<0·05). Compared with usual intake, estimates from one day yielded overestimated prevalences of inadequate micronutrient intakes but underestimated prevalences of excessive intakes among children aged >6 months.

There was overall low variability in energy and fat intakes but higher for micronutrients. Because the usual intake distributions are narrower, the prevalence of inadequate/excessive intakes may be biased when estimating nutrient adequacy if one day of data is used.

Obesity in children is a serious public health issue in Greece. The purpose of the current study was to identify risk factors such as birth weight, breast-feeding, dietary patterns, family history of obesity and sedentary behaviours that are possibly associated with paediatric obesity.

Two hundred and five overweight and obese children (OW/OB; group 1) aged 7–15 years from eight primary and secondary schools and a control group (group 2) of normal-weight children were matched for age and sex. Overweight and obesity were calculated based on the International Obesity Taskforce criteria. Lifestyle parameters as well as anthropometric data were collected in all children. Conditional logistic regression analysis was used to identify risk factors for obesity.

Breast-feeding (≥3 months) and leisure-time physical activity proved to be protector factors against obesity (OR = 0·21, 95 % CI 0·11, 0·79, P < 0·001 and OR = 0·87, 95 % CI 0·85, 0·89, P < 0·001 respectively). On the other hand, family history of obesity (OR = 3·79, 95 % CI 2·61, 4·18, P < 0·001), sugar-sweetened beverage consumption (OR = 1·77, 95 % CI 1·03, 2·76, P < 0·001) and watching television (OR = 1·99, 95 % CI 1·54, 2·76, P = 0·04) were found to be positively associated with a higher obesity risk.

The current findings support the literature according to which duration of breast-feeding (<3 months), a family history of obesity, watching television, sedentary lifestyle and consumption of sugar-sweetened beverages are important risk factors for childhood obesity. More studies are needed to elucidate the relationship of paediatric obesity and possible predictor factors in order to avoid health consequences in these children later on in life.

To assess trends in nutrient intakes and nutritional status of rural adult women (≥18–60 years) and the association of sociodemographic characteristics with overweight/obesity.

Community-based cross-sectional studies carried out during 1975–79 to 2011–12 by the National Nutrition Monitoring Bureau (NNMB) were used. Anthropometric measurements such as height, weight and waist circumference, carried out during the surveys, were used. Association and logistic regression analyses between sociodemographic characteristics and overweight/obesity and abdominal obesity were conducted using a complex samples procedure.

Ten NNMB states of India.

Non-pregnant and non-lactating rural women aged ≥18–60 years covered during the above periods from ten states in India.

The prevalence of chronic energy deficiency has declined from 52 % during 1975–79 to 34 % during 2011–12, while that of overweight/obesity has increased from 7 % to 24 % during the same period. Median intakes of most of the nutrients have increased over the same period, although they were below recommended levels. The chance of overweight/obesity and abdominal obesity was significantly (P<0·01) higher among women aged 40–60 years, those belonging to Christian religion and other backward communities, women living in pucca houses, literate women, women engaged in service and business, and those having higher per capita income.

Prevalence of chronic energy deficiency has declined significantly; however, overweight/obesity has increased during the same period. This increase in overweight/obesity may be attributed to increased consumption of fatty foods, sedentary lifestyle and improved socio-economic status. There is a need to educate the community about regular physical exercise, low intakes of fats and oils, and a balanced diet.

Food security is defined as being able to access enough food that will help maintain an active, healthy lifestyle for those living in a household. While there are no studies on food security issues among deaf people, research shows that communication barriers early in life are linked to poor physical and mental health outcomes. Childhood communication barriers may also risk later food insecurity.

A single food security screener question found to have 82 % sensitivity in classifying families who are at risk for food insecurity was taken from the six-item US Household Food Security Survey Module. Questions related to food insecurity screener, depression diagnosis and retrospective communication experience were translated to American Sign Language and then included in an online survey. Over 600 deaf adult signers (18–95 years old) were recruited across the USA.

After adjusting for covariates, deaf adults who reported being able to understand little to none of what their caregiver said during their formative years were about five times more likely to often experience difficulty with making food last or finding money to buy more food, and were about three times more likely to sometimes experience this difficulty, compared with deaf adults who reported to being able to understand some to all of what their caregiver said.

Our results have highlighted a marked risk for food insecurity and related outcomes among deaf people. This should raise serious concern among individuals who have the potential to effect change in deaf children’s access to communication.

Anaemia is a major contributor to the global disease burden and half of pregnant women in India were anaemic in 2016. The aetiology of anaemia is complex, yet anaemia determinants are frequently examined in isolation. We sought to explore how shifts in sociodemographic (wealth, age at pregnancy, education, open defecation, cooking fuel type, household size), programmatic (iron–folic acid tablet consumption, antenatal care visits) and dietary factors (intake of Fe, folic acid, vitamin B12, phytate) predicted changes in anaemia prevalence.

Nutrient levels for eighty-eight food items were multiplied by household consumption of these foods to estimate household-level nutrient supply. A synthetic panel data set was created from two rounds of the District Level Household and Facility Survey (2002–04 and 2012–13) and Household Consumer Expenditures Survey (2004–05 and 2011–12). Ordinary least-squares multivariate regression models were used.

Districts (n 446) spanning north, north-east, central and south India.

Pregnant women aged 15–49 years (n 17 138).

In the model accounting for both non-dietary and dietary factors, increased age at pregnancy (P<0·001), reduced village-level open defecation (P=0·001), consuming more Fe (P<0·001) and folic acid (P=0·018) and less phytate (P=0·002), and urbanization (P=0·015) were associated with anaemia reductions. A 10 mg increase in daily household Fe supply from 2012 levels was associated with a 10 % reduction in anaemia.

Public health interventions to combat anaemia in pregnant women should use a holistic approach, including promotion of delayed marriage, construction and use of toilets, and measures that facilitate adoption of nutrient-rich diets.

To assess the nutritional suitability of commercially produced complementary foods (CPCF) marketed in three South-East Asian contexts.

Based on label information declared on the products, nutrient composition and content of CPCF were assessed against the WHO Europe nutrient profile model (NPM). The proportion of CPCF that would require a ‘high sugar’ warning was also determined.

Khsach Kandal district, Cambodia; Bandung City, Indonesia; and National Capital Region, Philippines.

CPCF products purchased in Cambodia (n 68) and Philippines (n 211) in 2020, and Indonesia (n 211) in 2017.

Only 4·4 % of products in Cambodia, 10·0 % of products in Indonesia and 37·0 % of products in the Philippines fully complied with relevant WHO Europe NPM nutrient composition requirements. Sixteen per cent of CPCF in Cambodia, 27·0 % in Indonesia and 58·8 % in the Philippines contained total sugar content levels that would require a ‘high sugar’ warning.

Most of the analysed CPCF were not nutritionally suitable to be promoted for older infants and young children based on their nutrient profiles, with many containing high levels of sugar and sodium. Therefore, it is crucial to introduce new policies, regulations and standards to limit the promotion of inappropriate CPCF in the South-East Asia region.

To validate a picture book for estimation of food portion sizes using two approaches: (i) ‘perception’ of food portions by comparison with a series of food photos; and (ii) ‘conceptualization and memory’, using the same photos to estimate the amount of served food one hour after self-served food portions.

Each partner developed a country-specific picture book based on the so-called EPIC-Soft picture book. Representative and common photo series were chosen achieving approximately 25 % of the original picture book (n 23). Three portions from each photo series were randomly selected.

The study was performed within the Pilot study in the view of a Pan-European dietary survey – Adolescents, adults and elderly (PILOT-PANEU) project.

A sample of adolescents and adults was recruited in five countries: Bulgaria (n 103), Finland (n 34), Germany (n 69), Hungary (n 62) and Portugal (n 77).

Among the portions of the corresponding photo series and depending on the type of food, from 18 % (cheese) to 96 % (ratatouille) of participants chose the correct portions. In the perception study, agreement between the portions shown and reported was substantial (intraclass correlation coefficient (ICC)=0·805) and the mean difference was very low. In the memory study, agreement between the served and reported portions was lower than in the perception study (ICC=0·536). Agreement also seemed to decrease as the appearance of food on the plate differed from food in the picture.

Overall, the picture series selected can be applied in future intake surveys to quantify foods similar to those depicted in the pictures.

To identify major dietary patterns and their association with socio-economic status (SES) and food insecurity in two major ethnic groups living in Urmia, north-west Iran.

A cross-sectional study.

All four geographical zones of Urmia city.

Participants (n 723; 427 women and 296 men), aged 20–64 years, from two ethnic groups (445 Azeri Turks and 278 Kurds).

Three major dietary patterns were extracted: ‘Traditional High SES’ (THS), ‘Traditional Low SES’ (TLS) and ‘Transitional’. After adjusting for confounders, the THS pattern was positively associated with education level and negatively associated with moderate or severe food insecurity in Azeri Turks; whereas, among Kurds, it was more common in women and positively associated with age. The TLS pattern was more common among men and negatively associated with educational level and all levels of food insecurity in Azeris; while, among Kurds, it was more common among men, positively associated with being married and negatively associated with household income/capita. The ‘Transitional’ pattern was positively associated with being employed and negatively associated with age and all levels of food insecurity in Azeris; while, among Kurds, it was more common among men and negatively associated with age, being married and physical activity level.

Findings suggest that household SES and food insecurity are associated with detrimental dietary patterns and that this effect may be stronger than cultural and ethnic background. These patterns differ by age and gender. Therefore, such characteristics should be considered in planning and formulating diet-related policies and programmes.

To unravel the concept of nutrition awareness, as it relates to risky personal nutrition-related behaviours, and to assess the sociodemographic and psychosocial correlates of nutrition awareness.

Data were collected in a cross-sectional study with the aid of a face-to-face interview-assisted questionnaire that was based on the Precaution Adoption Process Model and Stages of Change Model.

Dutch consumer homes.

Six hundred and three Dutch adults aged 18 to 80 years, selected from a panel.

Our model explains nutrition awareness well (explained variance 53.7%). Psychosocial correlates were involvement with nutrition, health awareness, association with healthy food, perceived relevance of eating less fat, association with necessity, perceived relevance of vitamins, and perceived attributes of independent organisations. Sociodemographic correlates were gender and age. The relationship between nutrition awareness and nutrition-related behaviours proved to be very complicated.

The value of our study is that it unravels the concept of nutrition awareness. Understanding the correlates of nutrition awareness can contribute to a more effective application of behavioural change models. Our results support increasing involvement with nutrition through personalising and tailoring to the motivational stage.

People eat more unhealthy foods when served more (portion size effect) and when the food is served in larger units (unit size effect). The present study aimed to examine whether these effects can be used for the good: to increase vegetable consumption among children.

A 2×2 between-subjects experiment was conducted at two schools. Pupils were presented in class with cucumber that varied both in unit size (one piece v. pre-sliced) and portion size (one-third v. two-thirds of a cucumber). Children ate ad libitum during the morning break and filled in a survey.

Primary schools in the centre of the Netherlands.

Primary-school pupils (n 255) aged 8–13 years.

Children ate 54 % more cucumber when served a large compared with a smaller portion (difference of 49 g; P<0·001). Large units did not impact consumption (P=0·58), but were considered as less convenient to eat than small units (P=0·001).

Findings suggest that children’s vegetable intake can be improved by serving larger portions in smaller-sized pieces.

To identify whether picky eating during childhood is associated with dietary intake, weight status and disordered eating behaviour during young adulthood.

A population-based study using data from young adults who responded online or by mail to the third wave of the Project EAT (Eating and Activity in Teens and Young Adults) study in 2008–2009. Participants retrospectively reported the extent to which they were a picky eater in childhood, sociodemographic characteristics, disordered eating behaviours, usual dietary intake, and weight and height.

Participants were initially recruited in the Minneapolis/St. Paul metropolitan area of Minnesota, USA, in 1998–1999.

The analytic sample included 2275 young adults (55 % female, 48 % non-Hispanic White, mean age 25·3 (sd 1·6) years).

Young adults who reported picky eating in childhood were found to currently have lower intakes of fruit, vegetables and whole grains, and more frequent intakes of snack foods, sugar-sweetened beverages and foods from fast-food restaurants. No associations were observed between picky eating in childhood and young adults’ weight status, use of weight-control strategies or report of binge eating.

While young adults who report picky eating during childhood are not at higher risk for disordered eating, those who were picky eaters tend to have less healthy dietary intake. Food preferences and dietary habits established by picky eaters during childhood may persist into adulthood.

According to most prospective studies, being underweight (BMI<18·5 kg/m2) is associated with significantly higher mortality than being of normal weight, especially among smokers. We aimed to explore in a generally lean population whether being underweight is significantly associated with increased all-cause mortality.

Prospective cohort study.

Korea Medical Insurance Corporation study with 14 years of follow-up.

After excluding deaths within the first 5 years of follow-up (1993–1997) to minimize reverse causation and excluding participants without information about smoking and health status, 94 133 men and 48 496 women aged 35–59 years in 1990 were included.

We documented 5411 (5·7 %) deaths in men and 762 (1·6 %) in women. Among never smokers, hazard ratios (HR) for underweight individuals were not significantly higher than those for normal-weight individuals (BMI=18·5–22·9 kg/m2): HR=0·87 (95 % CI 0·41, 1·84, P=0·72) for underweight men and HR=1·12 (95 % CI 0·76, 1·65, P=0·58) for underweight women. Among ex-smokers, HR=0·86 (95 % CI 0·38, 1·93, P=0·72) for underweight men and HR=3·77 (95 % CI 0·42, 32·29, P=0·24) for underweight women. Among current smokers, HR=1·60 (95 % CI 1·28, 2·01, P<0·001) for underweight men and HR=2·07 (95 % CI 0·43, 9·94, P=0·36) for underweight women.

The present study does not support that being underweight per se is associated with increased all-cause mortality in Korean men and women.

Few published community garden studies have focused on low socio-economic youth living in public housing or used a community-based participatory research approach in conjunction with youth-focused community garden programmes. The objective of the present study was to evaluate the feasibility (i.e. demand, acceptability, implementation and limited-effectiveness testing) of a 10-week experiential theory-based gardening and nutrition education programme targeting youth living in public housing.

In this mixed-methods feasibility study, demand and acceptability were measured using a combination of pre- and post-programme surveys and interviews. Implementation was measured via field notes and attendance. Limited-effectiveness was measured quantitatively using a pre–post design and repeated-measures ANOVA tests.

Two public housing sites in the Dan River Region of south central Virginia, USA.

Forty-three youth (primarily African American), twenty-five parents and two site leaders.

The positive demand and acceptability findings indicate the high potential of the programme to be used and be suitable for the youth, parents and site leaders. Field notes revealed numerous implementation facilitators and barriers. Youth weekly attendance averaged 4·6 of 10 sessions. Significant improvements (P<0·05) were found for some (e.g. fruit and vegetable asking self-efficacy, overall gardening knowledge, knowledge of MyPlate recommendations), but not all limited-effectiveness measures (e.g. willingness to try fruits and vegetables, fruit and vegetable eating self-efficacy).

This community-based participatory research study demonstrates numerous factors that supported and threatened the feasibility of a gardening and nutrition programme targeting youth in public housing. Lessons learned are being used to adapt and strengthen the programme for future efforts targeting fruit and vegetable behaviours.

To test the hypothesis that diets with high glycaemic index (GI) and glycaemic load (GL) increase the risk of heart disease.

Overall GI and GL were assessed from 7 d diet records or diet history interviews.

Information on hospitalization and death due to CVD and CHD was obtained from the National Register of Cause of Death and the National Register of Patients.

In total 3959 adult Danes were – depending on time of entry – followed for 6–25 years until 31 December 1999.

Overall GI was inversely associated with heart disease in men. The hazard ratios (95 % CI) for the 10th and 90th GI percentiles compared with the median were 1·38 (1·13, 1·68) and 0·90 (0·76, 1·07) for CVD morbidity, 1·45 (1·05, 1·99) and 0·81 (0·62, 1·06) for CVD mortality, and 1·31 (0·97, 1·76) and 0·65 (0·51, 0·84) for CHD morbidity. In male subjects GL was not associated with either outcome. In women no clear association between overall GI and heart disease was found, whereas positive non-linear associations were found for GL: at very high levels of GL, increase in GL was associated with increasing CVD and CHD morbidity.

In men low-GI diets were associated increased risk of heart disease and GL was not associated with heart disease. In women there was no clear association between GI and heart disease, but to some extent a positive association between GL and heart disease was observed as hypothesized.