To assess and compare the food consumption and nutrient intake between 3-year-old children cared for at home full-time and those attending day care outside the home. Nutrient intake on weekdays and weekends was also studied.

Cross-sectional sample of children invited to the nutrition study within the Type 1 Diabetes Prediction and Prevention (DIPP) birth cohort born in 2001. Families returned 3-d food record completed close to the child’s third birthday.

A total of 471 pre-school children aged 3 years of whom 285 had only been cared for at home during the recording time and 186 had attended day care outside the home.

Among the children cared for outside the home, there were more consumers of recommendable foods as fresh vegetables, fruits, berries, rye bread, fish, skimmed milk and vegetable margarines, than among those cared for at home. The day-care group had higher intake of protein, dietary fibre, thiamine, potassium and magnesium, and lower intake of sucrose compared with the group cared for at home. Adjustment for sociodemographic factors did not change the results. In all children, food consumption was more varied on weekdays compared with weekends. On weekdays, children had higher intake of dietary fibre and protein and lower intake of sucrose compared to weekends.

The type of day care was associated with food consumption and nutrient intake among pre-school children and hence might have an impact on their nutrition and health. The diet of the children attending day care outside the home was more balanced and closer to the national recommendations.

Food has a considerable environmental impact. Diets with less meat and dairy reduce environmental impact but may pose nutritional challenges for children. The current modelling study investigates the impact of diets with less or no meat and dairy products on nutrient intakes.

Energy and nutrient intakes were assessed for observed consumption patterns (reference) and two replacement scenarios with data from the Dutch National Food Consumption Survey – Young Children (2005–2006). In the replacement scenarios, 30 % or 100 % of the consumed dairy and meat (in grams) was replaced by plant-derived foods with similar use.

The Netherlands.

Children (n 1279) aged 2–6 years.

Partial and full replacement of meat and dairy foods by plant-derived foods reduced SFA intake by 9 % and 26 %, respectively, while fibre intake was 8 % and 29 % higher. With partial replacement, micronutrient intakes were similar, except for lower vitamin B12 intake. After full meat and dairy replacement, mean intakes of Ca, Zn and thiamin decreased by 5–13 %, and vitamin B12 intake by 49 %, while total intake of Fe was higher but of lower bioavailability. With full replacement, the proportion of girls aged 4–6 years with intakes below recommendations was 15 % for thiamin, 10 % for vitamin B12 and 6 % for Zn.

Partial replacement of meat and dairy by plant-derived foods is beneficial for children’s health by lowering SFA intake, increasing fibre content and maintaining similar micronutrient intakes. When full replacements are made, attention is recommended to ensure adequate thiamin, vitamin B12 and Zn intakes.

Antioxidant nutrients like carotenoids, tocopherols and vitamin C have been suggested to protect against allergic rhinitis and allergic sensitisation but scientific evidence is scarce. The aims of the study were to measure the plasma concentration of six carotenoids, α- and γ-tocopherol and vitamin C as biomarkers of the intake, absorption and subsequent metabolism of these nutrients, and to assess their association with allergic rhinitis and sensitisation.

Data from a cross-sectional study on representative dietary and lifestyle habits of the population of Bavaria, Germany, were analysed. The plasma levels of six carotenoids (α-carotene, β-carotene, lycopene, lutein/zeaxanthin, canthaxanthin and cryptoxanthin) as well as of α-tocopherol, γ-tocopherol and vitamin C were measured in 547 adults aged between 19 and 81 years. Participants with specific serum immunoglobulin E ≥700 U l−1 were categorised as sensitised. The association of plasma antioxidant levels, allergic rhinitis and allergic sensitisation was assessed by means of unconditional logistic regression models.

We observed a negative association between plasma total carotenoids and the prevalence of allergic rhinitis, with odds ratio (95% confidence interval) of 1.13 (0.54–2.39) for the second, 0.72 (0.33–1.58) for the third and 0.44 (0.19–1.03) for the fourth quartile of total carotenoids concentration (P for trend = 0.0332); results for lycopene failed to reach statistical significance (P = 0.0608). Other single carotenoids, tocopherols and vitamin C were unrelated to allergic rhinitis. Allergic sensitisation was negatively associated with plasma γ-tocopherol, with odds ratio (95% confidence interval) of 0.92 (0.51–1.65) for the second, 1.00 (0.56–1.80) for the third and 0.45 (0.23–0.88) for the fourth quartile of plasma γ-tocopherol concentration (P for trend = 0.0410). No other antioxidant was significantly related to allergic sensitisation.

High plasma carotenoid concentrations reflecting a diet high in various fruits and vegetables might have a protective effect on allergic rhinitis in adulthood.

The present study aimed to compare the effects of a general dietary intervention and an intervention with low glycaemic load (GL) on glycaemic control, blood lipid metabolism and pregnancy outcomes in women with gestational diabetes mellitus.

Participants were randomly assigned to two groups, receiving either an individualized general dietary intervention (Control group) or an intensive low-GL intervention (Low-GL group) every two weeks, from 24–26 weeks of gestation to delivery.

The Center of Maternal Primary Care in Guangdong General Hospital, China.

Ninety-five women with gestational diabetes mellitus were enrolled from June 2008 to July 2009.

After the intervention, both groups significantly decreased their dietary intakes of energy, fat and carbohydrate. The Low-GL group had significantly lower values for GL (122 v. 136) and glycaemic index (50 v. 54) but greater dietary fibre intake (33 v. 29 g/d) than did the Control group (all P<0·01). Significantly greater decreases in fasting plasma glucose (−0·33 v. −0·02 mmol/l, P<0·01) and 2 h postprandial glucose (−2·98 v. −2·51 mmol/l, P<0·01), significantly lower increases in total cholesterol (0·12 v. 0·23 mmol/l) and TAG (0·41 v. 0·56 mmol/l) and a significantly lower decrease in HDL cholesterol (−0·01 v. −0·11 mmol/l) were also observed in the Low-GL group compared with the Control group (all P<0·05). There were no significant differences in body weight gain, birth weight or other maternal–fetal perinatal outcomes between the two groups.

The low-GL targeted dietary intervention outperformed the general dietary intervention in glycaemic control and the improvement of blood lipid levels in women with gestational diabetes mellitus.

We investigated emotional eating behaviours and perceived stress during COVID-19 partial quarantine according to BMI levels in healthy adults.

Cross-sectional study.

An online survey including demographic variables, eating attitude-related questions, Emotional Eater Questionnaire (EEQ) and Perceived Stress Scale-14 (PSS-14) was sent via online data collection platform. Self-reported weight, height and weight changes during the quarantine were also collected.

A total of 506 people aged between 20–65 years who were partially quarantined due to COVID-19 participated in this study.

BMI was positively correlated with EEQ (r 0 ·205, P = 0·001). However, BMI was negatively linked with PSS-14 during COVID-19 (r -0·125, P = 0·001), indicating that participants with lower BMI had higher perceived stress during COVID-19. Participants gained weight during the lockdown situation (+1·20 ± 1·70 kg in men; +0·91 ± 1·40 kg in women). EEQ and PSS-14 scores of women found to be significantly higher than men (9·39 ± 5·37 in men v. 11·17 ± 5·85 in women for EEQ; 24·67 ± 8·32 in men v. 27·99 ± 7·34 in women for PSS-14). Obese participants consumed sweetened and carbonated drinks two-fold more in those compared with other participants.

These findings suggest that partial quarantine may be closely related to emotional eating and weight gain, and participants with higher BMI showed more emotional eating behaviours. Therefore, certain precautions should be considered beforehand in order not to cause long-term eating disorder problems.

To assess the dietary quality of older women with and without rheumatoid arthritis (RA) using the Healthy Eating Index-2005 (HEI-2005) to identify potential strategies to improve the nutritional status.

Cross-sectional. Diet was assessed using 7 d food records and analysed for nutrient composition (Food Processor v. 7·11). Diet quality was determined using the HEI-2005, a measure of compliance with 2005 US Dietary Guidelines. Individuals with RA completed a self-reported evaluation of arthritis (pain scale and disability index). Independent two-tailed t tests or Mann–Whitney tests compared the differences between groups and correlations were computed between HEI-2005 and measures of disease reactivity.

Arizona, USA.

Older (≥ 55 years) women (n 108) with RA (n 52) and healthy controls (HC; n 56).

There were no differences between groups in age, weight, or BMI (kg/m2). HC participants had higher mean HEI-2005 scores for whole fruit (cups; P = 0·02), total fruit (cups; P = 0·05), whole grains (oz; P = 0·004), oil (g; P = 0·05) and total HEI score (P = 0·04) than the RA group. In the RA group, these same HEI components were inversely correlated with disability index (r = −0·20, P = 0·04). Participants with RA reported lower mean intakes of carbohydrate (g; P = 0·02), fibre (g; P = 0·01) and vitamin C (mg; P = 0·04).

This is the first study examining the dietary quality in older women with and without RA using the HEI-2005. Living with RA was associated with significantly lower dietary quality. Since even small changes in dietary quality can translate into better nutritional status, future interventions should focus on increasing dietary quality in this high-risk group.

To quantify short- and long-term associations between dietary patterns defined a priori and bone mineral density (BMD) during adolescence.

Dietary patterns were defined at 13 years old using a Mediterranean diet (MD) quality index, the Dietary Approaches to Stop Hypertension (DASH) diet index and the Oslo Health Study (OHS) dietary index. Linear regression coefficients were used to estimate associations between dietary patterns and forearm BMD at 13 and 17 years, measured by dual-energy X-ray absorptiometry.

Public and private schools of Porto, Portugal.

The EPITeen cohort comprising 1180 adolescents born in 1990, recruited at schools during the 2003/2004 school year and re-evaluated in 2007/2008.

In girls, at 13 years, mean BMD (g/cm2) in the first and third tertiles was 0·369 and 0·368 for the MD pattern, 0·368 and 0·369 for the DASH diet, and 0·370 and 0·363 for the OHS index. In boys, mean BMD (g/cm2) in the first and third tertiles was 0·338 and 0·347 for the MD pattern, 0·342 and 0·346 for the DASH diet, and 0·344 and 0·342 for the OHS index. None of these differences were significant. Mean BMD at 17 years and prospective variation were also not significantly different between tertiles of adherence to each score. However, a trend of increased BMD at 13 years with greater adherence to the MD pattern was observed in boys (adjusted coefficient = 0·248; 95 % CI 0·052, 0·444).

The selected dietary patterns may not capture truly important dietary differences in determining BMD or diet may not be, beyond nutrient adequacy, a limiting determinant of BMD.

Food packages were objectively assessed to explore differences in nutrition labelling, selected promotional marketing techniques and health and nutrition claims between countries, in comparison to national regulations.

Cross-sectional.

Chip and sweet biscuit packages were collected from sixteen countries at different levels of economic development in the EPOCH (Environmental Profile of a Community’s Health) study between 2008 and 2010.

Seven hundred and thirty-seven food packages were systematically evaluated for nutrition labelling, selected promotional marketing techniques relevant to nutrition and health, and health and nutrition claims. We compared pack labelling in countries with labelling regulations, with voluntary regulations and no regulations.

Overall 86 % of the packages had nutrition labels, 30 % had health or nutrition claims and 87 % displayed selected marketing techniques. On average, each package displayed two marketing techniques and one health or nutrition claim. In countries with mandatory nutrition labelling a greater proportion of packages displayed nutrition labels, had more of the seven required nutrients present, more total nutrients listed and higher readability compared with those with voluntary or no regulations. Countries with no health or nutrition claim regulations had fewer claims per package compared with countries with regulations.

Nutrition label regulations were associated with increased prevalence and quality of nutrition labels. Health and nutrition claim regulations were unexpectedly associated with increased use of claims, suggesting that current regulations may not have the desired effect of protecting consumers. Of concern, lack of regulation was associated with increased promotional marketing techniques directed at children and misleadingly promoting broad concepts of health.

The aim of this study was to investigate the association of the number of hours of nutrition education and teachers’ qualifications with nutrition knowledge and dietary behaviour in students.

In this representative cross-sectional study, socio-demographic data, anthropometric measurements, socio-economic status (SES), physical fitness, nutrition knowledge and eating habits were assessed. Differences between groups were tested by χ2 and t tests. Multiple linear and logistic regression modelling was used to examine the relationship between demographic characteristics, lifestyle and dietary behaviours, nutrition knowledge, nutrition-trained teachers and number of nutrition lessons.

Sixteen secondary schools in urban (n 6) and rural regions (n 10) of Tyrol, Western Austria.

Students (n 513) aged 14·2 (sd 0·7) years.

Higher nutrition knowledge was significantly associated with attending rural school (P = 0·001), having no migration background (P < 0·001), (very) good physical activity behaviour (P = 0·040), non-trained teacher (P = 0·006) but higher number of hours of nutrition education (P = 0·013). Regression models showed that higher nutrition knowledge was independently associated with lower intake of meat and iced tea and higher intake of vegetables and plant-based oils. A higher amount of nutrition education (h/week) was significantly associated with higher intake of dark (wholegrain) bread, lower intake of meat and of energy drinks sweetened with sweeteners.

Our results suggest that more hours in nutrition education result in higher nutrition knowledge and greater nutrition literacy, which may lead to health-promoting dietary habits. School-based nutrition education can be seen as preventive measure to increase nutritional competences in adolescents independent of their SES.

The food-frequency questionnaire (FFQ) can be an efficient tool to evaluate dietary intake in large, population-based studies, especially for specific foods. The objective of this study was to validate the assessment of soy and isoflavone (daidzein and genistein) intakes, measured by an FFQ, by comparing intakes with serum isoflavone concentrations.

Soy and isoflavone intakes and serum isoflavone concentrations were determined as part of a case–control study of dietary factors and risks of benign breast disease and breast cancer. The FFQ, administered during an in-person interview, included six soy-specific line items. Blood was drawn within one week of FFQ completion.

In total, 1823 women living in Shanghai, People's Republic of China.

In this population, soybean milk, fresh bean curd and other bean foods were eaten once per week, and fermented bean curd, fried bean curd puff and soybeans were eaten less than once per week. A significant linear trend (P > 0.01) in serum isoflavone concentrations across increasing categories of soy and isoflavone intakes was observed, indicating that soy and isoflavone intakes, measured by the FFQ, well distinguished serum isoflavone concentrations. Linear trends were also observed in both case and control groups in stratified analyses, suggesting little differential bias by case–control status.

The results suggest that the FFQ provides a useful marker of soy food consumption and isoflavone exposure in this population.

Young children are particularly vulnerable to malnutrition as nutrition transition progresses. The present study aimed to document the prevalence, coexistence and correlates of nutritional status (stunting, overweight/obesity and anaemia) in Samoan children aged 24–59 months.

A cross-sectional community-based survey. Height and weight were used to determine prevalence of stunting (height-for-age Z-score <−2) and overweight/obesity (BMI-for-age Z-score >+2) based on WHO growth standards. Anaemia was determined using an AimStrip Hemoglobin test system (Hb <110 g/l).

Ten villages on the Samoan island of Upolu.

Mother–child pairs (n 305) recruited using convenience sampling.

Moderate or severe stunting was apparent in 20·3 % of children, 16·1 % were overweight/obese and 34·1 % were anaemic. Among the overweight/obese children, 28·6 % were also stunted and 42·9 % anaemic, indicating dual burden of malnutrition. Stunting was significantly less likely among girls (OR=0·41; 95 % CI 0·21, 0·79, P<0·01) than boys. Overweight/obesity was associated with higher family socio-economic status and decreased sugar intake (OR per 10 g/d=0·89, 95 % CI 0·80, 0·99, P=0·032). The odds of anaemia decreased with age and anaemia was more likely in children with an anaemic mother (OR=2·20; 95 % CI 1·22, 3·98, P=0·007). No child, maternal or household characteristic was associated with more than one of the nutritional status outcomes, highlighting the need for condition-specific interventions in this age group.

The observed prevalences of stunting, overweight/obesity and anaemia suggest that it is critical to invest in nutrition and develop health programmes targeting early childhood growth and development in Samoa.

Development and validation of a short instrument to assess the dietary intake of heterocyclic aromatic amines (HCA).

At first, a longer instrument asking for the consumption of 11 meat and fish items and different preparation methods was developed. The degree of browning of these foods was assessed by means of photos. This questionnaire was sent to 500 participants of the European Prospective Investigation into Cancer and Nutrition (EPIC) in Heidelberg, Germany, in June 1999. Using 385 completed questionnaires, a short questionnaire was developed covering just seven food items, which was sent to the participants again. Of these, 344 were returned with in four months. Total dietary intake of HCA as well as the intake of different HCA were calculated and compared between both versions.

Median dietary intake of total HCA was 103ng day−1as assessed with the short version; the intakes of 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP),2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx) and 2-amino-3,4,8-trimethylimidazo[4,5-f]quinoxaline (DiMeIQx) were 63, 34 and 2ng day−1, respectively. These results did not differ significantly from those obtained with the longer version. Spearman rank correlation coefficients between the long and the short version ranged from 0.46 to 0.6. In quartile cross-classification, 70–78% of the participants were assigned into the same or an adjacent quartile while categorisation into opposite quartiles was ≤3.5%.

The short version of the HCA questionnaire demonstrates good validity compared with the longer version. The intake of HCA as assessed with the short questionnaire is comparable to that found in other studies using a short questionnaire.

To describe the meal patterns of Jena schoolchildren and their associations with children’s weight status and parental characteristics.

Cross-sectional study.

Twenty schools in Jena (∼100 000 inhabitants), south-east Germany.

A total of 2054 schoolchildren aged 7–14 years with information on BMI standard deviation score (BMI-SDS) and weight status (based on German reference values), of whom 1571 had additional information about their parents (parental education and employment status, weight status according to WHO guidelines) and meal patterns (school lunch participation rate, meal frequencies, breakfast consumption and frequency of family meals).

Weight status of the children was associated with weight status, education and employment status of the parents. Meal patterns were strongly dependent on children’s age and parental employment. As age increased, the frequency of meal consumption, participation rate in school lunches and the number of family meals decreased. Using linear regression analysis, a high inverse association between BMI-SDS and meal frequency was observed, in addition to relationships with parental weight status and paternal education.

Age-specific prevention programmes should encourage greater meal frequency. The close involvement of parents is essential in any strategy for improving children’s (families’) diets.

To propose a policy framework for the regulation of functional foods and health claims within a public health context.

This article reviews the empirical evidence and public health principles associated with functional foods and health claims to analyse the issues, challenge the assumptions that have emerged and explore options for moving forward.

Functional foods and health claims are among the more controversial and complex issues being debated by food regulators internationally. Proponents of functional foods and health claims state that functional foods may reduce health care expenditure and health claims are a legitimate nutrition education tool that will help them inform consumers of the health benefits of certain food products. Conversely, opponents of these developments respond that it is the total diet that is important for health, not so-called ‘magic bullets’. Moreover, they argue that health claims will enable manufacturers to indulge in marketing hyperbole and essentially blur the distinction between food and drugs. This topic provides a valuable case study of public policy in relation to food and health.

The need to maintain a general prohibition on health claims while accommodating specific exemptions supported by scientific substantiation is recommended. Nutrition education and monitoring and evaluation are integral to the proposed regulatory framework. The intention of this policy position is to encourage research and development of innovative food products while avoiding an inappropriate medicalization of the general food supply.

To analyse nutritional and packaging characteristics of toddler-specific foods and milks in the Australian retail food environment to identify how such products fit within the Australian Dietary Guidelines (ADG) and the NOVA classification.

Cross-sectional retail audit of toddler foods and milks. On-pack product attributes were recorded. Products were categorised as (1) food or milk; (2) snack food or meal and (3) snacks sub-categorised depending on main ingredients. Products were classified as a discretionary or core food as per the ADG and level of processing according to NOVA classification.

Supermarkets and pharmacies in Australia.

A total of 154 foods and thirty-two milks were identified. Eighty percentage of foods were snacks, and 60 % of foods were classified as core foods, while 85 % were ultraprocessed (UP). Per 100 g, discretionary foods provided significantly more energy, protein, total and saturated fat, carbohydrate, total sugar and Na (P < 0·001) than core foods. Total sugars were significantly higher (P < 0·001) and Na significantly lower (P < 0·001) in minimally processed foods than in UP foods. All toddler milks (n 32) were found to have higher energy, carbohydrate and total sugar levels than full-fat cow’s milk per 100 ml. Claims and messages were present on 99 % of foods and all milks.

The majority of toddler foods available in Australia are UP snack foods and do not align with the ADG. Toddler milks, despite being UP, do align with the ADG. A strengthened regulatory approach may address this issue.

To determine (i) the importance of parents’ motives for everyday family food choices; and (ii) the relationship between parental food choice motives and eating patterns of 12- to 13-year-old children.

Cross-sectional study. A modified version of the Food Choice Questionnaire was used to determine parental motives for food choices. The children's food and drink intake was reported by their parents using a retrospective FFQ. Eating patterns were derived using principal component analysis. The association between food choice motives and eating patterns was examined using multiple linear regression analysis.

Primary schools, Telemark County, Norway.

In total, 1095 children aged 12–13 years and their parents.

The parental motive ‘sensory appeal’ was the most important for food choice, followed by ‘health’, ‘convenience’, ‘natural content’ and ‘weight control’. The food choice motives were associated with the eating patterns of the children, independent of background variables. The motive ‘health’ was most strongly associated with a ‘varied Norwegian’ eating pattern, representing a diverse diet and regular meals, while the motive ‘convenience’ appeared to be the most important barrier to this eating pattern. ‘Weight control’ was not associated with the ‘varied Norwegian’ eating pattern.

To encourage parents to make healthy food choices for their children, health promotion activities should focus on the health benefits of a diverse diet and regular meals, rather than weight control. Recommended food products should be made more convenient and easily available for families with children.

To consider the use of systematic methods for categorising foods according to their nutritional quality (‘nutrient profiling’) as a strategy for promoting public health through better dietary choices.

We describe and discuss several well-developed approaches for categorising foods using nutrient profiling, primarily in the area of food labelling and also with respect to advertising controls. The best approach should be able to summarise and synthesise key nutritional dimensions (such as sugar, fat and salt content, energy density and portion size) in a manner that is easily applied across a variety of products, is understandable to users and can be strictly defined for regulatory purposes.

Schemes that provide relative comparisons within food categories may have limited use, especially for foods that are not easily categorised. Most nutrient-profiling schemes do not clearly identify less-healthy foods, but are used to attract consumers towards products with supposedly better profiles. The scheme used in the UK to underpin the colour-coded ‘traffic light’ signalling on food labels, and the one used by the UK broadcasting regulator Ofcom to limit advertising to children, together represent the most developed use of nutrient profiling in government policy-making, and may have wider utility.

Nutrient profiling as a method for categorising foods according to nutritional quality is both feasible and practical and can support a number of public health-related initiatives. The development of nutrient profiling is a desirable step in support of strategies to tackle obesity and other non-communicable diseases. A uniform approach to nutrient profiling will help consumers, manufacturers and retailers in Europe.

To assess the effect of the Dutch school-based education programme ‘Taste Lessons’ on children’s behavioural determinants towards tasting unfamiliar foods and eating healthy and a variety of foods.

In a quasi-experimental study design, data on behavioural determinants were collected at baseline, four weeks and six months after the intervention in both the intervention and control group. Children completed consecutively three questionnaires in which knowledge, awareness, skills, attitude, emotion, subjective norm and intention towards the two target behaviours were assessed. Teachers implemented on average a third of the programme activities. Multilevel regression analyses were conducted to compare individual changes in the determinants in the intervention group with those in the control group, corrected for children’s gender and age. Effect sizes were expressed as Cohen’s d.

Dutch elementary schools.

Forty-nine classes (1183 children, 9–12 years old) in grades 5–8 of twenty-one elementary schools.

The intervention group showed a higher increase in knowledge (d=0·26, P<0·01), which persisted after six months (d=0·23, P<0·05). After four weeks, the intervention group showed a higher increase in number of foods known (d=0·22, P<0·05) and tasted (d=0·21, P<0·05), subjective norm of the teacher (d=0·17, P<0·05) and intention (d=0·16, P<0·05) towards the target behaviours.

Partial implementation of Taste Lessons during one school year showed small short-term effects on increasing behavioural determinants in relation to tasting unfamiliar foods and eating healthy and a variety of foods. Full and repeated implementation of Taste Lessons in subsequent years might result in larger effects.

To determine the demographic profile of fast-food consumers among adult Singapore residents and ascertain whether fast-food consumption frequency is associated with diet quality and weight status.

A nationally representative cross-sectional survey including an FFQ and anthropometric measures. Participants were grouped based on their fast-food consumption frequency as non-consumer, occasional consumer or regular consumer, with regular defined as at least once per week.

Individuals living in the community in Singapore.

Singapore residents (n 1627) aged 18–69 years of Chinese, Malay and Indian ethnicity.

Proportions of regular fast-food consumers were higher in younger age groups, higher income groups and middle education level groups. Mean daily energy intake was positively associated with fast-food consumption frequency (non-consumers 9636 kJ (2303 kcal); occasional consumers 11 159 kJ (2667 kcal); regular consumers 13 100 kJ (3131 kcal); P for trend < 0·001). Fast-food consumers were more likely to exceed the RDA for energy, fat and saturated fat, and less likely to meet wholegrain and fruit recommendations. Both regular consumers (OR = 1·24; 95 % CI 1·03, 1·51) and occasional consumers (OR = 1·52; 95 % CI 1·32, 1·77) were more likely to have a waist:hip ratio indicating abdominal obesity. Occasional consumers were more likely to have a BMI ≥ 23·0 kg/m2 (OR = 1·19; 95 % CI 1·04, 1·37), whereas regular consumers were less likely (OR = 0·76; 95 % CI 0·64, 0·91) to have an ‘at-risk’ BMI.

Fast-food consumption is most prevalent in young adults, high income and middle education level groups. Frequent fast-food consumption in Singapore is associated with unfavourable dietary and nutrient profiles and abdominal obesity.