The insulin-like growth factor (IGF) system is implicated in the pathogenesis of diabetes and cardiovascular disease.

We report the effects of total energy intake on the IGF system in two populations with markedly different dietary macronutrient intake and cardiovascular event rate.

Dietary macronutrient intake was measured in a specific Gujarati migrant community in Sandwell, UK (n = 205) compared with people still resident in the same villages of origin in India (n = 246). Fasting IGF-I, IGF-binding protein (IGFBP)-1 and IGFBP-3, insulin and glucose (0 and 2-hour) were measured.

Total energy and total fat intake were higher in UK migrants, as were IGFBP-3 and IGF-I (mean (95% confidence interval): 145.9 (138.1–153.6) vs. 100.9 (94.6–107.3) ng ml-1; F = 76.6, P < 0.001). IGFBP-1 was lower in UK migrants (29.5 (25.9–33.0) vs. 56.5 (50.6–62.5) μg l-1; F = 48.4, P < 0.001). At both sites, IGF-I correlated positively with total energy (Spearman's ρ = 0.45, P < 0.001) and total fat (ρ = 0.44, P < 0.001) as did IGFBP-3 with total energy (ρ = 0.21, P < 0.05) and fat (ρ = 0.26, P < 0.001). Conversely, in Indian Gujaratis, IGFBP-1 fell with increasing total energy (ρ = -0.27, P < 0.001) and fat intake (ρ = -0.26, P < 0.01) but not in UK Gujaratis. Multiple linear regression modelling showed that increasing quartiles of fat intake were associated with higher IGF-I (β = 0.42, P = 0.007) independent of age, body mass index, plasma insulin, fatty acids and 2-hour glucose.

In these genetically similar groups, migration to the UK and adoption of a different diet is associated with marked changes in the IGF system, suggesting that environmental factors profoundly modulate serum concentrations and actions of IGFs.

Given the rapid increase in the prevalence of childhood obesity, identifying the sociodemographic influences on obesity status is important for planning and implementing effective prevention initiatives. However, this type of data is limited for Greek children. Therefore the aim of the present study was to identify possible sociodemographic factors associated with childhood obesity at the national level.

Cross-sectional, population-based survey, carried out from October to May 2009.

Under the context of the GRECO (Greek Childhood Obesity) study, a nationwide sample of 2315 primary-school children.

Children aged 10–12 years and their parents were voluntarily enrolled. Direct anthropometric measurements of the children were obtained and information on sociodemographic characteristics of the parents, as well as their self-reported values of body weight and height, were collected.

Overweight and obesity prevalence was 29·5 % and 13·1 %, respectively, among boys; 29·5 % and 9·0 %, respectively, among girls. Multiple logistic regression analysis revealed that the most important sociodemographic predictors of childhood obesity were mother's age, parental BMI classification and father's type of occupation. More specifically, increased mother's age and normal BMI status of the parents seemed to have a protective effect on the likelihood of having an overweight/obese child. Additionally, the odds of a female child of being overweight/obese were reduced when the father's type of occupation tended to be less manual.

Anti-obesity health policy interventions have to address to the parents and promote their active involvement, to effectively confront the alarming magnitude of the paediatric obesity problem in Greece.

To study whether service of a free school lunch has an impact on weight development and food intake among pupils at a lower secondary school, and to assess the association between self-perceived school behaviour and food intake.

A controlled intervention study involving service of a free healthy school lunch to 9th grade pupils took place over 4 months, from January to May 2007. Weight and height were measured before and after the intervention. The pupils also completed a short FFQ and a questionnaire concerning self-perceived school behaviour and the classroom environment before and after the intervention. A healthy food score was calculated using the FFQ data.

All 9th graders at three different lower secondary schools in southern Norway were invited to participate. One school was randomly selected as the intervention school.

Fifty-eight pupils (91 %) from the intervention school and ninety-two pupils (77 %) from the control schools participated.

BMI did not increase among the girls at the intervention school, but increased significantly among the boys at the intervention school and among the control school groups. The healthy food score correlated positively with the trait ‘satisfied with schoolwork’ (P < 0·001). Fifteen per cent of the variance in food score could be explained by gender and the trait ‘satisfied with schoolwork’.

Serving of a healthy free school lunch to secondary-school pupils may result in restricted weight gain. Further studies are needed to clarify the impact of school meals on overweight and academic performance.

Throughout the world, the proportion of the male population aged 65 years and older is increasing. Yet, we have limited information regarding diet quality and predictors of diet quality in this segment of the population. The objectives of the current analyses are to describe the diet quality of a cohort of men >65 years of age, and identify lifestyle factors associated with poor diet quality.

We present a cross-sectional analysis of the diet quality of 5928 men, aged 65–100 years, who are participants in the Osteoporotic Fractures in Men (MrOS) cohort study. Dietary intake was determined using a modified Block 98 food-frequency questionnaire. Diet quality was calculated using the previously validated Diet Quality Index-Revised (DQI-R). Univariate and multivariate modelling was used to estimate the variance in diet quality predicted by a number of sociodemographic factors, including age, race/ethnicity, body mass index (BMI), marital status, education, smoking status, physical activity, self-perceived health and nutritional supplement use.

Overall, we found that in this geographically diverse group of older men, diet quality was low, with a mean modified DQI-R for the entire study population of 62.5 (standard deviation 13.1) out of an ideal of 100. Further, younger age, very low total calorie intake ( ≤ 1187 kcal day− 1), higher BMI, residence in a North or Southeast community, being of African-American or Hispanic race, being less educated, not using dietary supplements and smoking were each significant independent predictors of a poorer diet.

These data may prove useful in both understanding the dietary intake of older US men as it relates to published dietary guidelines, and for targeting future dietary intervention programmes.

To assess produce availability, quality and price in a large sample of food stores in low-income neighbourhoods in California.

Cross-sectional statewide survey.

Between 2011 and 2015, local health departments assessed store type, WIC (Supplemental Nutrition Program for Women, Infants, and Children)/SNAP (Supplemental Nutrition Assistance Program) participation, produce availability, quality and price of selected items in stores in low-income neighbourhoods. Secondary data provided reference chain supermarket produce prices matched by county and month. t Tests and ANOVA examined differences by store type; regression models examined factors associated with price.

Large grocery stores (n 231), small markets (n 621) and convenience stores (n 622) in 225 neighbourhoods.

Produce in most large groceries was rated high quality (97 % of fruits, 98 % of vegetables), but not in convenience stores (25 % fruits, 14 % vegetables). Small markets and convenience stores participating in WIC and/or SNAP had better produce availability, variety and quality than non-participating stores. Produce prices across store types were, on average, higher than reference prices from matched chain supermarkets (27 % higher in large groceries, 37 % higher in small markets, 102 % higher in convenience stores). Price was significantly inversely associated with produce variety, adjusting for quality, store type, and SNAP and WIC participation.

The study finds that fresh produce is more expensive in low-income neighbourhoods and that convenience stores offer more expensive, poorer-quality produce than other stores. Variety is associated with price and most limited in convenience stores, suggesting more work is needed to determine how convenience stores can provide low-income consumers with access to affordable, high-quality produce. WIC and SNAP can contribute to the solution.

To examine the temporal pattern of the number of eating occasions that occurred at home, at work and outside the home, and to examine the contribution of fat to energy and the contribution of 26 food groups to fat at home and outside the home.

Food intake data were collected using a 7-day food diary from a random sample of 18–64-year-old adults from the Republic of Ireland (n = 958). Respondents recorded the day, time and location of every eating occasion.

The number of eating occasions was constant across the days of the week for meals consumed at home, whereas the number of eating occasions increased at weekends for meals outside the home. The contribution of fat to energy approximated the 35% recommendation at home from Monday to Friday, but increased above this on Saturday and Sunday. The contribution of fat to energy outside the home was always above the recommendation. The food groups that contributed most to fat were similar at home and outside the home. These included butter and full-fat spreads, fresh meat, meat products, meat dishes, biscuits, cakes and pastries, whole milk, and chips and processed potatoes.

The contribution of fat to energy was above the recommendations when eating outside the home, regardless of day of the week. A number of food groups have been identified that contributed most to fat intake outside the home and these might be targeted in developing public health nutrition strategies to reduce fat intake.

To study diet quality among pre-schoolers using the Diet Quality Index (DQI) and to investigate differences according to gender, socio-economic status (SES) and overweight/obesity status.

Kindergarten-based cross-sectional survey within the ToyBox-study. A standardized protocol was used and parents/caregivers self-reported sociodemographic data and a semi-quantitative FFQ. A total DQI and its four subcomponents (diversity, quality, equilibrium and meal index) were calculated based on this FFQ. High total DQI scores indicate better diet quality than low scores. Results of the total DQI and the subcomponents were reported as percentages of maximum scores (100 %).

Kindergartens in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain).

European pre-schoolers (aged 3·5–5·5 years) and their parents/caregivers (n 7063).

The mean total DQI score was 68·3 %. Mean scores of the subcomponents were 61·7 % for diversity, 56·5 % for quality, 65·4 % for equilibrium and 89·7 % for the meal index. Pre-schoolers of lower-SES backgrounds had lower scores on the total DQI and all its subcomponents. No clear differences were found by gender and overweight status. Results differed slightly according to country.

Pre-schoolers scored low on the total DQI and especially on dietary quality, as energy-dense, low-nutritious food items were more often consumed than highly nutritious food items. Furthermore, already in pre-schoolers lower-SES mothers were less likely to provide a good diet quality and this was consistent for all four subcomponents of the total DQI. Food intake in pre-schoolers should be enhanced, especially in pre-schoolers of lower-SES backgrounds.

To describe nutrition environments in formal child care for 3- and 4-year-olds.

Cross-sectional online survey of nutrition-related child-care policy and practice. Written nutrition policies were analysed using the Wellness Child Care Assessment Tool.

Licensed child-care services in the Auckland, Counties Manukau and Waikato regions of New Zealand.

Eight hundred and forty-seven services (private and community day care, kindergartens and playcentres).

Managers/head teachers of 257 child-care services completed the survey. Of services, 82·4 % had a written food, nutrition or wellness policy. Most policies did not refer to the national Food and Nutrition Guidelines and lacked directives for staff regarding recommended behaviours to promote healthy eating. Food was provided daily to children in 56·4 % of child-care services, including 33·5 % that provided lunch and at least two other meals/snacks every day. Teachers talked to children about food, and cooked with children, at least weekly in 60 % of child-care services. Nearly all services had an edible garden (89·5 %). Foods/beverages were sold for fundraising in the past 12 months by 37·2 % of services. The most commonly reported barrier to promoting nutrition was a lack of support from families (20·6 %).

Although the majority of child-care services had a written nutrition policy, these were not comprehensive and contained weak statements that could be difficult to action. Foods served at celebrations and for fundraising were largely high in sugar, salt and/or saturated fat. Most services promoted some healthy eating behaviours but other widespread practices encouraged children to overeat or form unhealthy food preferences.

To assess the relationship between adolescent perception of time to walk to neighbourhood food retail outlets and purchasing of sugar-sweetened beverages (SSB), fast and convenience food items, and to test for differences by urban v. suburban environment.

Cross-sectional observational study.

Twin Cities Metropolitan Area, Minnesota, USA.

Adolescents from two studies completed survey-based measures on perceptions of time to walk to food retail outlets from home, purchasing patterns of SSB and fast and convenience store items, perceptions of personal safety and pedestrian infrastructure, and demographic characteristics. Descriptive analysis, Spearman correlations and multivariate linear regression, accounting for clustering, were conducted.

There were 634 adolescents, approximately half male, predominantly white, with a middle-class background. Greater perceived time to food outlets was associated with less frequent purchasing of SSB, convenience store foods and fast-food items. Multivariate models showed that a perceived shorter walking time (i.e. 1−5 v. 31+ min) was significantly associated with more SSB purchasing. SSB purchases were also significantly associated with the number of food outlets within a 10 min walk (B = 0·05, P = 0·02).

A reduction in consumption of SSB and other energy-dense snacks is an important obesity prevention approach. An approach offering alternatives or reducing exposure in addition to education to alter purchasing habits may contribute to improving dietary habits and reducing the obesity epidemic.

To determine the reliability, validity and correlates of measures of food insecurity (FI) obtained using an individually focused food insecurity access scale (IFIAS) among pregnant women of mixed HIV status in northern Uganda.

A mixed-methods study involving cognitive interviews nested within a cross-sectional survey.

The antenatal care clinic of Gulu Regional Referral Hospital.

Survey respondents included 403 pregnant women, recruited in a ratio of one HIV-infected to two HIV-uninfected respondents, twenty-six (nine of them HIV-infected) of whom were asked to participate in the cognitive interviews.

Over 80 % of cognitive interview participants reported understanding the respective meanings of six of the nine items (i.e. items 4 to 9) on the IFIAS. Two main factors emerged from rotated exploratory factor analysis of the IFIAS: mild to moderate FI (IFIAS items 1–6) and severe FI (items 7–9). Together, they explained 90·4 % of the FI measure’s variance. The full IFIAS and the two subscales had moderate to high internal consistency (Cronbach’s α ranged from 0.75 to 0.87). Dose–response associations between IFIAS scores, and measures of socio-economic status and women’s diet quality, were observed. Multivariate linear regression revealed significant positive associations between IFIAS scores and HIV infection, maternal age, number of children and a history of internal displacement. IFIAS scores were negatively associated with women’s diet diversity score, asset index and being employed.

The IFIAS showed strong reliability, validity and contextual relevance among women attending antenatal care in northern Uganda.

Fruit and vegetable consumption is a focus of research and nutrition education; yet, there is no universal agreement on the meaning of ‘fruits’ and ‘vegetables’. Our objective was to describe survey respondent perceptions about a set of foods with regard to whether the food is a fruit, vegetable or something else.

Three cross-sectional studies.

Two small studies involving cognitive interviewing sessions; and one large self-administered population survey.

US adults in two small studies (n 55 and 80) and one large survey (n 3312), all with multiple race/ethnicities.

Perceptions varied. In the survey, rice was considered a vegetable by about 20 % of respondents. In one small study, Spanish speakers were more likely to consider rice a vegetable, and Chinese speakers less likely, than were English speakers. Black beans were frequently classified as something other than vegetable or fruit. Among Hispanics, Spanish speakers were less likely than English speakers to consider beans a vegetable. Overall, tomatoes were classified as both fruit and vegetable, and these perceptions varied by race/ethnicity.

Substantial disagreement among the fruit, vegetable and other food domains highlights the importance of clearly defining the desired constructs. Foods that require specific instruction include rice, dried beans, potatoes, tomatoes and fruits and vegetables in mixtures and condiments. For measurement, additional questions or explanations may be needed to clarify which foods are of interest. For communication, the global message to increase consumption of fruit and vegetables should be reinforced with specific guidance.

To investigate whether children with concurrent wasting and stunting require therapeutic feeding and to better understand whether multiple diagnostic criteria are needed to identify children with a high risk of death and in need of treatment.

Community-based cohort study, following 5751 children through time. Each child was visited up to four times at 6-month intervals. Anthropometric measurements were taken at each visit. Survival was monitored using a demographic surveillance system operating in the study villages.

Niakhar, a rural area of the Fatick region of central Senegal.

Children aged 6–59 months living in thirty villages in the study area.

Weight-for-age Z-score (WAZ) and mid-upper arm circumference (MUAC) were independently associated with near-term mortality. The lowest WAZ threshold that, in combination with MUAC, detected all deaths associated with severe wasting or concurrent wasting and stunting was WAZ <−2·8. Performance for detecting deaths was best when only WAZ and MUAC were used. Additional criteria did not improve performance. Risk ratios for near-term death in children identified using WAZ and MUAC suggest that children identified by WAZ <−2·8 but with MUAC≥115 mm may require lower-intensity treatment than children identified using MUAC <115 mm.

A combination of MUAC and WAZ detected all near-term deaths associated with severe anthropometric deficits including concurrent wasting and stunting. Therapeutic feeding programmes may achieve higher impact if WAZ and MUAC admission criteria are used.

To investigate dietary intake, BMI and supermarket access at varying geographic scales and transport modes across areas of socio-economic disadvantage, and to evaluate the implementation of an urban planning policy that provides guidance on spatial access to supermarkets.

Cross-sectional study used generalised estimating equations to investigate associations between supermarket density and proximity, vegetable and fruit intake and BMI at five geographic scales representing distances people travel to purchase food by varying transport modes. A stratified analysis by area-level disadvantage was conducted to detect optimal distances to supermarkets across socio-economic areas. Spatial distribution of supermarket and transport access was analysed using a geographic information system.

Melbourne, Australia.

Adults (n 3128) from twelve local government areas (LGA) across Melbourne.

Supermarket access was protective of BMI for participants in high disadvantaged areas within 800 m (P=0·040) and 1000 m (P=0·032) road network buffers around the household but not for participants in less disadvantaged areas. In urban growth area LGA, only 26 % of dwellings were within 1 km of a supermarket, far less than 80–90 % of dwellings suggested in the local urban planning policy. Low public transport access compounded disadvantage.

Rapid urbanisation is a global health challenge linked to increases in dietary risk factors and BMI. Our findings highlight the importance of identifying the most appropriate geographic scale to inform urban planning policy for optimal health outcomes across socio-economic strata. Urban planning policy implementation in disadvantaged areas within cities has potential for reducing health inequities.

To examine associations between the availability of residential-area food sources and dietary patterns among seniors.

Cross-sectional analyses. Individual-level data from the NuAge study on nutrition and healthy ageing were merged with geographic information system data on food store availability and area-level social composition. Two dietary patterns reflecting lower- and higher-quality diets (respectively designated ‘western’ and ‘prudent’) were identified from FFQ data. Two food source relative availability measures were calculated for a 500 m road-network buffer around participants’ homes: (i) proportion of fast-food outlets (%FFO) relative to all restaurants and (ii) proportion of stores potentially selling healthful foods (%HFS, healthful food stores) relative to all food stores. Associations between dietary patterns and food source exposure were tested in linear regression models accounting for individual (health and sociodemographic) and area-level (socio-economic and ethnicity) covariates.

Montréal metropolitan area, Canada.

Urban-dwelling older adults (n 751), aged 68 to 84 years.

%FFO was inversely associated with prudent diet (β = −0·105; P < 0·05) and this association remained statistically significant in models accounting for %HFS. %HFS was inversely associated with lower western diet scores (β = −0·124; P < 0·01). This latter association no longer reached significance once models were adjusted for area-level covariates.

In Montréal, the food environment is related to the diet of older adults but these links are more complex than straightforward. The absence of significant relationships between healthful food stores and prudent diets, and between fast-food outlets and western diets, deserves further investigation.

Diet in adolescence is important not only because of adolescents’ rapid growth but also due to its influence on future chronic diseases. On the other hand, dietary quality indices are noteworthy and useful approaches to evaluate dietary intakes. Thus the present study was conducted to assess dietary quality indices in adolescents.

Cross-sectional.

The data were collected from schools in Isfahan, Iran.

Female students (n 265) aged 11–13 years were enrolled using systematic cluster-random sampling in Isfahan (Iran). Dietary intakes were assessed by a validated FFQ. Diet quality indices including dietary diversity score (DDS), the Healthy Eating Index (HEI) and mean adequacy ratio (MAR) across ten nutrients were calculated.

Mean DDS, HEI score and MAR were 6·15 (sd 1·61) out of 10 points, 63·90 (sd 19·86) out of 100 points and 1·32 (sd 0·61), respectively. Mean nutrient adequacy ratio of all nutrients was above 1 except for vitamin D (0·53 (sd 0·51)). Those in the highest tertile of DDS had the most favourable anthropometric variables in comparison to the lowest tertile. There were no significant associations between HEI score and BMI, central or abdominal obesity and blood pressure. Those in the highest tertile of MAR had higher BMI, waist circumference and hip circumference.

Diet quality of Isfahani adolescents needs improvement. It may imply the necessity of implementing nutritional instructive policies in this age group and their parents.

To study how different meals contribute to intakes of fruits, vegetables, fish and whole grains in a group of Norwegian adults and in subgroups of this population. Moreover, to investigate the consequences of skipping the meal contributing most to the intake of each food group (main contributing meal).

Cross-sectional dietary survey in Norwegian adults. Dietary data were collected using two non-consecutive telephone-administered 24 h recalls. The recorded meal types were breakfast, lunch, dinner, supper/evening meal and snacks.

Nationwide, Norway (2010–2011).

Adults aged 18–70 years (n 1787).

Dinner was the main contributing meal for fish and vegetables, while snacks were the main contributing meal for fruit intake. For whole grains, breakfast was the main contributing meal. The main contributing meal did not change for any of the food groups when studying subgroups of the participants according to intake of each food group, educational level or age. A substantially lower intake of the food groups in question was found on days when the main contributing meal was skipped.

Intakes of fruits, vegetables, fish and whole grains largely depend on one meal type. Inclusion of these foods in other meals in addition to the main contributing meal, preferably replacing energy-dense nutrient-poor foods, should be promoted.

To identify predictors of increased adiposity for different measures of adiposity.

Prospective cohort study, the Melbourne Collaborative Cohort Study (MCCS), with data at baseline (1990–1994) and wave 2 (2003–2007).

Participants recruited from the community.

Australian-born participants (n 5879) aged 40 to 69 years who were not current smokers and who were free from common chronic diseases at recruitment. At baseline and at wave 2, weight and waist circumference were measured; while demographic and lifestyle variables were obtained at baseline via structured interviews.

Participants who reported any recreational physical activity at baseline had lower weight and smaller waist circumference at wave 2 than those who did not, particularly for younger participants and for vigorous physical activity. Walking for leisure was not associated, and greater physical activity at work was associated, with greater adiposity measures at wave 2. A diet low in carbohydrates and fibre, but high in fat and protein, predicted greater weight and waist circumference at wave 2. Participants were less likely to have elevated weight or waist circumference at wave 2 if they consumed low to moderate amounts of alcohol.

Our findings indicate that promoting vigorous physical activity, encouraging a diet high in carbohydrate and fibre but low in fat and protein, and limiting alcohol intake could be promising approaches for preventing obesity in middle-aged adults. Similar interventions should successfully address the management of both weight and waist circumference, as they were predicted by similar factors.

To determine the impact of BMI on post-operative outcomes and resource utilization following elective total hip arthroplasty (THA).

A retrospective cohort analysis on all primary elective THA patients between 1996 and 2004. Primary outcomes investigated using regression analyses included length of stay (LOS) and costs (US dollars).

Mayo Clinic Rochester, a tertiary care centre.

Patients were stratified by pre-operative BMI as normal (18·5–24·9 kg/m2), overweight (25·0–29·9 kg/m2), obese (30·0–34·9 kg/m2) and morbidly obese (≥35·0 kg/m2). Of 5642 patients, 1362 (24·1 %) patients had a normal BMI, 2146 (38·0 %) were overweight, 1342 (23·8 %) were obese and 792 (14·0 %) were morbidly obese.

Adjusted LOS was similar among normal (4·99 d), overweight (5·00 d), obese (5·02 d) and morbidly obese (5·17 d) patients (P = 0·20). Adjusted overall episode costs were no different (P = 0·23) between the groups of normal ($17 211), overweight ($17 462), obese ($17 195) and morbidly obese ($17 655) patients. Overall operative and anaesthesia costs were higher in the morbidly obese group ($5688) than in normal ($5553), overweight ($5549) and obese ($5593) patients (P = 0·03). Operating room costs were higher in morbidly obese patients ($3418) than in normal ($3276), overweight ($3291) and obese ($3340) patients (P < 0·001). Post-operative costs were no different (P = 0·30). Blood bank costs differed (P = 0·002) and were lower in the morbidly obese group ($180) compared with the other patient groups (P < 0·05). Other differences in costs were not significant. Morbidly obese patients were more likely to be transferred to a nursing home (24·1 %) than normal (18·4 %), overweight (17·9 %) or obese (16·0 %) patients (P = 0·001 each). There were no differences in the composite endpoint of 30 d mortality, re-admissions, re-operations or intensive care unit utilization.

BMI in patients undergoing primary elective THA did not impact LOS or overall institutional acute care costs, despite higher operative costs in morbidly obese patients. Obesity does not increase resource utilization for elective THA.

To examine: (i) children's food intake and adherence to both Canada's Food Guide for Healthy Eating and Dietary Reference Intakes; and (ii) the social and demographic factors related to children's food intake.

A cross-sectional study.

Data were obtained through the Quebec Longitudinal Study of Child Development 1998–2010, a representative sample (n 2103) of children born in 1998 in the province of Quebec, Canada. Information on energy, macronutrient and food consumption was derived from responses to a 24 h dietary recall interview addressed to children's mothers and day-care staff when the children were 4 years old.

A total of 1549 children aged 4 years who participated in a nutritional sub-study.

The mean daily total energy intake was 6360 kJ (1520 kcal) for girls and 6916 kJ (1653 kcal) for boys. For boys and girls alike, energy intake was comprised of approximately 54 % carbohydrates, 31 % fats and 15 % proteins. The mean number of servings consumed from each of the four essential food groups closely approached the dietary recommendations made by Canada's Food Guide for Healthy Eating; however, <2 % of the children in the present study actually met the full dietary guidelines. The dietary intake of pre-school children was associated with socio-economic and demographic factors, most notably mother's level of education, mother's immigrant status and sex of the child.

Diet-related disparities associated with socio-economic and demographic factors exist from as early as 4 years of age.

To examine the relationship between dietary cruciferous vegetable intake and selected tumour biomarkers for histone acetylation (H3K9ac, H3K18ac, HDAC3 and HDAC6), proliferation (Ki-67) and cell-cycle regulation (p21) from breast tissue.

The study used baseline data of women recruited to participate in a clinical trial of sulforaphane supplement. Dietary cruciferous vegetable intake was collected through a validated Arizona Cruciferous Vegetable Intake Questionnaire. Breast tissue was obtained from biopsy samples. Spearman correlations were calculated between intake of specific cruciferous vegetables and biomarkers. Tissue biomarkers were log2-transformed to obtain approximate normality. Linear regression analyses were conducted to examine associations between cruciferous vegetable intake and biomarkers adjusting for age and use of non-steroidal anti-inflammatory drugs. False discovery rate (FDR) was used to account for multiple comparisons.

Clinical trial baseline.

Fifty-four women who had abnormal mammogram findings and were scheduled for breast biopsy.

Mean intake of total cruciferous vegetables from all food sources was 81·7 (sd 57·3) g/d. Mean urinary total sulforaphane metabolites was 0·08 (sd 0·07) µm/mm creatinine. Total cruciferous vegetable intake was inversely associated with Ki-67 protein expression in breast ductal carcinoma in situ (DCIS) tissue (β=−0·004; se=0·001; FDR q value=0·03), but not in benign or invasive ductal carcinoma (IDC) tissue. No association was found for other biomarkers measured (HDAC3, HDAC6, H3K9, H3K18 and p21) in all tissues examined (benign, DCIS and IDC).

The present study sought to provide additional evidence for the potential role of sulforaphane in histone acetylation and cell proliferation. Here, we report that total cruciferous vegetable intake is associated with decreased cell proliferation in breast DCIS tissue.