To characterize meal patterns across ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study.

Cross-sectional study utilizing dietary data collected through a standardized 24 h diet recall during 1995–2000. Eleven predefined intake occasions across a 24 h period were assessed during the interview. In the present descriptive report, meal patterns were analysed in terms of daily number of intake occasions, the proportion reporting each intake occasion and the energy contributions from each intake occasion.

Twenty-seven centres across ten European countries.

Women (64 %) and men (36 %) aged 35–74 years (n 36 020).

Pronounced differences in meal patterns emerged both across centres within the same country and across different countries, with a trend for fewer intake occasions per day in Mediterranean countries compared with central and northern Europe. Differences were also found for daily energy intake provided by lunch, with 38–43 % for women and 41–45 % for men within Mediterranean countries compared with 16–27 % for women and 20–26 % for men in central and northern European countries. Likewise, a south–north gradient was found for daily energy intake from snacks, with 13–20 % (women) and 10–17 % (men) in Mediterranean countries compared with 24–34 % (women) and 23–35 % (men) in central/northern Europe.

We found distinct differences in meal patterns with marked diversity for intake frequency and lunch and snack consumption between Mediterranean and central/northern European countries. Monitoring of meal patterns across various cultures and populations could provide critical context to the research efforts to characterize relationships between dietary intake and health.

To quantify the environmental component of aetiology of overweight and obesity by examining the relationship between the degree of overweight in dogs and cats and the degree of overweight in their owners.

Cross-sectional study. Main outcome measures of the owners were weight, height (stature) and BMI. Of the animals, weight and divergence from ideal weight were measured by a veterinarian.

Three veterinary clinics in Amsterdam, The Netherlands.

Dogs and cats, together with their owners, who visited the veterinary clinic. Dogs and cats had to be older than 1 year, and their owners had to be at least 21 years old. After exclusion, there remained forty-seven pairs of dogs and their owners and thirty-six pairs of cats and their owners.

We found a significant relationship between the degree of overweight of dogs and the BMI of their owners (r = 0·31). Correction for length of ownership, gender and age of the animal, and gender, age, education level and activity score of the owner did not materially affect this relationship. However, after correction for the amount of time the dog was being walked each day, this relationship disappeared. No significant relationship was found between the degree of overweight of cats and the BMI of their owners.

The degree to which dogs are overweight is, in contrast to the degree to which cats are overweight, related to the BMI of their owners.

To identify examples of the ‘corporate political activity’ (CPA) of the industry producing and selling ultra-processed food and drink products (UPP) in Latin America and the Caribbean.

Searches were conducted on the national websites and social media accounts of large industry actors. Coding was deductive and based on a framework for classifying the CPA of the food industry.

Fifteen countries in Latin America and the Caribbean.

Twelve members of the International Food and Beverage Alliance (IFBA) and major trade associations and chambers of commerce in the region.

During the current pilot study, more than 200 examples of CPA were found in Latin America and the Caribbean. The UPP industry lobbied governments during the development of national health policies. UPP companies tried to build alliances with health professionals, but also with communities where they operated and with policy makers. In addition, the UPP industry fought against regulation in court and proposed weaker alternatives to public health policies, such as self-regulation.

Food systems in low- and middle-income countries, including in Latin America and the Caribbean, are increasingly penetrated by the UPP industry. These countries are at risk of being influenced by the CPA strategies described in the present study. There is a need to further identify, monitor and evaluate the impact of these CPA strategies on public health policies and public opinion in the region, in order to develop mechanisms to effectively prevent such interference.

The aim of this paper is to describe the source and the scope of social inequalities in infant feeding practices. It examines the extent to which different recommendations are followed in different social groups and highlights the main factors influencing the total adherence to three recommendations at the population level.

The study follows a representative sample (n = 2103) of the children born in 1998 in the province of Québec (Canada). Detailed information on breast-feeding and complementary feeding was collected at 5 and 17 months by face-to-face interviews with the mother. The independent variables were mother's age, mother's education level, poverty level, family type, socio-economic status (SES) and living area. Odds ratios (adjusted for baby's rank in the family, birth weight and premature birth) are presented for breast-feeding, and for formula and cows' milk consumption, at different ages. The adherence to a combined indicator cumulating three recommendations (breast-fed at birth, complementary food at 4 months or later and cows' milk at 9 months or later) is also presented.

The analysis indicates that adherence to the recommendations is low in Québec. Breast-feeding initiation, duration and its exclusivity improved with mother's age and education level and SES. Adherence to the different recommendations was interrelated, indicating an accumulation of bad nutritional circumstances for children in low-SES families. The odds of being fed in accordance with the three studied recommendations, when living in a family with the highest SES, was 2.3 times higher than when living in a family with the lowest SES. When living with a highly educated mother, the odds ratio was 2.7 times higher than when living with a low-educated mother. For mother's age, the odds ratio reached 3.7 for children from mothers aged ≥35 years, in comparison with children from mothers ≤24 years old. When SES or mother's education level was combined with mother's age, the children in the best situation were >8 more times likely than the least privileged children to be fed in accordance with these recommendations. Living area was not related with infant feeding during the first year of life

Breast-feeding and nutrition could be related with different health and cognitive outcomes in childhood and later in life. Consequently, social disparities in diet during infancy could play a role in the development of social and health inequalities more broadly observed at the population level. Intervention to improve adherence to breast-feeding and nutrition recommendations in infancy should be prioritised and evaluated for its impact on the reduction on infant diet inequalities over time

Food insecurity, lack of access to food due to financial constraints, is highly associated with poor health outcomes. Households dependent on social assistance are at increased risk of experiencing food insecurity, but food insecurity has also been reported in households reporting their main source of income from employment/wages (working households). The objective of the present study was to examine the correlates of food insecurity among households reliant on employment income.

Working households reporting food insecurity were studied through analysis of the Canadian Community Health Survey, 2007–2008, employing descriptive statistics and logistic regression. Food insecurity was measured using the Household Food Security Survey Module; all provinces participated.

Canada.

Canadian households where main income was derived through labour force participation. Social assistance recipients were excluded.

For the period 2007–2008, 4 % of working households reported food insecurity. Canadian households reliant on primary earners with less education and lower incomes were significantly more likely to experience food insecurity; these differences were accentuated across some industry sectors. Residence in Quebec was protective. Working households experiencing food insecurity were more likely to include earners reporting multiples jobs and higher job stress. Visible minority workers with comparable education levels experienced higher rates of food insecurity than European-origin workers.

Reliance on employment income does not eliminate food insecurity for a significant proportion of households, and disproportionately so for households with racialized minority workers. Increases in work stress may increase the susceptibility to poor health outcomes of workers residing in households reporting food insecurity.

Community kitchens have been implemented by communities as a public health strategy to prevent food insecurity through reducing social isolation, improving food and cooking skills and empowering participants. The aim of the present paper was to investigate whether community kitchens can improve the social and nutritional health of participants and their families.

A systematic review of the literature was conducted including searches of seven databases with no date limitations.

Community kitchens internationally.

Participants of community kitchens across the world.

Ten studies (eight qualitative studies, one mixed-method study and one cross-sectional study) were selected for inclusion. Evidence synthesis suggested that community kitchens may be an effective strategy to improve participants’ cooking skills, social interactions and nutritional intake. Community kitchens may also play a role in improving participants’ budgeting skills and address some concerns around food insecurity. Long-term solutions are required to address income-related food insecurity.

Community kitchens may improve social interactions and nutritional intake of participants and their families. More rigorous research methods, for both qualitative and quantitative studies, are required to effectively assess the impact of community kitchens on social and nutritional health in order to confidently recommend them as a strategy in evidence-based public health practice.

Because farmers’ markets include a variety of fruits and vegetables, shopping at farmers’ markets would likely improve diet quality among low-income consumers, as well as promote sustainable direct farm-to-consumer business models. However, not much is known about how to promote farmers’ market shopping among low-income consumers. Therefore, the purpose of the present paper was to examine barriers to and facilitators of shopping at farmers’ markets and associations between shopping at farmers’ markets and self-reported dietary behaviours (fruit and vegetable, sugar-sweetened beverage and fast-food consumption) and BMI.

Cross-sectional analyses of associations between farmers’ market shopping frequency, awareness of markets, access to markets, dietary behaviours and BMI.

Department of Social Services, Pitt County, eastern North Carolina, USA.

Between April and July 2013, Supplemental Nutrition Assistance Program (SNAP) participants (n 205) completed a quantitative survey.

Barriers to shopping at farmers’ markets included does not accept SNAP/electronic benefit transfer, out of the way and lack of transportation. Farmers’ market shopping was associated with awareness of farmers’ markets (estimate =0·18 (se 0·04), P<0·001). Fruit and vegetable consumption was positively associated with farmers’ market shopping (estimate =1·06 (se 0·32), P=0·001).

Our study is one of the first to examine SNAP participants’ farmers’ market shopping, distance to farmers’ markets and dietary behaviours. Barriers to shopping at farmers’ markets and increasing awareness of existing markets should be addressed in future interventions to increase SNAP participants’ use of farmers’ markets, ultimately improving diet quality in this high-risk group.

The objective of the present work was to cross-sectionally examine and compare dietary behaviours and home food environments by young adults’ living situation.

Using data from Project EAT (Eating Among Teens)-II, a large diverse youth cohort originally sampled in Minnesota, linear regression was used to examine self-reported meal frequency, dietary intake and home food availability outcomes by living situation (i.e. living with parents, renting an apartment/house or living on a college campus).

Young adults (n 1687), mean age 20·5 years.

Results suggested that young adults living with their parents or in rented apartments/houses had less frequent meals, poorer dietary intake and less healthy home food availability compared with those living on campus. These findings were evident even after controlling for sociodemographic factors (e.g. race/ethnicity, socio-economic status), particularly among females.

Although few emerging adults consume diets that are consistent with national recommendations, those living with parents and in rented apartments/houses may represent particularly at-risk groups. These differences in dietary factors across living situations appear to exist beyond the sociodemographic differences in these populations. Effective nutrition and healthy eating promotion strategies are needed for young adults.

The USA and Canada both want to reduce social health inequalities in their population. These two countries have recently begun a process of harmonization of their nutrient recommendations.

To develop a standardized indicator to measure the impact of these recommendations on the health of different social groups in North America. The authors have compared three of the methods currently used for measuring overall diet quality for a population.

The three methods, adjusted to the 1990 Canadian nutrition recommendations, were used to analyse the Québec Nutrition Survey data collected by Santé Québec in 1990.

The authors found that the indicator developed by Kennedy and collaborators works best for analysing the Québec data. Moreover, it allows comparisons with the USA. Some questions, such as whether or not to add calories from alcohol consumption to the model and whether the indicators should be adjusted to the different cultures and specific population groups remain unanswered.

In order to determine the role of nutrition in social health inequalities, it is important to develop standard indicators that are suitable for monitoring the relationship between dietary recommendations and eating habits.

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

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

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

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

To describe issues related to energy requirements of free living adults and discuss the importance of basal metabolic rate (BMR) and their relationships to total energy expenditure (TEE ) and physical activity level (PAL, derived as TEE/BMR) and to determine the influence of body weight, height, age and sex.

Based on a review of the literature, this paper examines the variability in BMR due to methodology, ethnicity, migration and adaptation (both metabolic and behavioural) due to changes in nutritional status. Collates and compiles data on measurements of TEE in free living healthy adults, to arrive at limits and to compare TEE of populations with different life-styles.

The constancy of BMR and its validity as a reliable predictor of TEE in adults as well as the validity of PAL as an index of TEE adjusted for BMR and thus its use to categorise the physical activity pattern and lifestyle of an individual was confirmed. The limits of human daily energy expenditure at around 1.2×BMR and 4.5×BMR based on measurements made in free living adults have been reported in the literature. A large and robust database now exists of energy expenditure measurements obtained by the doubly labelled water method in the scientific literature and the data shows that, in general, levels of energy expenditure are similar to the recommendations for energy requirements adopted by FAO/WHO/UNU (1985). The review also confirms that metabolic adaptation to energy restriction is not an important factor that needs to be considered when recommending energy requirements for adults in developing countries.

To estimate the extent of under- and over-reporting, to examine associations with misreporting and sociodemographic and lifestyle characteristics and mental health status and to identify differential reporting in micro- and macronutrient intake and quality of diet.

A health and lifestyle questionnaire and a semi-quantitative FFQ were completed as part of the 2007 Survey of Lifestyle, Attitudes and Nutrition. Energy intake (EI) and intake of micro- and macronutrients were determined by applying locally adapted conversion software. A dietary score was constructed to identify healthier diets. Accuracy of reported EI was estimated using the Goldberg method. ANOVA, χ2 tests and logistic regression were used to examine associations.

Residential households in Ireland.

A nationally representative sample of 7521 adults aged 18 years or older.

Overall, 33·2 % of participants were under-reporters while 11·9 % were over-reporters. After adjustment, there was an increased odds of under-reporting among obese men (OR = 2·01, 95 % CI 1·46, 2·77) and women (OR = 1·68, 95 % CI 1·23, 2·30) compared to participants with a healthy BMI. Older age, low socio-economic status and overweight/obesity reduced the odds of over-reporting. Among under-reporters, the percentage of EI from fat was lower and overall diet was healthier compared to accurate and over-reporters. The reported usage of salt, fried food consumption and snacking varied significantly by levels of misreporting.

Patterns in differential reporting were evident across sociodemographic, lifestyle and mental health factors and diet quality. Consideration should be given to how misreporting affects nutrient analysis to ensure sound nutritional policy.

To show that nutrition science, with its application to food and nutrition policy, now needs a new conceptual framework. This will incorporate nutrition in its current definition as principally a biological science, now including nutritional aspects of genomics. It will also create new governing and guiding principles; specify a new definition; and add social and environmental dimensions and domains.

A narrative review of nutrition science, its successes and achievements, and its dilemmas, paradoxes, shortcomings, dissonances and challenges. Reference is made to 16 associated papers. Equal use is made of continuous text and of boxed texts that extend the review and give salient examples.

Recent and current interrelated electronic and genomic discoveries and linked sequential demographic, nutritional and epidemiological shifts, in the context of associated and interlinked global social, cultural, environmental, economic, political and other developments, altogether amount to a world in revolution, requiring all disciplines including that of nutrition science to make comparably radical responses.

Nutrition in principle and practice should be a biological and also an environmental and social science. This new broad integrated structure brings much recent and current progressive work into the centre of nutrition science, and in some ways is a renewal of the period when nutrition science had its greatest impact. It amounts to a map charting well-known and also new worlds. The new nutrition science is concerned with personal and population health, and also with planetary health – the welfare and future of the whole physical and living world of which humans are a part. In this way the discipline will make a greater contribution to the preservation, maintenance, development and sustenance of life on Earth, appropriate for the twenty-first century.

To evaluate the impact of nutrition education in kindergartens and to promote healthy dietary habits in children.

Prospective cohort study. Four kindergartens with 1252 children were randomized to the intervention group and three with 850 children to the control group. The personal nutritional knowledge, attitudes and dietary behaviours of the parents were also investigated. Each month, children and parents in the intervention group participated in nutrition education activities. The main outcome measures were anthropometrics and diet-related behaviours of the children and the nutritional knowledge and attitudes of the parents at baseline, 6 months (mid-term) and 1 year (post-test). Baseline demographic and socio-economic characteristics were also collected.

Seven kindergartens from Hefei, the capital city of Anhui Province, eastern China.

Two thousand one hundred and two 4- to 6-year-old pre-schoolers from seven kindergartens participated.

The prevalence of children’s unhealthy diet-related behaviours decreased significantly and good lifestyle behaviours increased in the group receiving nutrition education compared with controls. Parental eating habits and attitudes to planning their children’s diets also changed appreciably in the intervention group compared with the control group (P < 0·05). However, there were no statistically significant differences in children’s height, weight, height-for-age Z-score or weight-for-age Z-score between the two groups.

Kindergarten-based nutrition education improves pre-schoolers’ lifestyle behaviours and brings about beneficial changes in parents’ attitudes to planning their children’s diets and their own personal eating habits.

To assess attributions for overweight and the level of support for policy initiatives in Great Britain.

Cross-sectional. Respondents indicated their agreement (5-point scales: strongly disagree to strongly agree) to three potential causes of overweight (environment, genes, willpower) and five policies (free weight-loss treatment, taxing unhealthy foods, healthy lifestyle campaigns, food labelling, advertising restrictions).

Data were collected as part of a computer-assisted, face-to-face Omnibus survey of adults (aged >15 years) from across Great Britain in April 2012 carried out by a market research company.

A population-representative sample of British adults (n 1986).

More people attributed overweight to the food environment (61 %) and lack of willpower (57 %) than to genes (45 %). Policy support was highest for healthy lifestyle campaigns (71 %) and food labelling (66 %), and lowest for taxing unhealthy foods (32 %). Food environment attributions were associated with higher support for all policies (P < 0·001). Genetic attributions were associated with higher support for free weight-loss treatments and healthy lifestyle campaigns (P < 0·001), but not other policies. Attributions to lack of willpower were not associated differentially with support for any policies (P > 0·01).

Belief that overweight is caused by the food environment or genes – both seen as outside individual control – was associated with greater support for government policies to prevent and treat obesity. Improving awareness of the multiple causes of obesity could facilitate acceptance of policy action to reduce obesity prevalence.

To assess participants’ acquaintance with and willingness to try healthful food alternatives, and to test the psychometric properties of an adapted Dutch version of the Food Neophobia Scale (FNS) in order to study the role of food neophobia in this context.

A cross-sectional study incorporating two web-based questionnaires, including a retest of the FNS one week later. Measures included acquaintance with and willingness to try 15 healthful food alternatives, level of food neophobia, level of education, gender and age. Multiple linear regression analyses were used to study associations between demographics and level of food neophobia as well as associations between level of food neophobia and acquaintance with and willingness to try the healthful alternatives.

The study was conducted in The Netherlands using a representative Internet panel.

A total of 326 participants aged 18–50 years participated.

Internal consistency and test–retest reliability of the FNS version used were sufficient. On average participants were acquainted with 7.9 of the products and modestly willing to try the products. Lowly educated participants had significantly higher FNS scores than highly educated participants (β = −0.23, P < 0.01). FNS score was significantly associated with acquaintance with (β = −0.21, P < 0.001) and willingness to try the healthful alternatives (β = −0.26, P < 0.001).

Further research into the role of food neophobia is warranted when wanting to stimulate the integration of healthful alternative products in the daily diet, especially among persons with low education.

To assess levels of and identify factors associated with food insecurity on the Navajo Nation.

A cross-sectional study was conducted utilizing the ten-item Radimer/Cornell food insecurity instrument. Sociodemographic, psychosocial and anthropometric data were collected.

Navajo Nation, USA.

Two hundred and seventy-six members of the Navajo Nation were randomly selected at food stores and other community locations.

Of the sample, 76·7 % had some level of food insecurity. Less education (mean years of schooling: P = 0·0001; non-completion of higher education: P = 0·0003), lower full-time employment rates (P = 0·01), and lower material style of life (P = 0·0001), food knowledge (P = 0·001) and healthy eating self-efficacy (P < 0·0001) scores were all positively associated with food insecurity. Perceived expensiveness (P < 0·0001) and perceived inconvenience (P = 0·0001) of healthy choices were also positively associated with food insecurity.

Food insecurity rates on the Navajo Nation are the highest reported to date in the USA and are likely attributable to the extremely high rates of poverty and unemployment. Reducing food insecurity on the Navajo Nation will require increasing the availability of affordable healthy foods, addressing poverty and unemployment, and providing nutrition programmes to increase demand.

To specify the principles, definition and dimensions of the new nutrition science.

To identify nutrition, with its application in food and nutrition policy, as a science with great width and breadth of vision and scope, in order that it can fully contribute to the preservation, maintenance, development and sustenance of life on Earth.

A brief overview shows that current conventional nutrition is defined as a biological science, although its governing and guiding principles are implicit only, and no generally agreed definition is evident. Following are agreements on the principles, definition and dimensions of the new nutrition science, made by the authors as participants at a workshop on this theme held on 5–8 April 2005 at the Schloss Rauischholzhausen, Justus-Liebig University, Giessen, Germany.

Nutrition science as here specified will retain its current [classical] identity as a biological science, within a broader and integrated conceptual framework, and will also be confirmed as a social and environmental science. As such it will be concerned with personal and population health, and with planetary health – the welfare and future of the whole physical and living world of which humans are a part.

To examine the contribution of selected child-, maternal- and household-related factors to child undernutrition across two different age groups of Kenyan under-5s.

Demographic and Health Survey data, multistage stratified cluster sampling methodology.

Rural and urban areas of Kenya.

A total of 1851 children between the ages of 0 and 24 months and 1942 children between the ages of 25 and 59 months in Kenya.

Thirty per cent of the younger children were stunted, 13 % were underweight and 8 % were wasted. Forty per cent of the older children were stunted, 17 % were underweight and 4 % were wasted. Longer breast-feeding duration, small birth size, childhood diarrhoea and/or cough, poor maternal nutritional status and urban residence were associated with higher odds of at least one form of undernutrition, while female gender, large birth size, up-to-date immunization, higher maternal age at first birth, BMI and education level at the time of the survey and higher household wealth were each associated with lower odds of at least one form of undernutrition among Kenyan children. The more proximal child factors had the strongest impact on the younger group of children while the intermediate and more distal maternal and household factors had the strongest impact on child undernutrition among the older group of children.

The present analysis identifies determinants of undernutrition among two age groups of Kenyan pre-school children and demonstrates that the contribution of child, maternal and household factors on children's nutritional status varies with children's age.

To describe how Indigenous Peoples understand how to enhance use of their food systems to promote sustainability, as demonstrated in several food-based interventions.

Comments contributed by partners from case studies of Indigenous Peoples and their food systems attending an international meeting were implemented with public health interventions at the community level in nine countries.

The Rockefeller Foundation Bellagio Conference Center in Bellagio, Italy, where experiences from case studies of Indigenous Peoples were considered and then conducted in their home communities in rural areas.

Leaders of the Indigenous Peoples’ case studies, their communities and their academic partners.

Reported strategies on how to improve use of local food systems in case study communities of Indigenous Peoples.

Indigenous Peoples’ reflections on their local food systems should be encouraged and acted upon to protect and promote sustainability of the cultures and ecosystems that derive their food systems. Promoting use of local traditional food biodiversity is an essential driver of food system sustainability for Indigenous Peoples, and contributes to global consciousness for protecting food biodiversity and food system sustainability more broadly. Key lessons learned, key messages and good practices for nutrition and public health practitioners and policy makers are given.