Our goal was to assess the potential for evaluating strengths of the Awajún traditional food system using dietary assessment, a traditional food diversity score and ranking of local foods.

The method was used for dietary data obtained from mothers and children in the Awajún culture of the Peruvian Amazon where >90% of the dietary energy is derived from local, traditional food. Traditional food diversity scores were calculated from repeat 24-hour recalls. Group mean intakes of energy, fat, protein, iron, vitamin A and vitamin C from each food item were used to rank foods by nutrient contribution.

The study took place in six remote communities along the lower Cenepa River in the Amazonas District of Peru, South America.

Dietary data were collected from 49 Awajún mothers and 34 children aged 3–6 years, representative of the six communities.

Higher traditional food diversity was associated with greater protein, fibre, vitamin and mineral intakes when controlling for energy (partial correlations = 0.37 to 0.64). Unique sources for iron, total vitamin A and vitamin C were found in the Awajún traditional food system.

A traditional food diversity score was a useful tool for predicting nutrient adequacy for the Awajún. Promotion of the Awajún traditional food system should focus on dietary diversity and unique nutrient-dense local foods.

To review the literature on bisphenol A (BPA) exposure and obesity in human populations.

Systematic review of the literature via searches of PubMed, EMBASE, Web of Science and reference lists for articles published to 1 August 2014.

China, Italy, Japan, Republic of Korea, Sweden, UK, USA.

Adults (≥18 years).

Eighteen articles were identified and included in the review. Twelve studies included secondary evaluations of BPA exposure and BMI, and six studies evaluated body composition as the primary outcome. All analyses were cross-sectional and no study included in the review received a positive quality rating (twelve negative, six neutral). Eight studies observed a statistically significant positive association between urinary or serum BPA levels and BMI, and ten studies observed no association. Studies where BMI was a primary outcome and studies of neutral quality were more likely to observe an association.

Study results are conflicting and significant methodological issues limit the ability to draw conclusions from these studies. Prospective studies that measure BPA exposure and changes in body weight and composition are needed to establish temporality, causality and the direction of any observed associations.

To estimate the prevalence of physical activity and sedentary behaviours in European children, and to evaluate the relationship between media availability in personal space and physical activity in relation to total screen time.

Data from the baseline IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) cross-sectional survey. Information on hours of television/digital video disk/video viewing and computer/games-console use (weekday and weekend days), media device availability in personal space, sports club membership, hours of active organized play and commuting (to and from school) were assessed via a self-reported parental questionnaire. Total screen time was defined as the sum of daily media use and subsequently dichotomized into meeting or not meeting the guidelines of the American Academy of Pediatrics.

Eight survey centres (Italy, Estonia, Cyprus, Belgium, Sweden, Germany, Hungary and Spain).

Children (n 15 330; 51 % males) aged 2–10 years.

Percentage of children engaged in total screen time for >2 h/d was higher on weekend days (52 % v. 20 % on weekdays) and in the older group (71 % in males; 57 % in females), varying by country. Children with a television set in their bedroom were more likely not to meet the screen time recommendations (OR = 1·54; 95 % CI 1·60, 1·74).

Approximately a third of the children failed to meet current screen time recommendations. Availability of a television set in personal space increased the risk of excess total screen time. This information could be used to identify potential targets for public health promotion actions of young population groups.

To assess sociodemographic correlates of micronutrient intakes from food and dietary supplements in an urban, ethnically diverse sample of pregnant women in the USA.

Cross-sectional analyses of data collected using a validated semi-quantitative FFQ. Associations between racial, ethnic and sociodemographic factors and micronutrient intakes were examined using logistic regression controlling for pre-pregnancy BMI, maternal age and smoking status.

Prenatal clinics, Boston, MA, USA.

Analyses included pregnant women (n 274) in the PRogramming of Intergenerational Stress Mechanisms (PRISM) study, an urban longitudinal cohort designed to examine how stress influences respiratory health in children when controlling for other environmental exposures (chemical stressors, nutrition).

High frequencies of vitamin E (52 %), Mg (38 %), Fe (57 %) and vitamin D (77 %) inadequacies as well as suboptimal intakes of choline (95 %) and K (99 %) were observed. Factors associated with multiple antioxidant inadequacies included being Hispanic or African American, lower education and self-reported economic-related food insecurity. Hispanics had a higher prevalence of multiple methyl-nutrient inadequacies compared with African Americans; both had suboptimal betaine intakes and higher odds for vitamin B6 and Fe inadequacies compared with Caucasians. Nearly all women (98 %) reported Na intakes above the tolerable upper limit; excessive intakes of Mg (35 %), folate (37 %) and niacin (38 %) were also observed. Women reporting excessive intakes of these nutrients were more likely Caucasian or Hispanic, more highly educated, US-born and did not report food insecurity.

Racial/ethnic and other sociodemographic factors should be considered when tailoring periconceptional dietary interventions for urban ethnic women in the USA.

Food-insecure populations employ multiple strategies to ensure adequate household food supplies. These strategies may increase the risk of overweight and obesity. However, existing literature reports conflicting associations between these strategies and BMI. The objective of the present study was to examine whether food insecurity and strategies for managing food insecurity are associated with BMI in adults.

In 2005, RTI International and Project Bread conducted a representative survey of 435 adult residents of low-income census tracts in Massachusetts. Food insecurity was assessed using the US Department of Agriculture’s eighteen-item Household Food Security Module.

The prevalence of overweight and obesity was 51 % and 25 %, respectively. After adjusting for age, sex, sociodemographic characteristics and food insecurity, both participation in the Food Stamp Program (FSP) and participation in any federal nutrition programme 12 months prior to the survey were each associated with an approximate 3·0 kg/m2 higher adult BMI. In the subset of current FSP participants (n 77), participation for ≥6 months was associated with an 11·3 kg/m2 lower BMI compared with participation for <6 months. Respondents who consumed fast foods in the previous month had a mean BMI that was 2·4 kg/m2 higher than those who did not. Food insecurity was not associated with BMI after adjustment for sociodemographic characteristics and FSP participation.

Participation in federal nutrition programmes and consumption of fast food were each associated with higher adult BMI independent of food insecurity and other sociodemographic factors. However, prolonged participation in the FSP was associated with lower BMI.

The purpose of the present study was to evaluate the effects of a school-based, 2-year, multi-component intervention on BMI, eating and physical activity behaviour in Flanders, Belgium, targeting children aged 3–6 years in communities of high and low socio-economic status (SES).

Cluster-randomized controlled trial.

Thirty-one pre-primary and primary schools in three different intervention communities and three paired-matched (on SES profile) control communities in Flanders, Belgium.

BMI Z-scores at baseline and follow-up were calculated for 1102 children. Questionnaires with sociodemographic data and FFQ were available from 694 of these 1102 children.

No significant effects were found on BMI Z-scores for the total sample. However, there was a significant decrease in BMI Z-score of 0·11 in the low-SES intervention community compared with the low-SES control community, where the BMI Z-score increased by 0·04 (F = 6·26, P = 0·01). No significant intervention effects could be found for eating behaviour, physical activity or screen-time. There were no significant interaction effects of age and gender of the children on the outcome variables.

Although no significant effects were found for BMI Z-scores in the total sample, this intervention had a promising effect in the low-SES community of reducing excess weight gain among young children.

To evaluate habitual levels of physical activity in a nationally representative sample of adults in Ireland.

Cross-sectional survey using a self-administered questionnaire. Usual levels of work, recreational and household activities were evaluated in relation to anthropometric, demographic and socio-economic characteristics. The amount and intensity of all activities were quantified by assigning metabolic equivalents (METS) to each activity.

Republic of Ireland and Northern Ireland, 1997–1999.

Random sample of 1379 adults aged 18–64 years.

Men were approximately twice as active in work and recreational activity (139.7 ± 83.9 METS) as women (68.5 ± 49.8 METS; P < 0.001), but women were three times more active in household tasks (65.9 ± 58.7 METS vs. 22.6 ± 24.6 METS; P < 0.001). Overall levels of physical activity declined with increasing age, particularly leisure activity in men. In women the decline in work activity was offset by spending more time in household pursuits. Twenty-five per cent of the subjects were extremely overweight (body mass index (BMI) > 28kg m−2) or obese (BMI > 30kg m−2). Fewer obese subjects reported higher levels of work and leisure activities. However, a higher percentage of obese women reported participation in the higher levels of household activities. Participation rates in recreational activities were low. Walking was the most important leisure activity of both men (41%) and women (60%). In terms of hours per week spent in vigorous physical activity, men were more active than women, professional and skilled non-manual women were more active than women in other social classes, and younger subjects (aged 18–35 years) were more active than older subjects.

The holistic approach used in the assessment of physical activity in this study has revealed important and subtle differences in the activity patterns of men and women. Failure to fully characterise the respective activity patterns of men and women could lead to ill-informed public health policy aimed at promoting and sustaining lifetime habits of physical activity. The results suggest that simple population-focused programmes to promote physical activity are unlikely to offer the same chance of long-term success as more sensitive and individualised strategies.

To assess overweight and related risk factors among urban low socio-economic status (SES) African-American adolescents in an attempt to study the underlying causes of ethnicity and gender disparities in overweight.

Cross-sectional data collected on anthropometric measures, diet, physical activity and family characteristics from 498 students in grades 5–7 in four Chicago public schools were analysed to study the risk factors for overweight using stepwise regression analysis.

Only 37.2% of the students lived with two parents. Nearly 90% had a television (TV) in their bedroom, and had cable TV and a video game system at home. Overall. 21.8% (17.7% boys versus 25.1% girls) were overweight (body mass index (BMI) ≥ 95th percentile); and 39.8% had a BMI ≥ 85th percentile. Compared with national recommendations, they had inadequate physical activity and less than desirable eating patterns. Only 66.1% reported having at least 20 min vigorous exercise or 30 min of light exercise in ≥ 5 days over the past 7 days; 62.1% spent >3 h days− 1 watching TV/playing video games/computer, while 33.1% spent ≥ 5 h days− 1. Their vegetable and fruit consumption was low, and they consumed too many fried foods and soft drinks: 55.1% consumed fried food twice or more daily and 19.5% four times or more daily; 70.3% consumed soft drinks twice or more daily and 22.0% four times or more daily on average. Gender, physical activity and pocket money were significant predictors of overweight (P < 0.05).

Several factors in the students' behaviours, school and family environments may increase overweight risk among this population. There is a great need for health promotion programmes with a focus on healthy weight and lifestyle, and targeting urban low-SES minority communities.

To evaluate the impact of the Baby-Friendly Hospital Initiative (BFHI) on breast-feeding initiation and duration overall and according to maternal education.

Quasi-experimental study using data from five states (Alaska, Maine, Nebraska, Ohio, Washington) that participated in the Pregnancy Risk Assessment Monitoring System from 1999 to 2009. Using differences-in-differences models that included year and hospital fixed effects, we compared rates of breast-feeding initiation and duration (any and exclusive breast-feeding for ≥4 weeks) before and after BFHI accreditation between mothers who gave birth in hospitals that were accredited or became accredited and mothers from matched non-BFHI facilities. We stratified analyses into lower and higher education groups.

Thirteen BFHI hospitals and nineteen matched non-BFHI facilities across five states in the USA.

Mothers (n 11 723) who gave birth in BFHI hospitals and mothers (n 13 604) from nineteen matched non-BFHI facilities.

Although we did not find overall differences in breast-feeding initiation between birth facilities that received BFHI accreditation compared with non-Baby-Friendly facilities (adjusted coefficient = 0·024; 95 % CI −0·00, 0·51), breast-feeding initiation increased by 3·8 percentage points among mothers with lower education who delivered in Baby-Friendly facilities (P = 0·05), but not among mothers with higher education (adjusted coefficient = 0·002; 95 % CI −0·04, 0·05). BFHI accreditation also increased exclusive breast-feeding for ≥4 weeks by 4·5 percentage points (P = 0·02) among mothers with lower education who delivered in BFHI facilities.

By increasing breast-feeding initiation and duration among mothers with lower education, the BFHI may reduce socio-economic disparities in breast-feeding.

To evaluate FFQ estimates of dietary intake of individual antioxidants, fruit and vegetables in comparison to plasma concentrations of each antioxidant, and to determine which individual foods are associated with plasma antioxidant concentrations.

Dietary (α-carotene, β-carotene, β-cryptoxanthin, lutein/zeaxanthin, lycopene, retinol, and vitamin E) intakes over 12 months were estimated from a 121-item FFQ. Correlation coefficients, corrected for within-person variability in diet and plasma antioxidants, were used to examine associations between antioxidant concentrations in diet and plasma.

Melbourne Collaborative Cohort Study (MCCS).

Men and women (n 3110) who were randomly selected from the MCCS. Participants were aged 36–72 years and were born in Australia, Greece, Italy or the UK.

Correlation coefficients for the carotenoids ranged from 0·28 for lycopene to 0·46 for β-cryptoxanthin. There was no association between dietary and plasma retinol or dietary vitamin E with plasma α- and γ-tocopherol. Individual plasma carotenoid concentrations were associated with intakes of fruit and vegetables.

Our data suggest that the FFQ provides useful information on intakes of each of the carotenoids: α-carotene, β-carotene, β-cryptoxanthin, lycopene and lutein/zeaxanthin. There was no association between diet and plasma markers of retinol or vitamin E; this may reflect the importance of factors other than intake in modifying circulating levels of these nutrients.

To fulfil a comprehensive approach to consumption, which is necessary to characterise food habits and their relationship to diseases, using a diet quality index (DQI) developed for a Mediterranean region (Med-DQI).

A cross-sectional nutritional survey provided the data for the construction of the DQI.

A representative sample made up of 964 subjects from a French Mediterranean area, Hérault département.

Foods such as olive oil, fish and cereals were used instead of nutrients to build up scores which constructed the Med-DQI. Biochemical analysis identified biomarkers used to validate the Med-DQI. Correspondence factorial analysis illustrated the characteristics of subjects with different scores given by the Med-DQI.

The subjects could be satisfactorily classified by the Med-DQI. The oldest age, less educated, overweight, manual workers, living in a rural area and male classes showed a better Med-DQI. For women, they were also from the oldest age class, but some of them were from the upper social class, with an ideal BMI and lived by the Mediterranean shore. A composite biomarker index, based on plasma carotene and vitamin E levels and the percentage of EPA and DHA in erythrocytes membranes, can identify subjects with good and poor Med-DQI.

Med-DQI G is a good instrument to identify groups at risk with regard to nutritional quality. Subjects with α+β-carotene levels > 1 mg/l, vitamin E > 30 mg/l, EPA > 0.65% and DHA > 4% of fatty acids in erythrocytes are likely to have a good diet.

To examine associations between grandmothers’ knowledge and infant and young child feeding (IYCF) practices and to test whether the associations are independent of or operate via maternal knowledge.

Cross-sectional household survey data from households with a child under 5 years (n 4080). We used multivariate regression analyses, adjusted for child, maternal, grandmother and household characteristics, and district-level clustering, to test associations between grandmothers’ knowledge and IYCF practices for children aged 6–24 months living with a grandmother. We used causal mediation to formally test the direct effect of grandmothers’ knowledge on IYCF practices v. maternal knowledge mediating these associations.

Two hundred and forty rural communities, sixteen districts of Nepal.

Children aged 6–24 months (n1399), including those living with grandmothers (n 748).

We found that the odds of optimal breast-feeding practices were higher (early breast-feeding initiation: 2·2 times, P=0·002; colostrum feeding: 4·2 times, P<0·001) in households where grandmothers had correct knowledge v. those with incorrect knowledge. The same pattern was found for correct timing of introduction of water (2·6), milk (2·4), semi-solids (3·2), solids (2·9), eggs (2·6) and meat (2·5 times; all P<0·001). For the two pathways we were able to test, mothers’ correct knowledge mediated these associations between grandmothers’ knowledge and IYCF practices: colostrum feeding (b=10·91, P<0·001) and the introduction of complementary foods (b=5·18, P<0·001).

Grandmothers’ correct knowledge translated into mothers’ correct knowledge and, therefore, optimal IYCF practices. Given grandmothers’ influence in childcare, engagement of grandmothers in health and nutrition interventions could improve mothers’ knowledge and facilitate better child feeding.

To examine (i) the prevalence of and associations between breast-feeding initiation and continuation by maternal diabetes status and (ii) the reasons for not initiating and/or continuing breast-feeding by maternal diabetes status.

Secondary data analyses of a population-based cross-sectional study were conducting using data from the US Centers for Disease Control and Prevention’s Pregnancy Risk Assessment Monitoring System (PRAMS), 2009–2011. Multivariable logistic regression was used to investigate the associations between breast-feeding initiation and continuation by diabetes status.

Thirty states and New York City, USA.

Mothers of recently live-born infants, selected by birth certificate sampling.

Among 72755 women, 8·8 % had gestational diabetes mellitus (GDM) and 1·7 % had pregestational diabetes mellitus (PDM). Breast-feeding initiation was similar among GDM and no diabetes mellitus (NDM) women (80·8 % v. 82·2 %, respectively, P=0·2), but continuation was lower among GDM (65·7 % v. 68·8 %, respectively, P=0·01). PDM women had lower initiation and continuation compared with NDM (78·2 %, P=0·03 and 60·4 %, P<0·01, respectively). In adjusted analyses, current smoking status was a significant effect modifier for initiation, but not for continuation.

Differences in breast-feeding initiation and continuation prevalence by maternal diabetes status may reflect differences in prenatal education, indicating the need for increased efforts among PDM women. Additionally, non-smoking women with PDM or GDM would benefit from additional breast-feeding education.

To describe the average consumption of carbohydrate-providing food groups among study centres of the European Prospective Investigation into Cancer and Nutrition (EPIC).

Of the 27 redefined EPIC study centres, 19 contributed subjects of both genders and eight centres female participants only (men, n=13 031; women, n=22924, after exclusion of subjects under 35 and over 74 years of age from the original 36 900 total). Dietary data were obtained using the 24-hour recall methodology using the EPIC-SOFT software. The major sources of dietary carbohydrate were identified, and 16 food groups were examined.

The 10 food groups contributing most carbohydrate were bread; fruit; milk and milk products; sweet buns, cakes and pies; potato; sugar and jam; pasta and rice; vegetables and legumes; crispbread; and fruit and vegetable juices. Consumption of fruits as well as vegetables and legumes was higher in southern compared with northern centres, while soft drinks consumption was higher in the north. Italian centres had high pasta and rice consumption, but breakfast cereal, potato, and sweet buns, cakes and pies were higher in northern centres. In Sweden, lower bread consumption was balanced with a higher consumption of crispbread, and with sweet buns, cakes and pies. Overall, men consumed higher amounts of vegetables and legumes, bread, soft drinks, potatoes, pasta and rice, breakfast cereal and sugar and jam than women, but fruit consumption appeared more frequent in women.

The study supports the established idea that carbohydrate-rich foods chosen in northern Europe are different from those in the Mediterranean region. When comparing and interpreting diet–disease relationships across populations, researchers need to consider all types of foods.

To document knowledge, attitudes, beliefs and eating habits of health professionals with respect to obesity, nutrition and weight management.

A self-complete questionnaire postal survey.

Primary care and dietetic practice in Scotland.

A systematic stratified sample of 2290 subjects incorporated general practitioners (n = 1400), practice nurses (n = 613) and all practising dietitians (n = 360) who were members of the British Dietetic Association.

The overall response rate was 65%. All professionals showed a clear understanding of nutrition and health. Understanding of obesity as a disease and of the effectiveness of weight management using low-energy diets was limited. Below 10% had carried out audit to determine the incidence of obesity and overweight, and most were uncertain about their own effectiveness in delivering weight management advice.

This study confirms that health professionals have some knowledge of nutrition and weight management but are unclear how to deliver effective weight management advice. Further training is justified to ensure the effective provision of nutritional advice to patients.

Young children's knowledge about healthy food may influence the formation of their eating behaviours, and parents have a major influence on the development of children's knowledge in the early years.

We investigated the extent to which parental nutrition knowledge and attitudes around food predicted young children's knowledge of healthy foods, controlling for other influences such as socio-economic status (SES) and parent education levels in a cross-sectional research design. Children were given a healthy food knowledge activity and parents completed questionnaires.

Twenty primary schools in Adelaide, Australia, stratified by SES.

We recruited 192 children aged 5–6 years and their parents.

Structural equation modelling showed that parent nutrition knowledge predicted children's nutrition knowledge (r = 0·30, P < 0·001) independently of attitudes, SES and education level.

Nutrition education for parents, targeted at low-SES areas at higher risk for obesity, may contribute to the development of healthy food knowledge in young children.

To describe the diet of a population of pregnant Finnish women over a period of 7 years, with special attention paid to seasonal fluctuations in food consumption and nutrient intake.

A validated 181-item FFQ was applied retrospectively, after delivery, to assess the maternal diet during the 8th month of pregnancy.

Type 1 Diabetes Prediction and Prevention Nutrition Study Cohort.

The cohort comprised a total of 4880 women who had newly delivered during the years 1997–2004, with the offspring carrying increased genetic risk for type 1 diabetes mellitus.

Over the study period, the proportion of energy derived from fat decreased while the intake from protein and carbohydrate increased. The intake of vitamin D increased from food sources. Seasonal variation was observed in the mean daily consumption of vegetables, fruits and berries and cereals. Intake of dietary fibre, total fat, MUFA, vitamins A, D, E and C, folate and iron also showed seasonal fluctuation.

These results show an overall positive trend in the diet of pregnant Finnish women through the study years. However, there is still room for improvement, particularly in the types of dietary fats. Although food fortification with vitamin D since 2003 was reflected in the increased intake of vitamin D from foods, the mean intake levels still fell below the recommendations. Seasonal changes in food consumption were observed and related to corresponding fluctuations in nutrient intakes. The mean folate intake fell below the recommendation throughout the year.

In some high-income countries, a sizeable proportion of households are estimated to be food insecure. It is well known that food insecurity varies between countries and is strongly tied to household income level. The local environment may be another level of influence, which has been relatively understudied. The present review sought to synthesize and critically appraise the existing literature examining local environmental characteristics in relation to individual/household-level food insecurity in the general population.

A systematic search strategy was used to search MEDLINE, MEDLINE In-process and Other Non-indexed, EMBASE, PsychINFO, Social Services Abstracts and Sociological Abstracts databases for studies examining local place characteristic(s) in relation to self-reported food insecurity.

Studies could be experimental or observational, but had to be published in a peer-reviewed journal in French or English, and involve individuals from developed countries. ‘Place’ was defined locally, as ranging from the street to the county level.

The target population for the review included non-institutionalized individuals in the general population.

After obtaining full-text articles, eighteen primary studies met the eligibility criteria. Most studies were conducted in the USA and all but one was cross-sectional. Seven of the eleven studies that examined location of residence found that rural living was inversely associated with food insecurity. Mixed results were seen for other place measures such as social capital and distance to food stores.

Studies were heterogeneous and had various limitations that preclude definitive conclusions from being drawn. Recommendations for future research are provided.

To examine the association between complementary feeding indicators and attained linear growth at 6–23 months.

Secondary analysis of Phase V Demographic and Health Surveys data (2003–2008). Country-specific ANOVA models were used to estimate effects of three complementary feeding indicators (minimum meal frequency, minimum dietary diversity and minimum adequate diet) on length-for-age, adjusted for covariates and interactions of interest.

Twenty-one countries (four Asian, twelve African, four from the Americas and one European).

Sample sizes ranging from 608 to 13 676.

Less than half the countries met minimum meal frequency and minimum dietary diversity, and only Peru had a majority of the sample receiving a minimum adequate diet. Minimum dietary diversity was the indicator most consistently associated with attained length, having significant positive effect estimates (ranging from 0·16 to 1·40 for length-for-age Z-score) in twelve out of twenty-one countries. Length-for-age declined with age in all countries, and the greatest declines in its Z-score were seen in countries (Niger, −1·9; Mali, −1·6; Democratic Republic of Congo, −1·4; Ethiopia, −1·3) where dietary diversity was persistently low or increased very little with age.

There is growing recognition that poor complementary feeding contributes to the characteristic negative growth trends observed in developing countries and therefore needs focused attention and its own tailored interventions. Dietary diversity has the potential to improve linear growth. Using four food groups to define minimum dietary diversity appears to capture enough information in a simplified, standard format for multi-country comparisons of the quality of complementary diets.