Television, Internet and print media are saturated with advertisements for unhealthy food that use marketing tactics aimed to build long-term brand loyalty and ‘relationships’ with children. While research in this area has largely focused on television, the current study examines children’s responses to relationship-building marketing communications found in popular children’s magazines.

A qualitative study consisting of friendship-pair interviews in which children were interviewed and asked to comment on a range of recent food advertisements.

A university-based after-school care programme in New South Wales, Australia.

Ten children aged 6–13 years, interviewed in self-selected friendship pairs.

The children reported being attracted to the advertisements because of specific elements of the marketing strategies utilised. Some children were able to recognise the persuasive intent of the media, whereas others did not even identify the pages as advertisements.

It was clear from the children’s responses that these types of relationship-building marketing communications influence children’s attitudes towards branded food products and their views on the nutritional value and social meanings of food.

We examined the distribution of diabetes and modifiable risk factors to provide data to aid diabetes prevention programmes in India.

Population-based cross-sectional survey of men and women included in India's third National Family Health Survey (NFHS-3, 2005–2006).

The sample is a multistage cluster sample with an overall response rate of 98 %. All states of India are represented in the sample (except the small Union Territories), covering more than 99 % of the country's population.

Women (n 99 574) and men (n 56 742) aged 20–49 years residing in the sample households.

Prevalence of diabetes was 1598/100 000 (95 % CI 1462, 1735) among men and 1054/100 000 (95 % CI 974, 1134) among women in India. Rural–urban and marked geographic variation were found with higher rates in south and north-eastern India. Weekly and daily fish intake contributed to a significantly higher risk of diabetes among both women and men. Risks of diabetes increased with increased BMI, age and wealth status of both women and men, but no effects of the consumption of milk/curd, vegetables, eggs, television watching, alcohol consumption or smoking were found. Daily consumption of pulse/beans or fruits was associated with a significantly reduced risk of diabetes among women, whereas non-significant inverse associations were observed in the case of men.

Prevalence was underestimated using self-reports. The wide variation in self-reported diabetes is unlikely to be due entirely to reporting biases or access to health care, and indicates that modifiable risk factors exist. Prevention of diabetes should focus on obesity and target specific socio-economic groups in India.

To examine the differences in dietary intakes of children consuming school meals and packed lunches, the contribution of lunchtime intake to overall dietary intake, and how lunchtime intake relates to current food-based recommendations for school meals.

Cross-sectional analysis of overall intake of macronutrients and food choice from 4 d food diaries and school lunchtime intake from the two diary days completed while at school.

Norfolk, UK.

One thousand six hundred and twenty-six children (aged 9–10 years) attending ninety Norfolk primary schools.

At school, lunchtime school meal eaters consumed more vegetables, sweet snacks, chips, starchy foods and milk, and less squash/cordial, fruit, bread, confectionery and savoury snacks than packed lunch eaters. These differences were also reflected in the overall diet. On average school meal eaters met the School Food Trust (SFT) food-based standards, while food choices among packed lunch eaters were less healthy. The contribution of food consumed at school lunchtime to overall diet varied by food and lunch type, ranging from 0·8 % (milk intake in packed lunches) to 74·4 % (savoury snack intake in packed lunches).

There were significant differences in the foods consumed by school meal and packed lunch eaters, with food choices among school meal eaters generally in line with SFT standards. The food choices made at school lunchtime make a significant contribution to overall diet.

Malnutrition in drug abusers has been attributed to poor diet. However, previous studies are conflicting. Many studies have not considered possible concurrent HIV disease. The purpose of this study was to determine the relationship between drug abuse and dietary intake in Hispanic Americans with and without HIV infection.

Dietary intake was measured using 3-day food records and 24-hour dietary recalls in three groups: HIV-positive drug abusers, HIV-negative drug abusers and HIV-positive persons who do not use drugs (‘non-drug abusers’).

The baseline data from a prospective cohort study of the role of drug abuse in HIV/AIDS weight loss and malnutrition conducted in Boston, Massachusetts, USA.

The first 284 participants to enrol in the study.

HIV-positive drug abusers had a body mass index (BMI) that was significantly lower than that of HIV-positive non-drug abusers. Reported energy, fat and fibre intakes did not differ between groups. All groups had median reported intakes of vitamin A, vitamin B6, vitamin B12, selenium and zinc that were in excess of the dietary reference values (DRI). Intakes of α-tocopherol were below the DRI, but did not differ from intakes of the general US population. However, increasing levels of drug abuse were associated with lower reported intakes of vitamin B6, vitamin B12, selenium and zinc.

Overall, this study does not support the notion that dietary intake can explain the lower BMI of HIV-positive drug abusers. Further studies examining non-dietary determinants of nutritional status in drug abusers are warranted.

To investigate the direct and indirect associations between psychological and physical intimate partner violence and the occurrence of common mental disorders (CMD) and how they relate to the occurrence of household food insecurity (HFI).

This was a population-based cross-sectional study. Intimate partner violence was assessed using the Brazilian version of the Revised Conflict Tactics Scale (CTS2) and HFI was assessed using the Brazilian Food Insecurity Scale. The propositional analytical model was based on a review of the literature and was tested using path analysis.

Duque de Caxias, Greater Rio de Janeiro, Brazil (April–December 2010).

Women (n 849) who had been in a relationship in the 12 months preceding the interview.

Both psychological and physical violence were found to be major risk factors of HFI. Psychological violence was associated with HFI indirectly via physical violence and CMD, and directly by an unidentified path. The effects of physical violence seemed to be manifested exclusively through CMD. Most of the variables in the propositional model related to socio-economic position, demographic characteristics, degree of women’s social support and partner alcohol misuse were retained in the ‘final’ model, indicating that these factors contribute significantly to the increased likelihood of HFI.

The results reinforce the importance of considering domestic violence and other psychosocial aspects of family life when implementing interventions designed to reduce/eradicate HFI.

To describe trends in the prevalence of obesity and overweight in English adults.

Analysis of nationally representative cross-sectional population surveys. Sociodemographic information was gathered by an interviewer-administered questionnaire and measurements of height and weight were used to calculate the prevalence of obesity and overweight.

A total of 61 515 men and 69 733 women aged 16–65 years participating in the annual Health Survey for England between 1991 and 2006.

When the 4-year periods 1991/94 and 2003/06 were compared, male and female obesity had risen by 8·2 % and 6·0 %, and male and female overweight had risen by 8·8 % and 7·4 %. However, the rate of increase appears to be slowing down: the increases between 1995/98 and 1999/02 were greater than those between 1999/02 and 2003/06. There was relatively little variation across the age range in the average changes in obesity or overweight prevalence between time periods, except that the increase in male obesity between periods was significantly greater for older than younger males. When the subjects were divided into 10-year pseudo birth cohorts, it was seen that the prevalence of obesity and overweight was consistently higher at a given average age for pseudo cohorts born more recently. This agreed with data from two British cohort studies.

Obesity and overweight continued to rise over the study period, but there are signs that the rate of increase is slowing down, even though the prevalence is consistently higher for a given age in cohorts born more recently.

To assess the public health significance of premature weaning of infants from breast milk on later-life risk of chronic illness.

A review and summary of recent meta-analyses of studies linking premature weaning from breast milk with later-life chronic disease risk is presented followed by an estimation of the approximate exposure in a developed Western country, based on historical breast-feeding prevalence data for Australia since 1927. The population-attributable proportion of chronic disease associated with current patterns of artificial feeding in infancy is estimated.

After adjustment for major confounding variables, current research suggests that the risks of chronic disease are 30–200 % higher in those who were not breast-fed compared to those who were breast-fed in infancy. Exposure to premature weaning ranges from 20 % to 90 % in post-World War II age cohorts. Overall, the attributable proportion of chronic disease in the population is estimated at 6–24 % for a 30 % exposure to premature weaning.

Breast-feeding is of public health significance in preventing chronic disease. There is a small but consistent effect of premature weaning from breast milk in increasing later-life chronic disease risk. Risk exposure in the Australian population is substantial. Approximately 90 % of current 35–45-year-olds were weaned from breast-feeding by 6 months of age. Encouraging greater duration and exclusivity of breast-feeding is a potential avenue for reducing future chronic disease burden and health system costs.

The present study investigates the relationship between BMI and all-cause mortality among middle-aged and older adults with or without pre-existing diseases.

A population-based cohort study.

The Taiwan Longitudinal Study on Aging is a nationwide prospective cohort study comprising a representative random sample of middle-aged and older adults. The study period was 1996–2007.

We followed 4145 middle-aged and older adults, totalling 42 353 person-years.

Overweight and mildly obese participants showed a 16 % and 30 % decrease in the risk of death, respectively, compared with those of normal weight after adjusting for potential covariates (e.g. demographic characteristics, health behaviour, co-morbidities and physical function). Underweight adults showed a 1·36-fold increased adjusted hazard ratio of death compared with normal-weight adults. Adults with a BMI of 27·0–28·0 kg/m2 showed a significantly lower adjusted hazard ratio of all-cause mortality rate compared with adults who had normal BMI values when they had coexisting hypertension or diabetes (adjusted hazard ratio=0·50; 95 % CI 0·30, 0·81 for hypertension and adjusted hazard ratio=0·41; 95 % CI 0·18, 0·89 for diabetes).

The study demonstrates that underweight people have a higher risk of death, and overweight and mildly obese people have a lower risk of death, compared with people of normal weight among middle-aged and older adults. An optimal BMI may be based on the individual, who exhibits pre-existing diseases or not.

Food marketing has been identified as a significant driver of the childhood obesity epidemic. The purpose of the present study was to (i) conduct a content analysis of the types of sports references that appear on supermarket food and beverage products and (ii) assess each product's nutritional and marketing profile.

This was a descriptive study. Every product featuring sports references on the packaging was purchased in two major supermarkets during 2010. A content analysis was conducted and nutritional evaluations were made based on the Nutrient Profile Model, a validated nutrition model. Marketing data were obtained from The Nielsen Company.

Two major supermarkets in Connecticut, USA.

Food and beverage products (n 102) were selected from two supermarkets.

The 102 products (fifty-three foods and forty-nine beverages) had sports references as part of their packaging: 72·5 % featured a character exercising, 42·2 % were endorsed by a professional sports entity and 34·0 % were child-targeted. The median nutrition score for food products was 36 (1 = unhealthiest and 100 = healthiest; scores of ≥63 are considered healthy according to this model). More than two-thirds of beverages (69·4 %) were 100 % sugar-sweetened. Children saw significantly more commercials for these products than adults.

Companies place sports figures on food and beverage products that are child-targeted and unhealthy.

To assess the reliability and relative validity of a diet index score derived from a Short Food Survey (SFS).

The thirty-eight-item SFS was designed to assess recent dietary intake of 4–11-year-olds to enable calculation of the Dietary Guideline Index for Children and Adolescents. Reliability was assessed based on two online administrations of the SFS, one week apart. Relative validity was assessed by comparing intakes derived from the SFS with those from the mean of three 24 h recalls. Intra-class correlations, Bland–Altman plots and estimated biases were assessed. Cohen's κ coefficients were used to determine the level of agreement between the two methods.

Adelaide, Australia.

Sixty-three parents reported on their children's intake (mean age 7·1 (sd 2·1) years).

The intra-class correlation for reliability ranged from 0·43 for dairy foods to 0·94 for beverages, and was 0·92 for total diet index score (all P < 0·01). The intra-class correlation for validity ranged from 0·04 for meat and alternatives to 0·41–0·44 for fruit, beverages and extra foods, and was 0·44 for the total diet index score. The SFS overestimated the mean diet index score by 16 %, and the bias was consistent across levels of compliance. The percentage agreement into tertiles of index scores was 84% between the administrations of the two SFS, but only 43 % when comparing the SFS with the mean of the recalls.

The SFS can provide a consistent estimate of overall compliance to dietary guidelines for children aged 4–11 years, but overestimated the total diet index score by 16 % across all levels of compliance.

To systematically review the literature and map published studies on 4–8-year-olds’ intake of discretionary choices against an ecological framework (ANalysis Grid for Environments Linked to Obesity; ANGELO).

Articles were identified through database searches (PubMed, PyscINFO®, Web of Science) in February and March 2014 and hand-searching reference lists. Studies were assessed for methodological quality and mapped against the ANGELO framework by environment size (macro and micro setting) and type (physical, economic, policy and socio-cultural influences).

Studies were conducted in the USA (n 18), Australia (n 6), the UK (n 3), the Netherlands (n 3), Belgium (n 1), Germany (n 1) and Turkey (n 1).

Children aged 4–8 years, or parents/other caregivers.

Thirty-three studies met the review criteria (observational n 23, interventions n 10). Home was the most frequently studied setting (67 % of exposures/strategies), with the majority of these studies targeting family policy-type influences (e.g. child feeding practices, television regulation). Few studies were undertaken in government (5·5 %) or community (11 %) settings, or examined economic-type influences (0 %). Of the intervention studies only four were categorised as effective.

The present review is novel in its focus on mapping observational and intervention studies across a range of settings. It highlights the urgent need for high-quality research to inform interventions that directly tackle the factors influencing children’s excess intake of discretionary choices. Interventions that assist in optimising a range of environmental influences will enhance the impact of future public health interventions to improve child diet quality.

To describe the food and nutrient intakes of 9-month-old infants.

A survey undertaken as part of a longitudinal study of child growth and development. Infant diet was characterised through a structured interview in which consumption frequency and portion size of foods were obtained. This method was compared with a 4 d diary and had adequate relative validity.

Adelaide, Australia.

Three hundred and forty-one infants for whom dietary data were plausible according to pre-specified criteria.

At 9 months of age, the median body weights for 161 girls and 180 boys were 8·8 and 9·6 kg, respectively. Differences in intakes between boys and girls largely reflected differences in size. Median daily energy intake was 3541 kJ and median contributions of protein, fat and carbohydrate to total energy were 13 %, 36 % and 50 %. Using published Estimated Average Requirements, Zn intake was inadequate for <1 % of children not breast-fed at this age while Fe intake was inadequate for 9 %. Infants who were still breast-fed (35 %) had more diversity in the foods that provided additional energy, compared with those not receiving breast milk, and were less likely to consume nutrient-displacing drinks such as juice or cordial. Cow’s milk was the main drink for 5 % of infants.

In a group of Australian-born children, an important proportion had weaning diets that were low in Fe. Fat intake of many children was below current recommendations and cow’s milk was the main milk source for a small minority.

To describe adherence with infant feeding and complementary feeding guidelines.

Prospective study of infant feeding and complementary feeding practices were collected as part of the Cork BASELINE Birth Cohort Study.

Cork, Ireland.

Data are described for the 823 infants for whom a diary was completed.

Breast-feeding was initiated in 81 % of infants, and 34 %, 14 % and 1 % of infants were exclusively breast-fed at hospital discharge, 2 and 6 months, respectively. Stage one infant formula decreased from 71 % at 2 months to 13 % at 12 months. The majority of infants (79 %) were introduced to solids between 17 and 26 weeks and 18 % were given solid foods before 17 weeks. Mothers of infants who commenced complementary feeding prior to 17 weeks were younger (29·8 v. 31·5 years; P<0·001) and more likely to smoke (18 v. 8 %; P=0·004). The first food was usually baby rice (69 %), infant breakfast cereals (14 %) or fruit/vegetables (14 %). Meals were generally home-made (49 %), cereal-based (35 %), manufactured (10 %), dairy (3 %) and dessert-based (3 %). The median gap between the first–second, second–third, third–fourth and fourth–fifth new foods was 4, 2, 2 and 2 d, respectively.

We present the largest prospective cohort study to date on early infant feeding in Ireland. The rate of breast-feeding is low by international norms. Most mothers introduce complementary foods between 4 and 6 months with lengthy gaps between each new food/food product. There is a high prevalence of exposure to infant breakfast cereals, which are composite foods, among the first foods introduced.

In the current meta-analysis, we aimed to systematically review and summarize eligible studies for the association between dietary inflammatory index (DII) and blood pressure, hypertension (HTN) and glucose homeostasis biomarkers.

In a systematic search of PubMed, Scopus and Google Scholar electronic databases up to February 2019, relevant studies were included in the literature review. Observational studies evaluating the association between DII and HTN, hyperglycaemia, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), insulin, homeostatic model assessment of insulin resistance (HOMA-IR) and glycated Hb (HbA1c) were included.

Not applicable.

Total numbers of studies were as follows: OR for DII and HTN (n 12), OR for DII and hyperglycaemia (n 9), HTN prevalence (n 9), mean (sd) of SBP and DII (n 12), mean (sd) of DBP and DII (n 10), mean (sd) of FBS and DII (n 13), mean (sd) of HbA1c and DII (n 3), mean (sd) of insulin and DII (n 6), mean (sd) of HOMA-IR and DII (n 7). Higher DII scores were associated with higher odds of HTN (OR = 1·13; 95 % CI 1·01, 1·27; P < 0·001), SBP (weighted mean difference (WMD) = 1·230; 95 % CI 0·283, 2·177; P = 0·011), FBS (WMD = 1·083; 95 % CI 0·099, 2·068; P = 0·031), insulin (WMD = 0·829; 95 % CI 0·172, 1·486; P = 0·013), HbA1c (WMD = 0·615; 95 % CI 0·268, 0·961; P = 0·001) and HOMA-IR (WMD = 0·192; 95 % CI 0·023, 0·361; P = 0·026) values compared with lowest DII categories.

Lower inflammatory content of diets for prevention of cardiovascular risk factors is recommended.

In contrast to non-vegetarians, vegetarians consume more legumes and meat analogues as sources of protein to substitute for meat intake. The present study aimed to assess the association between foods with high protein content (legumes, meat, meat analogues) by dietary pattern (vegetarians, non-vegetarians) and hip fracture incidence, adjusted for selected lifestyle factors.

A prospective cohort of Adventist Health Study-2 (AHS-2) enrollees who completed a comprehensive lifestyle and dietary questionnaire between 2002 and 2007.

Every two years after enrolment, a short questionnaire on hospitalizations and selected disease outcomes including hip fractures was sent to these members.

Respondents (n 33 208) to a baseline and a follow-up questionnaire.

In a multivariable model, legumes intake of once daily or more reduced the risk of hip fracture by 64 % (hazard ratio = 0·36, 95 % CI 0·21, 0·61) compared with those with legumes intake of less than once weekly. Similarly, meat intake of four or more times weekly was associated with a 40 % reduced risk of hip fracture (hazard ratio = 0·60, 95 % CI 0·41, 0·87) compared with those whose meat intake was less than once weekly. Furthermore, consumption of meat analogues once daily or more was associated with a 49 % reduced risk of hip fracture (hazard ratio = 0·51, 95 % CI 0·27, 0·98) compared with an intake of less than once weekly.

Hip fracture incidence was inversely associated with legumes intake and, to a lesser extent, meat intake, after accounting for other food groups and important covariates. Similarly, a high intake of meat analogues was associated with a significantly reduced risk of hip fracture.

This study systematically reviewed literature on the neighbourhood food environment in relation to diet and obesity among residents in China.

A keyword search of peer-reviewed articles was performed in Cochrane Library, PubMed, and Web of Science. Eligibility criteria include study designs: longitudinal/cohort studies or cross-sectional studies; study participants: people of all ages; exposures: neighbourhood food environment (e.g. restaurants, supermarkets, wet markets, fast-food restaurants, or convenience stores); outcomes: diet and/or body weight status; and country: China.

Seventeen studies met all criteria and were included. Among the eight studies that assessed the neighbourhood food environment in relation to diet, six reported at least one statistically significant relationship in the expected direction, whereas the remaining two exclusively reported null effects. Among the eleven studies that assessed the neighbourhood food environment in relation to body weight or overweight/obesity, ten reported a significant association whereas the remaining one reported a null relationship. Variety, density, and proximity of food outlets were positively associated with local residents’ dietary diversity, portion size, and daily caloric intake. Density and proximity of fast-food restaurants and convenience stores were positively associated with local residents’ adiposity in some but not all studies. Evidence linking any specific food outlet type to diet/obesity remains lacking due to the small number of studies and heterogeneities in food environment measures, geographical locations, and population subgroups.

The neighbourhood food environment may influence diet and obesity among Chinese residents but the evidence remains preliminary. Future studies adopting an experimental study design and objective/validated environment and dietary measures are warranted.

To investigate whether adherence to the adapted Mediterranean Diet Score for Adolescents (MDS_A) and the adapted Mediterranean Diet Quality Index for Adolescents (KIDMED_A) is associated with better food/nutrient intakes and nutritional biomarkers.

The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study is a cross-sectional study aiming to obtain comparable data on a variety of nutritional and health-related parameters in European adolescents aged 12·5–17·5 years.

Nine European countries.

European adolescents (n 2330) recruited to the HELENA study. Dietary intake was obtained with 24 h dietary recalls, an FFQ and a Food Choices and Preferences questionnaire. MDS_A was calculated as a categorical variable using cut-offs (MDS_A), as a continuous variable (zMDS_A) and with energy adjustments (zEnMDS_A). The KIDMED_A score was also calculated.

Multilevel linear regression analysis showed positive associations for zMDS_A and KIDMED_A with serum levels of vitamin D, vitamin C, plasma folate, holo-transcobalamin, β-carotene and n-3 fatty acids, while negative associations were observed with trans-fatty acid serum levels. For categorical indices, blood biomarkers showed few significant results. zMDS_A and KIDMED_A showed positive associations with vegetables and fruits intake, and negative associations with energy-dense and low-nutritious foods. zMDS_A and KIDMED_A were positively associated with all macronutrients, vitamins and minerals (all P < 0·0001), except with monosaccharides and PUFA for KIDMED_A and cholesterol for both indices (P < 0·05).

zMDS_A and KIDMED_A have shown the strongest associations with the dietary indicators and biomarkers that have been associated with the Mediterranean diet before, and are therefore considered the most appropriate and valid Mediterranean diet scores for European adolescents.

To investigate item non-response in a postal food-frequency questionnaire (FFQ), and to assess the effect of substituting/imputing missing values on dietary intake levels in the Norwegian Women and Cancer study (NOWAC). We have adapted and probably for the first time applied k nearest neighbours (KNN) imputation to FFQ data.

Data from a recent reproducibility study were used. The FFQ was mailed twice (test–retest) about 3 months apart to the same subjects. Missing responses in the test FFQ were imputed using the null value (frequencies = null, amount = smallest), the sample mode, the sample median, KNN, and retest values.

A methodological substudy of NOWAC, a national population-based cohort.

A random sample of 2000 women aged 46–75 years was drawn from the cohort in 2002 (response 75%). The imputation methods were compared for 1430 women who completed at least 50% of the test FFQ.

We imputed 16% missing values in the overall test data matrix. Compared to null value imputation, the largest differences in estimated dietary intake were seen for KNN, and for food items with a high proportion of missing. Imputation with retest values increased total energy intake, indicating that not all missing values are caused by respondents failing to specify no consumption, and that null value imputation may lead to underestimation and misclassification.

Missing values in FFQs present a methodological challenge. We encourage the application and evaluation of newer imputation methods, including KNN, which may reduce imputation errors and give more accurate intake estimates.

Despite the promising results related to intuitive eating, few studies have attempted to explain the processes encouraging this adaptive eating behaviour. The focus of the present study was on exploring mechanisms of change in intuitive eating and weight in acceptance and commitment therapy (ACT) interventions. Mediation provides important information regarding the treatment processes and theoretical models related to specific treatment approaches. The study investigates whether psychological flexibility, mindfulness skills and sense of coherence mediated the interventions’ effect on intuitive eating and weight.

Secondary analysis of a randomized control trial. Mediation analysis compared two ACT interventions – face-to-face (in a group) and mobile (individually) – with a control group using a latent difference score model.

Data were collected in three Finnish towns.

The participants were overweight or obese (n 219), reporting symptoms of perceived stress.

The effect of the interventions on participants’ (i) BMI, (ii) intuitive eating and its subscales, (iii) eating for physical rather than emotional reasons and (iv) reliance on internal hunger and satiety cues was mediated by changes in weight-related psychological flexibility in both ACT groups.

These findings suggest that ACT interventions aiming for lifestyle changes mediate the intervention effects through the enhanced ability to continue with valued activities even when confronted with negative emotions and thoughts related to weight.

The study aimed to detail the lifestyle (physical activity and dietary habits) of Moroccan adolescents.

Cross-sectional study undertaken in the framework of the ATLS (Arab Teens Lifestyle Study).

Physical activity and dietary habits were determined using a validated questionnaire in public secondary schools.

A total of 669 adolescents aged 15·0–19·9 years were randomly recruited from Kenitra, Morocco.

Physical activity patterns and intensity differed between genders. As anticipated, male adolescents were more active than female adolescents across a typical week and engaged in more vigorous-intensity physical activity than female adolescents, who spent more time than male adolescents in moderate-intensity physical activity. Of particular concern was that one in five of the adolescents surveyed was inactive, with almost 45 % of the sample reporting television viewing for more than 2 h/d and 38 % engaged in computer use for a similar period. From a dietary perspective, most adolescents reported that they do not take breakfast or consume milk and dairy products, fruits and vegetables on a daily basis. In contrast, most reported consumption of doughnuts, cakes, candy and chocolate more than three times per week and approximately 50 % consumed sugary drinks more than three times per week.

Based on a continuation of the self-reported lifestyle behaviours, adolescents in the present study are at risk of developing chronic diseases. Education programmes are urgently needed to assist in the promotion of a healthy lifestyle and reduce the likelihood of overweight and obesity and related health risks among young people.