Malnutrition is a common and relevant syndrome in elderly people due to its influence on quality of life. The main aim of the present study was to identify health determinants of malnutrition or risk of malnutrition.

Cross-sectional study collecting information on sociodemographic and health factors (co-morbidity, cognitive or affective problems, prescription medication use, frailty status, self-rated health) as determinants of nutritional status, assessed by the short form of the Mini Nutritional Assessment.

Forty-three senior centres from Galicia (north-western Spain) participated to recruit participants.

A representative community-dwelling sample of 749 elderly people aged ≥65 years.

Of the total participants, 14·3 % were malnourished/at risk of malnutrition. Presence of overweight or obesity, depressive symptoms, polypharmacy (use of five or more prescription medications), presence of pre-frailty or frailty status and poor self-rated health showed the strongest relationship to malnutrition/risk of malnutrition. This model predicted 86·0 % of the cases correctly. The best determinants for women were polypharmacy and poor self-rated health, reaching 82·8 % of cases of malnourishment/risk of malnutrition predicted correctly. In men, the main determinants were overweight or obesity, depressive symptomatology and polypharmacy, with 89·8 % of cases of malnourishmen/risk of malnutrition predicted correctly.

Screening for nutritional status and its determinant factors should be included as part of comprehensive assessments to ensure an early screening of malnutrition and to propose possible intervention strategies that would be important for both elderly people and the health-care system.

Nutrition information aims to reduce information asymmetries between manufacturers and consumers. To date, however, it remains unclear how nutrition information that is shown on the front of the packaging should be designed in order to increase both visual attention and the tendency to make healthful food choices. The present study aimed to address this gap in research.

An experimental laboratory study applying mobile eye-tracking technology manipulated the presence of two directive cues, i.e. health marks and traffic light colour-coding, as part of front-of-package nutrition information on actual food packages.

Participants wore mobile eye-tracking glasses during a simulated shopping trip. After the ostensible study had finished, they chose one snack (from an assortment of fifteen snacks) as a thank you for participation. All products were labelled with nutrition information according to the experimental condition.

Consumers (n 160) who were mainly responsible for grocery shopping in their household participated in the study.

The results showed that, in the absence of traffic light colouring, health marks reduced attention to the snack food packaging. This effect did not occur when the colouring was present. The combination of the two directive cues (v. presenting traffic light colours only) made consumers choose more healthful snacks, according to the nutrient profile.

Public policy makers may recommend retailers and manufacturers implement consistent front-of-pack nutrition labelling that contains both health marks and traffic light colouring as directive cues. The combination of the cues may increase the likelihood of healthful decision making.

To summarise our present knowledge on the Mediterranean diet in secondary prevention of CHD.

Review of literature.

Adult coronary patients.

CHD patients at high risk of cardiac death.

The two main causes of death in these patients are sudden cardiac death (SCD) and chronic heart failure (CHF). The main mechanism underlying recurrent cardiac events is coronary thrombosis resulting from atherosclerotic plaque erosion or ulceration. The occurrence of thrombosis is usually associated with plaque weakness in relation to high lipid content of the lesion where cholesterol only represents a very small part compared with other lipids (i.e. fatty acids). Thus, the three main aims of the preventive strategy are to prevent coronary thrombosis, malignant ventricular arrhythmia and the development of left ventricular dysfunction (and CHF) and finally to minimise the risk of plaque erosion and ulceration. There is now a consensus about recommending the Mediterranean diet pattern for the secondary prevention of CHD because no other dietary pattern has been successfully tested so far in these patients. The most important aspect, in contrast with the pharmacological prevention of CHD (including cholesterol lowering), is that the Mediterranean diet results in a striking effect on survival.

The traditional Mediterranean diet is effective in reducing both coronary atherosclerosis/thrombosis and the risk of fatal complications such as SCD and heart failure.

There is some evidence that plasma insulin levels might influence ovarian cancer risk. Glyacemic index (GI) and glycaemic load (GL) are measures that allow the carbohydrate content of individual foods to be classified according to their postprandial glycaemic effects and hence their effects on circulating insulin levels. Therefore, we examined ovarian cancer risk in association with GI and GL, and intake of dietary carbohydrate and sugar.

The study was conducted in a prospective cohort of 49 613 Canadian women enrolled in the National Breast Screening Study (NBSS) who completed a self-administered food-frequency questionnaire (FFQ) between 1980 and 1985. Linkages to national mortality and cancer databases yielded data on deaths and cancer incidence, with follow-up ending between 1998 and 2000. Data from the FFQ were used to estimate overall GI and GL, and Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between energy-adjusted quartile levels of GL, overall GI, total carbohydrates, total sugar and ovarian cancer risk.

During a mean 16.4 years of follow-up, we observed 264 incident ovarian cancer cases. GI and total carbohydrate and sugar intakes were not associated with ovarian cancer risk in the total cohort. GL was positively associated with a 72% increase in risk of ovarian cancer (HR = 1.72, 95% CI = 1.13–2.62, Ptrend = 0.01) and the magnitude of the association was slightly greater among postmenopausal (HR = 1.89, 95% CI = 0.98–3.65, Ptrend = 0.03) than among premenopausal women (HR = 1.64, 95% CI = 0.95–2.88, Ptrend = 0.07).

Our data suggest that consumption of diets with high GL values may be associated with increased risk of ovarian cancer.

The present study aimed to examine the trends and differentials in key breast-feeding indicators in Nigeria for the period 1999–2013.

Longitudinal study of trends (1999–2013) in optimal feeding practices using a series of population-based Nigerian Demographic and Health Surveys. Trends in socio-economic, health service and individual characteristics associated with key breast-feeding indicators were examined using multilevel regression analyses.

Nigeria.

Children (n 88 152) aged under 24 months (n 8199 in 1999; n 7620 in 2003; n 33 385 in 2008; n 38 948 in 2013).

Among educated mothers, there was an increase in prevalence of exclusive breast-feeding (26 % in 1999 to 30 % in 2013) and predominant breast-feeding (27 % in 1999 to 39 % in 2013) compared with mothers with no schooling. A similar increasing trend was evident for mothers from wealthier households and mothers who had a higher frequency of health service access compared with mothers from poorer households and women who reported no health service access, respectively. Mothers with no schooling predominantly breast-fed, but the odds for bottle-feeding were higher among educated mothers and women from wealthier households. The odds for early initiation of breast-feeding were lower for mothers who reported no health service contacts and mothers of lower socio-economic status.

Significant increasing trends in key breast-feeding indicators were evident among mothers with higher socio-economic status and mothers who had more health service access in Nigeria. Broader national and sub-national policies that underpin nursing mothers in work environments and a comprehensive community-based approach are proposed to improve feeding practices in Nigeria.

Epidemiological studies have shown that adults tend to underestimate their weight and overestimate their height. This may lead to a misclassification of their BMI in studies based on self-reported data. The aim of the present study was to assess the validity of self-reported weight and height in Austrian adults.

Data on weight, height, health behaviour and sociodemographic characteristics of adults were collected in a standardized procedure via a self-filling questionnaire and a medical examination including measurements of weight and height.

A publicly accessible out-patient clinic in southern Austria.

Austrian residents (n 473) aged 18 years and older who attended a health check participated in the study.

The mean difference between reported and measured BMI was not significant in younger adults (<35 years: mean difference −0·21 kg/m2; P < 0·08) but increased significantly with age (≥55 years: mean difference −0·68 kg/m2; P < 0·001). The prevalence of normal weight (BMI = 18·5–24·9 kg/m2) and overweight (BMI = 25·0–29·9 kg/m2) was overestimated based on the self-reported data on BMI, while that for underweight (BMI < 18·5 kg/m2) and obesity (BMI ≥ 30·0 kg/m2) was underestimated (P < 0·001). The self-reported data showed an obesity prevalence of 12·5 %, while measurement showed a prevalence of 15·4 % (P < 0·001).

Our results indicate that prevalence rates of obesity are probably underestimated for Austrian adults when using self-reported weight and height information. The deviations from the measured data clearly increased with age. Analyses based on self-reported data should therefore be adjusted for the age dependency of the validity.

To obtain projections of the prevalence of childhood malnutrition indicators up to 2030 and to analyse the changes of wealth-based inequality in malnutrition indicators and the degree of contribution of socio-economic determinants to the inequities in malnutrition indicators in Bangladesh. Additionally, to identify the risk factors of childhood malnutrition.

Cross-sectional study. A Bayesian linear regression model was used to estimate trends and projections of malnutrition. For equity analysis, slope index, relative index and decomposition in concentration index were used. Multilevel logistic models were used to identify risk factors of malnutrition.

Household surveys in Bangladesh from 1996 to 2014.

Children under the age of 5 years.

A decreasing trend was observed for all malnutrition indices. In 1990, predicted prevalence of stunting, wasting and underweight was 55·0, 15·9 and 61·8 %, respectively. By 2030, prevalence is projected to reduce to 28·8 % for stunting, 12·3 % for wasting and 17·4 % for underweight. Prevalence of stunting, wasting and underweight were 34·3, 6·9 and 32·8 percentage points lower in the richest households than the poorest households. Contribution of the wealth index to child malnutrition increased over time and the largest contribution of pro-poor inequity was explained by wealth index. Being an underweight mother, parents with a lower level of education and poorer households were the key risk factors for stunting and underweight.

Our findings show an evidence-based need for targeted interventions to improve education and household income-generating activities among poor households to reduce inequalities and reduce the burden of child malnutrition in Bangladesh.

Longitudinal research has shown that eating fruit and vegetables during childhood has a positive impact on long-term health outcome from heart disease and asthma. However, recommendations for fruit and vegetable intakes in pre-school children are not as explicit as those for adults and few data exist on actual intakes of fruit and vegetables in this particular age group.

To describe fruit and vegetable intakes in the daily diets of a sample of pre-school children in Bradford, West Yorkshire, and to compare the findings with existing national UK data.

Pre-school children aged 3 and 4 years (n = 207). All subjects attended nurseries in the Airedale and Bradford South and West regions at the time of the study.

Dietary data were collected using the pre-validated CADET (Child and Diet Evaluation Tool) diary. All children were also seen individually in order to assess their awareness and preference for a range of fruit and vegetables.

Intakes of fruit and vegetables in this sample of pre-school children were below recommended levels. Only 16% of children in this sample were successfully eating fruit and vegetables on five occasions a day and conversely 14% ate no fruit and vegetables at all. Vegetable intakes were far lower than fruit intakes with 39% of the sample consuming no vegetables. There were statistically significant differences in median fruit and vegetable intakes between children with different demographic and lifestyle variables, such as which nursery they attended and what the highest educational qualification in the household was. Children's awareness of and preferences for different fruit and vegetables significantly affected their median intakes of fruit and vegetables.

Fruit and vegetable intakes in this sample of pre-school children were far lower than the recommended levels of 5 portions a day. A greater diversity of intakes should be encouraged and these data suggest that this may be attained by increasing children's awareness by exposing them to a wider range of fruit and vegetables.

The purpose of the present paper is to assess the relationship between food insecurity and food consumption patterns, anthropometric measures and serum micronutrient levels in rural Kilimanjaro, Tanzania.

A population-based cross-sectional study was carried out between March and May of 2005.

Rural Kilimanjaro, Tanzania.

Analysis was restricted to 1014 adults aged 15–44 years with children and complete data.

A large majority of the participants (91 %) reported some kind of food insecurity. Food insecurity was significantly associated with age, marital status and occupation. Participants reporting food insecurity were significantly less likely to frequently consume animal products, fruits and vegetables compared with participants categorized as food secure. Women categorized as experiencing individual food insecurity had a larger waist circumference than food-secure women (P = 0·026) while the mean BMI of women appeared to decline if they had a child who was food insecure (P = 0·038). There were no observed differences in serum micronutrient levels by food insecurity status.

Food insecurity is highly prevalent and associated with food consumption patterns, waist circumference and BMI of women in rural Tanzania. Further studies should apply self-report measures in assessing food insecurity to larger and more diversified populations.

To explore associations of early infant feeding with (i) eating patterns in the second year of life and (ii) weight status in the fourth year of life in a prospective cohort of children in Scotland.

Growing Up in Scotland (GUS) longitudinal birth cohort study (2005–2008).

Scotland, UK.

Children aged 9–12 months (n 5217) followed through to 45–48 months.

Infant feeding was associated with eating patterns, defined by using SPSS two-step cluster analysis, in the second year of life. Children who were ever breast-fed compared with never breast-fed (adjusted OR = 1·48, 95 % CI 1·27, 1·73) were more likely to have a positive eating pattern (Cluster 2). Children who started complementary feeding at 4–5 months or 6–10 months compared with 0–3 months (adjusted OR = 1·32, 95 % CI 1·09, 1·59 or AOR = 1·50, 95 % CI 1·19, 1·89) were more likely to belong to Cluster 2. Breast-feeding was negatively associated with being overweight or obese in the fourth year of life compared with no breast-feeding (adjusted OR = 0·81, 95 % CI 0·81, 1·01). Introduction of complementary feeding at 4–5 months compared with 0–3 months was negatively associated with being overweight or obese (adjusted OR = 0·74, 95 % CI 0·57, 0·97).

Breast-feeding and introduction of complementary feeding after 4 months were associated with a positive eating pattern in the second year of life. Introduction of complementary feeding at 4–5 months compared with 0–3 months was negatively associated with being overweight or obese.

To assess the iodine status of Swiss population groups and to evaluate the influence of iodized salt as a vector for iodine fortification.

The relationship between 24 h urinary iodine and Na excretions was assessed in the general population after correcting for confounders. Single-day intakes were estimated assuming that 92 % of dietary iodine was excreted in 24 h urine. Usual intake distributions were derived for male and female population groups after adjustment for within-subject variability. The estimated average requirement (EAR) cut-point method was applied as guidance to assess the inadequacy of the iodine supply.

Public health strategies to reduce the dietary salt intake in the general population may affect its iodine supply.

The study population (1481 volunteers, aged ≥15 years) was randomly selected from three different linguistic regions of Switzerland.

The 24 h urine samples from 1420 participants were determined to be properly collected. Mean iodine intakes obtained for men (n 705) and women (n 715) were 179 (sd 68·1) µg/d and 138 (sd 57·8) µg/d, respectively. Urinary Na and Ca, and BMI were significantly and positively associated with higher iodine intake, as were men and non-smokers. Fifty-four per cent of the total iodine intake originated from iodized salt. The prevalence of inadequate iodine intake as estimated by the EAR cut-point method was 2 % for men and 14 % for women.

The estimated prevalence of inadequate iodine intake was within the optimal target range of 2–3 % for men, but not for women.

The main objective was to assess iodine status (thyroid volume (Tvol) and urinary iodine concentration (UIC)) and their determinants in Saharawi refugee women.

A cross-sectional survey was performed during January–February 2007. Tvol was measured by ultrasound and iodine concentration was analysed in spot urine samples and in household drinking water. Anthropometry and Hb concentration were measured and background variables were collected using pre-coded questionnaires.

The survey was undertaken in four long-term refugee camps in the Algerian desert.

Non-pregnant women (n 394), 15–45 years old, randomly selected.

Median (25th percentile–75th percentile (P25–P75)) UIC was 466 (294–725) μg/l. Seventy-four per cent had UIC above 300 μg/l and 46 % above 500 μg/l. Median (P25–P75) Tvol was 9·4 (7·4–12·0) ml and the goitre prevalence was 22 %. UIC was positively associated with iodine in drinking water and negatively associated with breast-feeding, and these two variables explained 28 % of the variation in UIC. The mean (sd) Hb level was 11·8 (2·4) g/dl. In total 46 % were anaemic with 14 %, 25 % and 7 %, classified with respectively mild, moderate and severe anaemia.

The Saharawi women had high UIC, high levels of iodine in drinking water and increased Tvol and probably suffered from iodine-induced goitre. The high prevalence of anaemia is considered to be a severe public health concern. To what extent the excessive iodine intake and the anaemia have affected thyroid function is unknown and should be addressed in future studies.

To assess the dependence on fish consumption of families and its impact on nutritional status and neurodevelopment of pre-school children.

Cross-sectional study that measured children’s hair mercury (HHg) as an indicator of family fish consumption, growth (anthropometric Z-scores, WHO standards) and neurological (Gesell developmental scores (GDS)) development.

Traditional living conditions among families residing in the area adjacent to the Samuel Dam (Western Amazon) hydroelectric reservoir.

Two hundred and forty-nine pre-school children (1–59 months of age) from families transitioning from the traditional Amazonian lifestyle.

Family fish consumption was significantly correlated with children’s HHg concentration (Spearman’s r = 0·246, P < 0·0001); however, HHg had no significant association with growth (Z-scores). Overall, the prevalence of severe malnutrition, i.e. stunting (height-for-age Z-score (HAZ) ≤ −3), underweight (weight-for-age Z-score (WAZ) ≤ −3) and wasting (weight-for-height Z-score (WHZ) ≤ −3) was 5·2 % (n 13), 0 % and 0·8 % (n 2), respectively. The prevalence of moderate stunting (HAZ ≥ −3 to ≤ −2), underweight (WAZ ≥ −3 to ≤ −2) and wasting (WHZ ≥ −3 to ≤ −2) was 8·8 % (n 22), 2·4 % (n 6) and 4·8 % (n 12), respectively. Although 76 % of the children showed adequate GDS (>85), multiple regression analysis showed that fish consumption (as HHg) had no impact on GDS, but that some variables did interact significantly with specific domains (motor and language development).

The study showed that the families’ shift in fish consumption had no negative impact on the growth of young children and that ensuing methylmercury exposure has not been a noticeable neurodevelopmental hindrance.

The persistence of undernutrition, along with overweight and obesity, constitute the double burden of malnutrition. The present study aimed to: (i) describe the prevalence and trends of concurrent stunting and overweight in Indonesian children; (ii) identify potentially associated risk factors; and (iii) determine whether stunted children are at greater risk of overweight compared with those of healthy height.

A secondary data analysis of children aged 2·0–4·9 years in four cross-sectional studies of the Indonesian Family Life Survey. Children’s height and BMI Z-scores were calculated based on the WHO Child Growth Standards (2006). We defined ‘concurrent stunting and overweight’ as height-for-age Z-score <−2 and BMI Z-score >+1. Multivariate generalised linear latent and mixed models were used to determine associated risk factors.

Thirteen out of twenty-seven provinces in Indonesia.

Children (n 4101) from four waves of the Indonesian Family Life Survey (1993–2007).

There were inconsistent trends in the prevalence of concurrent stunting and overweight from waves 1 to 4. Children were more likely to be stunted and overweight when they were in the youngest age group (2·0–2·9 years), were weaned after the age of 6 months, had short-statured mothers or lived in rural areas. Stunted children were significantly more likely to be overweight than healthy-height children (OR>1) but did not differ significantly different across each wave (OR=1·34–2·01).

Concurrent stunting and overweight occurs in Indonesian children aged 2·0–4·9 years. Current policies and programmes need to be tailored for the management of this phenomenon.

To investigate the feasibility and acceptability of using wearable cameras as a method to capture the opportunities for food and drink purchasing/consumption that young people encounter on their regular journeys to and from school.

A qualitative study using multiple data-collection methods including wearable cameras, global positioning system units, individual interviews, food and drink purchase and consumption diaries completed by participants over four days, and an audit of food outlets located within an 800 m Euclidean buffer zone around each school.

A community setting.

Twenty-two students (fourteen girls and eight boys) aged 13–15 years recruited from four secondary schools in two counties of England.

Wearable cameras offered a feasible and acceptable method for collecting food purchase and consumption data when used alongside traditional methods of data collection in a small number of teenagers. We found evidence of participants making deliberate choices about whether or not to purchase/consume food and drink on their journeys. These choices were influenced by priorities over money, friends, journey length, travel mode and ease of access to opportunities for purchase/consumption. Most food and drink items were purchased/consumed within an 800 m Euclidean buffer around school, with items commonly selected being high in energy, fat and sugar. Wearable camera images combined with interviews helped identify unreported items and misreporting errors.

Wearable camera images prompt detailed discussion and generate contextually specific information which could offer new insights and understanding around eating behaviour patterns. The feasibility of scaling up the use of these methods requires further empirical work.

The objective of the present study was to examine associations between exposure to nutrition information as covered in mass media and daily fruit and vegetable (FV) consumption among adolescents.

Cross-sectional nutrition survey.

Vocational schools in Vienna, Austria.

A sample of 2949 ethnically diverse adolescents with mean age 17·3 (sd 1·7) years. An FFQ was used to assess usual FV consumption. Data on mass media exposure and sociodemographic characteristics were collected by means of a self-administered questionnaire. Multiple logistic regression analyses were used to control for potentially confounding variables.

Adolescents who reported exposure to nutrition information provided by booklets, the Internet or newspaper articles were more likely to eat FV daily. For example, the OR for daily fruit consumption (ORfru) was 1·6 (P < 0·001) when exposure to the Internet was reported after adjustment for age, gender, ethnicity, BMI and salary. No such associations were found for radio, television and magazines as sources of nutrition information. A negative impact on daily FV consumption was found for exposure to radio commercials (ORfru = 0·74, P = 0·04 and ORveg = 0·67, P = 0·03). Exposure to TV commercials had a negative impact on vegetable consumption (ORveg = 0·81, P = 0·05).

Newspaper articles, the Internet and booklets as a source of nutrition information are positively associated with daily FV consumption among adolescents, whereas radio commercials have a negative impact. Dissemination of ‘healthy eating’ slogans should make use of print media and the Internet.

To identify the major perceived influences on food choice, to examine the use of and trust in information sources concerning healthy eating, and to assess attitudes towards and barriers to adopting healthy eating practices in a post-USSR country (Ukraine).

A survey of an urban adult population. The questions were adopted from the Pan-European Union (EU) Survey of Consumer Attitudes to Food, Nutrition and Health (1995–1996).

Lviv city, Ukraine.

The survey included 296 adults (84 males, 212 females) aged 18–55 years; they were primarily college students and subjects with tertiary education – the groups most likely to be both interested in healthy eating and affected by current socioeconomic downturns.

The major factors in food choice were: ‘quality/freshness’ (cited by 80%), ‘price’ (58%) and ‘taste’ (47%); only 34% cited ‘trying to eat healthily’. More older people cited ‘price’ than ‘quality/freshness’, and men were more likely than women to cite ‘taste’. Sources of healthy eating information included: ‘relatives/friends’ (cited by 65%, trusted by 85%) and health professionals (trusted by 92%, but used by only 35%); while advertising was the least trusted source (cited by 28%). Fifty-three per cent of respondents considered their diet to be healthy enough without further changes; 50% thought of the nutritional aspects of the food they ate; fewer women than men considered their diet healthy, and more women than men thought about nutrition. Barriers to healthy eating included: ‘cost’ (cited by 65%), ‘lack of time’ (55%), ‘self-control’ (54%), ‘selection influences’ (41%), ‘lack of knowledge’ (32%), ‘unpleasant foods’ and ‘resistance to change’ (both 30%).

Strategies to encourage healthy eating in this population should involve word-of-mouth nutrition education concerning low-cost healthy alternatives.

The Newest Vital Sign© (NVS) was developed in the USA to measure patient health literacy in clinical settings. We adapted the NVS for use in Canada, in English and French, and created a computerized version. Our objective was to evaluate the reliability of the Canadian NVS as a self-administered computerized tool.

We used a randomized crossover design with a washout period of 3–4 weeks to compare health literacy scores obtained using the computerized version with scores obtained using the standard interviewer-administered NVS. ANOVA models and McNemar’s tests assessed differences in outcomes assessed with each version of the NVS and order effects of the testing.

Participants were recruited from multicultural catchment areas in Ontario and Nova Scotia.

English- and French-speaking adults aged 18 years or older.

A total of 180 (81 %) of the 222 adults (112 English/110 French) initially recruited completed both the interviewer-NVS and computer-NVS. Scores for those who completed both assessments ranged from 0 to 6 with a mean of 3·63 (sd 2·11) for the computerized NVS and 3·41 (sd 2·21) for the interview-administered NVS. Few (n 18; seven English, eleven French) participants’ health literacy assessments differed between the two versions.

Overall, the computerized Canadian NVS performed as well as the interviewer-administered version for assessing health literacy levels of English- and French-speaking participants. This Canadian adaptation of the NVS provides Canadian researchers and public health practitioners with an easily administered health literacy assessment tool that can be used to address the needs of Canadians across health literacy levels and ultimately improve health outcomes.

To produce prediction equations for basal metabolic rate (BMR) derived from weight and height covering the age range from birth to old age.

Cross-sectional data on BMR, sex, age, weight, height, ethnicity and measurement technique from the Oxford Brookes BMR database.

Worldwide.

Data for 13 910 men, women and children from 174 papers published between 1914 and 2001.

Absolute and proportional regression models were developed for each sex, showing a steep rise in predicted BMR with age until 15 years, more pronounced in males than females, then a gradual fall through adulthood. Predicted BMR increased by 6% and 1.4%, respectively, per standard deviation increase in weight and height. Predicted BMR in Caucasians was 4% higher than in non-Caucasians, though the effect size was sensitive to the inclusion or exclusion of data from certain influential publications. The effect of measurement technique on BMR, closed-circuit versus open-circuit, was small, near 1%.

It is possible to develop prediction equations that avoid splitting the data into arbitrary age groups. Heterogeneity between publications is greater than might be expected by chance, probably due to undocumented differences in technique.

To evaluate the long-term effects of a horticultural and nutrition education intervention in rural Tanzania.

A quasi-experimental post-test design was used.

The research was carried out in 10 villages in Singida region, Tanzania.

Mothers and their children aged 6–71 months (n = 236) from an experimental (Ilongero) and control (Ihanja) area were interviewed regarding knowledge and practices related to vitamin A nutrition. Intake of vitamin A-rich foods by the children during the 7 days prior to the interview was recorded. Stools were examined for helminths and serum samples were analysed for retinol and C-reactive protein (CRP) (n = 146) for the children aged 12–71 months.

Knowledge and practices were more favourable to vitamin A intake in the experimental area than in the control area, and an increased frequency of intake of green leaves was associated with higher serum retinol values. The experimental area had lower mean serum retinol levels (13.7 μg dl−1, n = 75) than the control area (19.3 μg dl−1, n = 71). One likely confounder was the higher helminth infestation in the experimental area (n = 75, 79%) than in the control area (n = 71, 49%) (P > 0.001). Children with helminths (n = 94) had a lower mean serum retinol level than those without (n = 52) (12.3 ± 5 vs. 24 ± 10 μg dl−1; P = 0.001).

Food-based vitamin A programmes can make sustainable improvements in knowledge and dietary practices but these may not necessarily be reflected in increases in serum retinol. Programme implementation and evaluation should take confounders into consideration as, in this case, helminth infestation.