To investigate the prevalence and sociodemographic determinants of household-level mother–child double burden (MCDB) of malnutrition in Bangladesh.

The analysis was done using Bangladesh Demographic and Health Survey 2014 data. Multivariable logistic regression identified the sociodemographic factors associated with double-burden households.

Nationally representative cross-sectional survey.

A total of 5951 households were included in the analysis.

A coexistence of overweight or obese mother and underweight or stunted or wasted child (OWOBM/USWC) was found in 6·3 % households. The prevalence of overweight or obese mother and underweight child (OWOBM/UWC) was 3·8 %, of overweight or obese mother and stunted child (OWOBM/STC) was 4·7 %, and of overweight or obese mother and wasted child (OWOBM/WSC) was 1·7 %. Mother’s age 21–25 years at first birth, middle wealth index group, having two or three children and having four or more children showed statistically significant (P<0·05) associations with OWOBM/UWC. Households with mother’s age 21–25 years at first birth, middle wealth index group, no exposure to information media, having two or three children and having four or more children had higher odds of OWOBM/STC and OWOBM/USWC which were statistically significant (P<0·05). Delivery of child through caesarean section was significantly associated with OWOBM/USWC (P<0·05).

Although the prevalence of MCDB of malnutrition in Bangladesh is low, prevention programmes must consider the nutrition concerns of the entire household to prevent future risks. Such programmes also need to be tagged with family planning and increasing awareness through social and behaviour change counselling and exposure to information media.

To identify and monitor food industry use of political practices during the adoption of nutrition warning labels (WL) in Colombia.

Document analysis of publicly available information triangulated with interviews.

Colombia.

Eighteen key informants from the government (n 2), academia (n 1), civil society (n 12), the media (n 2) and a former food industry employee (n 1).

In Colombia, the food industry used experts and groups funded by large transnationals to promote its preferred front-of-pack nutrition labelling (FOPL) and discredit the proposed warning models. The industry criticised the proposed WL, discussing the negative impacts they would have on trade, the excessive costs required to implement them and the fact that consumers were responsible for making the right choices about what to eat. Food industry actors also interacted with the government and former members of large trade associations now in decision-making positions in the public sector. The Codex Alimentarius was also a platform through which the industry got access to decision-making and could influence the FOPL policy.

In Colombia, the food industry used a broad range of political strategies that could have negatively influenced the FOPL policy process. Despite this influence, the mandatory use of WL was announced in February 2020. There is an urgent need to condemn such political practices as they still could prevent the implementation of other internationally recommended measures to improve population health in the country and abroad, nutrition WL being only of them.

The present study aimed to review the association of conjugated linoleic acid (CLA) consumption in two forms, foods enriched in CLA and CLA supplements, with serum lipid profile in human studies.

Systematic review and meta-analysis.

Search process was conducted in PubMed, Cochrane Library, Google Scholar, Scopus and Science Direct. Clinical trials that investigated the association of CLA intakes either in the form of supplements or enriched foods with lipid profile in healthy adults were included. All outcomes were recorded as continuous variables, and the effect size was measured by analysis of the mean and standard deviation before and after the intervention for case and control groups.

Healthy adult population.

CLA supplementation was associated with a significant decrease in LDL cholesterol (mean difference=−0·218; 95 % CI −0·358, −0·077; P=0·002), a non-significant decrease in HDL cholesterol (mean difference=−0·051; 95 % CI −0·188, 0·086; P=0·468), a non-significant increase in total cholesterol (mean difference=0·009; 95 % CI −0·128, 0·146; P=0·896) and a non-significant decrease in TAG (mean difference=−0·065; 95 % CI −0·20, 0·07; P=0·344). Foods enriched with CLA were associated with significantly decreased LDL cholesterol (mean difference=−0·231; 95 % CI −0·438, −0·024; P=0·028), non-significantly increased HDL-C (mean difference=0·075; 95 % CI −0·121, 0·270; P=0·455), non-significantly decreased total cholesterol (mean difference=−0·158; 95 % CI −0·349, 0·042; P=0·124) and non-significantly decreased TAG (mean difference=−0·078; 95 % CI −0·274, 0·117; P=0·433).

According to our analysis, consumption of foods enriched with CLA or CLA supplements has favourable effects on LDL cholesterol levels.

FFQ are often used to estimate food and nutrient intakes to rank individuals by their level of intake. We evaluated the relative validity of a semi-quantitative FFQ created for use in Tanzania by comparing it with two 24 h diet recalls.

We measured relative validity of the FFQ with deattenuated energy-adjusted rank correlations for nutrients, deattenuated rank correlations for food groups, and performed a cross-classification analysis of energy-adjusted nutrient quartiles using percentage of agreement and Bland–Altman analysis.

Interviews were conducted in 2014 in participants’ homes in Ukonga, Dar es Salaam, Tanzania.

We surveyed 317 adults aged 40 years or older from the general public.

Deattenuated energy-adjusted rank correlation coefficients of nutrients ranged from −0·03 for riboflavin to 0·41 for percentage of energy from carbohydrates, with a median correlation of 0·21. Coefficients for food groups ranged from 0·00 for root vegetables to 0·51 for alcohol, with a median of 0·35. Relative to the average of the two 24 h diet recalls, the FFQ overestimated energy intake and intakes of all nutrients and food groups, other than tea, with ratios among nutrients ranging from 1·34 for SFA to 7·08 for vitamin A; and among food groups from 0·92 for tea to 9·00 for fruit. The percentage of participants classified into the same nutrient intake quartile ranged from 23 % for SFA to 32 % for both niacin and pantothenic acid, with a median of 28 %.

The FFQ performed moderately well in urban Tanzanian adults.

The KIDMED questionnaire was published in 2004 to evaluate adherence to the Mediterranean diet (MD) in children and adolescents. In the last 14 years, several respected official dietetics and health organizations have recommended appropriate dietary habits, including eating whole grains and consuming whole fruit rather than fruit juice. We propose an update of the KIDMED questionnaire.

Based on the scientific evidence, the present commentary suggests some changes to the KIDMED questionnaire.

We suggest deleting ‘or fruit juice’ from the first question of the questionnaire, rewording the question as ‘Takes a fruit every day’, and assigning a positive value of +1. We suggest adding ‘whole-grain’ to the eighth question of the questionnaire, rewording the question as ‘Consumes whole-grain pasta or whole-grain rice almost every day (5 or more times per week)’, and assigning a positive value of +1. Further, we propose to add ‘whole cereals or whole grains’ to the ninth question of the questionnaire, reword the question as ‘Has whole cereals or whole grains (whole-meal bread, etc.) for breakfast’, and assign a positive value of +1.

The present commentary examines some signs of a paradigm shift about fruit juice and whole grains after the development of the KIDMED questionnaire. The changes are of paramount importance in order to make the questionnaire an updated tool to evaluate adherence to the MD.

In Mali, an estimated 73% of pregnant women are anaemic largely due to iron deficiency. National policy recommends women to take iron and folic acid supplements daily from first prenatal contact until 3 months postpartum. However, many pregnant women in Mali could benefit from multiple micronutrient supplements.

To assess pregnant women's acceptability of and adherence to a daily multiple micronutrient supplementation scheme compared with the current daily iron and folic acid supplementation scheme.

Seventy pregnant women were allocated to either the daily multiple micronutrient or daily iron and folic acid supplementation scheme. Women started receiving supplements at the end of the first trimester of pregnancy until delivery and throughout the first 3 months postpartum.

No significant differences were observed between comparison groups with respect to women's perceptions about supplement size, colour, taste or flavour. Adherence to the multiple micronutrient supplementation scheme was better (257.5±20.9 tablets; average adherence 95.4%) than that to the iron and folic acid supplementation scheme (238.5±32.7 tablets; average adherence 92.2% P = 0.008) although both were very good, as were women's perceptions about the benefits of micronutrient supplements to their health and that of their newborns.

Malian women adhere to prenatal/postpartum micronutrient supplementation – no matter what supplement is chosen – when access to supplements is guaranteed and when they are provided with minimum, consistent and easily understandable information and counselling, indicating that these are key elements to ensure effective programmes. These findings, together with those of the global research agenda on the efficacy of multiple micronutrient supplements for pregnant women, will inform policy development in Mali for the effective control of iron deficiency and iron-deficiency anaemia in pregnant women.

To examine energy intakes (El), their ratio to estimated basal metabolic rate (BMRest) and the contribution of food groups to energy intake in the North/South Ireland Food Consumption Survey.

Random sample of adults from the populations of Northern Ireland and the Republic of Ireland. Food intake data were collected using a 7-day food diary. Body weight and height were measured and EI/BMRest was calculated from reported energy intake and estimated basal metabolic rate. Dieting practices were assessed as part of a self-administered questionnaire.

Mean energy intake in men was 11.0 MJ and in women was 7.6 MJ, which is comparable to reported energy intakes in Northern Ireland and the Republic of Ireland over a decade ago. Mean EI/BMRest was 1.38. This increased to 1.42 after the exclusion of dieters and those who were unwell, but still remained less than the established cut-off of 1.53. EI/BMRest was significantly (P < 0.05) higher in men than in women and decreased significantly (P < 0.05) with increasing BMI in both sexes. The four food groups that contributed 50% of energy in men and women were meat and meat products, breads and rolls, potatoes and potato products, and biscuits, cakes, pastries and puddings.

Energy intakes have not changed remarkably in Northern Ireland or the Republic of Ireland in the last 10 years, but the mean EI/BMRest of 1.38 suggests that energy underreporting occurred. EI/BMRest was lower in women and in the overweight/obese. Additional multivariate analysis of the data is needed to identify more clearly subgroups of the population reporting lower than expected energy intakes and to evaluate the effect of low energy reporting on the consumption of various foods and food groups.

To investigate nutrition literacy among adult grocery buyers regarding energy-related labelling terms on food packaging.

Qualitative interviews and quantitative surveys to determine shoppers’ understanding of energy terms (‘energy’, ‘calories’ and ‘kilojoules’) and how energy terms affect perceptions of healthiness and intentions to purchase breakfast cereals, muesli bars and frozen meals.

Individual in-depth interviews and surveys in two metropolitan supermarkets, Sydney, Australia.

Australian adults (interview n 40, survey n 405) aged 18–79 years.

The relationship between energy and perceived healthiness of food varied by product type: higher energy breakfast cereals were perceived to be healthier, while lower energy frozen meals were seen as healthier choices. Likewise, intentions to purchase the higher energy product varied according to product type. The primary reason stated for purchasing higher energy products was for sustained energy. Participants from households of lower socio-economic status were significantly more likely to perceive higher energy products as healthier. From the qualitative interviews, participants expressed uncertainty about their understanding of kilojoules, while only 40 % of participants in intercept surveys correctly answered that kilojoules and calories measured the same thing.

Australian consumers have a poor understanding of energy and kilojoules and tend to perceive higher energy products as healthier and providing sustained energy. This has implications regarding the usefulness of industry front-of-pack labelling initiatives and quick service restaurant menu labelling that provides information on energy content only. Comprehensive and widely communicated education campaigns will be essential to guide consumers towards healthier choices.

To assess the reliability and validity of an FFQ to evaluate dietary patterns of Na consumption among low-income and low-literacy Brazilian hypertensive subjects.

The initial FFQ was submitted to content analysis with the pre-test administered to fifteen subjects. Reliability was evaluated according to the reproducibility criterion, with interviewer administration of the FFQ twice within a 15 d interval. Validity was assessed against a 24 h recall (132 subjects), a 3 d diet record (121 subjects) and a biomarker (24 h urinary Na; 121 subjects). To test the correlation with the biomarker, discretionary salt was added to the FFQ Na values.

A large urban teaching hospital in south-eastern Brazil.

The study was based on 132 randomly selected subjects (eighty-three women and forty-nine men) aged 18 to 85 years.

Kappa coefficients ranged from 0·79 to 0·98, confirming the reproducibility of the FFQ. There was no correlation between urinary Na excretion, the FFQ and the 24 h recall for the general sample, although significant correlations had been observed when methods were summed up (24 h recall + discretionary salt + FFQ; 0·32, P = 0·01). The addition of discretionary salt significantly improved the biomarker-based FFQ validity, with correlation coefficients varying from 0·19 (general sample) to 0·31 (female sub-sample).

The developed FFQ demonstrated satisfactory evidence of validity and reliability and can be used as an important complementary tool for the evaluation of Na intake among Brazilian hypertensive subjects.

To examine the association between fast-food consumption, diet quality and body weight in a community sample of working adults.

Cross-sectional and prospective analysis of anthropometric, survey and dietary data from adults recruited to participate in a worksite nutrition intervention. Participants self-reported frequency of fast-food consumption per week. Nutrient intakes and diet quality, using the Healthy Eating Index-2010 (HEI-2010), were computed from dietary recalls collected at baseline and 6 months.

Metropolitan medical complex, Minneapolis, MN, USA.

Two hundred adults, aged 18–60 years.

Cross-sectionally, fast-food consumption was significantly associated with higher daily total energy intake (β=72·5, P=0·005), empty calories (β=0·40, P=0·006) and BMI (β=0·73, P=0·011), and lower HEI-2010 score (β=−1·23, P=0·012), total vegetables (β=−0·14, P=0·004), whole grains (β=−0·39, P=0·005), fibre (β=−0·83, P=0·002), Mg (β=−6·99, P=0·019) and K (β=−57·5, P=0·016). Over 6 months, change in fast-food consumption was not significantly associated with changes in energy intake or BMI, but was significantly inversely associated with total intake of vegetables (β=−0·14, P=0·034).

Frequency of fast-food consumption was significantly associated with higher energy intake and poorer diet quality cross-sectionally. Six-month change in fast-food intake was small, and not significantly associated with overall diet quality or BMI.

Elderly people may be at particular risk of Zn deficiency due to an increased prevalence of malnutrition. The aim of the present study was to evaluate the Zn status in community-living elderly people at risk of malnutrition.

Cross-sectional population-based survey. Individuals at risk of malnutrition were identified by the Malnutrition Universal Screening Tool. Zn status was assessed by measuring serum Zn. Logistic regression was performed to evaluate the association between the risk of malnutrition and Zn deficiency.

Municipality of Tromsø, Norway.

Random sample of 743 men and 778 women aged 65–87 years.

Zn deficiency was found in 10·1 % of the participants, including 13·1 % of the men and 7·3 % of the women. Among the men and women at risk of malnutrition, 31·0 % and 12·7 %, respectively, had Zn deficiency. In a model adjusted for age, gender, serum albumin and smoking status, Zn deficiency was positively associated with the risk of malnutrition (OR=2·2; 95 % CI 1·3, 3·6).

Overall, Zn deficiency was found in one out of ten community-living elderly people and was associated with the risk of malnutrition. Our results encourage the assessment of Zn status in elderly people at risk of malnutrition, with a special emphasis on elderly men.

To examine whether nutrient and food intakes among South Asian adult immigrants differ by length of residence in the USA.

Cross-sectional analysis to examine differences in nutrient and food intakes by length of residence in the USA. Dietary data were collected using an interviewer-administered, culturally appropriate FFQ, while self-reported length of residence was assessed using a questionnaire and modelled as tertiles.

The Mediators of Atherosclerosis in South Asians Living in America (MASALA) study.

Eight hundred and seventy-four South Asians (mean age=55 (sd 9) years; 47 % women; range of length of residence in the USA=2–58 years), part of the baseline examination of the MASALA study.

Intakes of fat, including saturated and trans fats, dietary cholesterol and n-6 fatty acids, were directly associated with length of residence, while intakes of energy, carbohydrate, glycaemic index and load, protein, dietary fibre, folate and K were inversely associated with length of residence (P trend <0·05). A longer length of residence in the USA was also associated with higher intakes of alcoholic beverages, mixed dishes including pizza and pasta, fats and oils, and lower intakes of beans and lentils, breads, grains and flour products, milk and dairy products, rice, starchy vegetables and sugar, candy and jam (P for differences across groups <0·05).

Length of residence in the USA influences diet and nutrient intakes among South Asian adult immigrants and should be considered when investigating and planning dietary interventions to mitigate chronic disease risk.

The objective was to develop a Finnish Children Healthy Eating Index (FCHEI), to determine the relative validity of the index and to examine associations between the index and familial sociodemographic and lifestyle characteristics.

Cross-sectional samples of children participating in a population-based birth cohort study in Finland.

Type I Diabetes Prediction and Prevention (DIPP) Study cohort.

Three-day food records from 1-year-old (n 455), 3-year-old (n 471) and 6-year-old (n 713) children were completed between 2003 and 2005.

Validity of the FCHEI was assessed by studying the associations between the FCHEI and nutrient intakes of the children. Among all age groups, intakes of SFA and sugars decreased across increasing quartiles of the FCHEI while intakes of PUFA, dietary fibre, vitamin D and vitamin E increased. Among 3- and 6-year-olds, being cared for at home was associated with the lowest FCHEI quartile (diet that deviates most from the recommendations). The lowest FCHEI quartile was also associated with residence in a semi-urban area among the 3-year-olds and low maternal education and smoking during pregnancy among the 6-year-olds.

The FCHEI serves as a valid indicator of the quality of Finnish children's diet. Public health programmes aimed at improving the dietary behaviours of pre-school aged children should aim to improve the quality of food served at home. Families with history of lower parental education, maternal smoking during pregnancy or non-urban place of residence may require special attention.

To investigate Irish consumers’ use and understanding of and their belief in nutrition and health (NH) claims in the context of the European Union (EU) legislation (Regulation no. 1924/2006), which permits a number of NH claims on food products.

An interview-assisted questionnaire was administered to consumers (n 400). Preference for three types of NH claims across six products was tested. Perception of NH claims was assessed across a further eight food products. Claims were categorised as content, structure–function and disease–risk factor reduction claims.

Six supermarkets in the Republic of Ireland.

Four hundred adult Irish supermarket consumers.

Older (P < 0·001), female (P < 0·01) consumers were more likely to seek NH claims. Structure–function and content claims were preferred across six products. Consumers’ perception was associated with the health benefit claimed rather than with the strength of the claim itself. Preference for claim type and claim perception differed with gender, age and educational level.

Irish consumers prefer content and simpler NH claims rather than more complex disease–risk factor reduction claims. The food industry may thus be better served using these types of claims. Although the reported levels of understanding were high, evidence of positivity bias and misinterpretation was found. Thus, with regard to Regulation 1924/2006, consumers need more information on both simpler and more complex claims. Public health messages should be targeted according to gender, age and educational level.

To determine the number of 24 h dietary recalls required to adequately estimate nutrient intake in overweight and obese adults using the US Department of Agriculture's (USDA) automated multiple-pass method (AMPM). In addition, the study quantified sources of variation in dietary intake, such as day of the week, season, sequence of diet interviews (training effect), diet interviewer, body weight and within- and between-subject variances in the intake of selected nutrients.

Adults having a BMI of ≥ 28 but <38 kg/m2 were included in the study. The USDA's AMPM was used to obtain 24 h dietary recalls every 10 d for 6 months. Dietary intake data were analysed to adequately estimate the number of 24 h recalls necessary to assess nutrient intake. Variance component estimates were made by using a mixed-model procedure.

The greater Washington, DC, metropolitan area.

Adults (34 men and 39 women) aged 35–65 years.

Overweight and obese adults completed fourteen 24 h dietary recalls. Utilizing within- and between-subject variances requires 5–10 and 12–15 d of 24 h dietary recalls in men and women, respectively, to estimate energy and macronutrient intakes in a 6-month period. Within- and between-subject variances were the major contributors to variance in nutrient intakes. Day of the week, season, sequence, diet interviewer and body weight had little impact on variance.

This information is valuable for researchers planning to conduct studies on free-living individuals that include the collection of dietary intake data.

To assess milk feeding on the maternity ward and during infancy, and their relationship to sociodemographic determinants. The validity of our 3-month questionnaire in measuring hospital feeding was assessed.

A prospective Finnish birth cohort with increased risk to type 1 diabetes recruited between 1996 and 2004. The families completed a follow-up form on the age at introduction of new foods and age-specific dietary questionnaires.

Type 1 Diabetes Prediction and Prevention (DIPP) project, Finland.

A cohort of 5993 children (77 % of those invited) participated in the main study, and 117 randomly selected infants in the validation study.

Breast milk was the predominant milk on the maternity ward given to 99 % of the infants. Altogether, 80 % of the women recalled their child being fed supplementary milk (donated breast milk or infant formula) on the maternity ward. The median duration of exclusive breast-feeding was 1·4 months (range 0–8) and that of total breast-feeding 7·0 months (0–25). Additional milk feeding on the maternity ward, short parental education, maternal smoking during pregnancy, small gestational age and having no siblings were associated with a risk of short duration of both exclusive and total breast-feeding. In the validation study, 78 % of the milk types given on the maternity ward fell into the same category, according to the questionnaire and hospital records.

The recommendations for infant feeding were not achieved. Infant feeding is strongly influenced by sociodemographic determinants and feeding practices on the maternity wards. Long-term breast-feeding may be supported by active promotion on the maternity ward.

The effect on individual rankings and total intakes of nutrients of correcting total fruit and vegetable frequencies from a long food frequency questionnaire (FFQ) using the responses to two summary questions was examined in a group of women.

The performance of a self-administered FFQ in ranking individual levels of intake and estimating absolute levels of nutrient and energy intake was compared with the performance of the questionnaire when it was corrected for fruit and vegetable intake reported using the Block summary questions.

The study population included 123 women, aged between 18 and 54 years, who were recruited from the Family Planning Association Colposcopy Clinic in Sydney.

Substantial and significant differences (P<0.001) were found in fruit and vegetable intakes between the FFQ and the summary questions. Intake frequency by the FFQ was more than double that by the summary questions. When the FFQ was corrected for fruit and vegetable intakes using the summary questions, the intakes of beta-carotene, vitamins A and C, and dietary fibre were more than 20% lower (P<0.001) than the uncorrected results. However, this had little effect on ranking individuals. This study also examined seasonal differences in vegetable intakes and differences in nutrient intakes when either summer or winter vegetable consumption was substituted for seasonal vegetable intake in the FFQ. Although there were seasonal differences for some foods, the substitution had little effect on intake of nutrients.

These results indicate that important differences in intakes are observed when two methods, which appear to yield the same results, are used. Further work is needed to determine which, if either, of the two methods yields intakes that can be compared quantitatively with national references for assessing the adequacy of population intakes.

To evaluate the relative validity of a food frequency questionnaire (FFQ) for assessing nutrient intakes in 6-month-old infants.

The FFQ was developed to assess the diets of infants born to women in the Southampton Women’s Survey (SWS), a population-based survey of young women and their offspring. The energy and nutrient intakes obtained from an interviewer-administered FFQ were compared with those obtained from a 4-day weighed diary.

A sub-sample of 50 infants aged 6 months from the SWS had their diets assessed by both methods. The FFQ recorded the frequencies and amounts of milks, baby foods, regular foods and drinks consumed by the infants over the previous seven days. The diaries recorded the weights of all foods and drinks consumed by the infants on four separate days within 15 days following FFQ completion.

Spearman rank correlation coefficients for intakes of energy, macronutrients and 18 micronutrients, determined by the two methods, ranged from r = 0·39 to 0·86; adjustment for energy intake tended to increase the correlation coefficients, range ra = 0·55 to 0·89. Bland–Altman statistics showed that mean differences between methods were in the range of −12·5 % to +12·5 % except for vitamin B12 (−18·9 %).

Although there were differences in absolute energy and nutrient intakes between methods, Spearman rank correlation coefficients indicated reasonable agreement in the ranking of intakes. The interviewer-administered FFQ is a useful tool for assessing energy and nutrient intakes of healthy infants aged about 6 months.

To investigate the differences in acculturation experiences between parent and adolescent refugees from the Horn of Africa in Melbourne, Australia and to explore food beliefs and perceived health risks from an intergenerational perspective.

Qualitative cross-sectional study involving a combination of semi-structured one-on-one interviews and focus group discussions.

North-West suburbs of Melbourne, Australia.

Eritrean, Ethiopian, Somali and Sudanese refugees.

Using a purposeful sampling technique, twelve semi-structured face-to-face interviews (nine adults and three adolescents) and four in-depth focus groups (two with adolescents each containing six participants and two with adults one containing six participants and the other ten participants) were carried out. Thus overall data were obtained on fifteen adolescents and twenty-five parents. Qualitative analysis identified differences between parents and adolescents in relation to lifestyle, diet and physical activity. Views regarding health consequences of their changed diets also differed. Parental feeding practices encompassed a variety of methods and were enforced in an attempt by parents to control their children's dietary behaviours and prevent their drift away from traditional eating habits.

These findings call for more research to contextualise dietary acculturation among refugee youth and the impact of migration on parenting styles and feeding practices in communities from the Horn of Africa. Preventive health programmes with Horn of Africa refugees need to acknowledge the effect of acculturation on diet and physical activity levels and a socio-cultural framework needs to be developed with respect to the importance and influence of the family environment.

To study the dynamics of childhood overweight and the influence of dietary intake on tracking of overweight.

A follow-up study conducted in China.

Ninety-five overweight children, 6–13 years old, identified from 1455 children at baseline, were followed over a 2-year period.

Data on anthropometry and 3-day dietary intake were collected at baseline and during follow-up. Overweight was defined using the International Obesity Task Force reference of body mass index (BMI)-for-age. Differences between groups were tested using analysis of variance and Cochran-Mantel-Haenszel tests.

Of the 95 overweight children, 36.8% remained overweight 2 years later (‘tracking group’). Urban boys were the three times more likely than rural boys to remain overweight (63.2% vs. 21.9%). At baseline, the tracking group had higher BMI, body weight and fat intake (% of energy), and lower carbohydrate intake (% of energy), than the non-tracking group (who shifted from overweight to not overweight); they were more likely to have a high-fat or high-meat diet, but less likely to have a diet high in carbohydrate or vegetables and fruit. During the follow-up, the tracking group increased fat intake and reduced carbohydrate intake while the non-tracking group did not; and they also grew slower in height but faster in weight. Tracking of overweight seemed to be related to tracking of high-meat (relative risk (RR) 2.4, 95% confidence interval (CI) 1.0–5.6, P < 0.05) and high-fat (RR 1.5, 95% CI 0.9–2.5, P < 0.1) diets.

Considerable changes in children's overweight status during childhood and adolescence were observed in China, a transitional society. Dietary patterns, particularly dietary composition, seemed to influence the tracking patterns of overweight.