We examined the association of metabolic syndrome (MetS) and its components with dietary intakes of Mg in Tehran adults.

In a cross-sectional study, dietary intakes were assessed using a valid and reliable FFQ. MetS was defined according to the modified guidelines of the National Cholesterol Education Program Adult Treatment Panel III. Waist circumference (WC) was coded according to the newly introduced cut-off points for Iranian adults (≥95 cm for both genders).

Participants of the Tehran Lipid and Glucose Study (2006–2008).

Adults (n 2504; 1120 men and 1384 women) aged 18–74 years.

The mean age of participants was 40·8 (sd 14·6) years and 38·2 (sd 13·5) years for men and women, respectively. The reported mean intake of Mg was 349 (sd 109) mg/d. After adjustment for confounding factors, dietary Mg intake was inversely associated with fasting blood glucose (β = −0·08, P = 0·006), TAG (β = −0·058, P = 0·009) and WC (β = −0·013, P = 0·006); however, there were no associations between dietary Mg and diastolic blood pressure, systolic blood pressure or HDL cholesterol. An association was observed between MetS Z-score and Mg intake (crude β = −0·017, P = 0·001), independent of age, gender, smoking, physical activity and BMI; this association was attenuated following further adjustment for dietary factors and menopausal status (β = −0·034, P = 0·061).

Our findings suggest a significant inverse association between dietary Mg, MetS and its components.

To describe the prevalence of ‘graded thinness’ in children aged 11, 13 and 15 years in eleven developed countries and to identify trends in the prevalence of ‘thinness’ (BMI < 17 kg/m2 at age 18 years) by age and gender.

Cross-sectional study using data collected through self-reported questionnaires.

Data were taken from the 1997/1998, 2001/2002 and 2005/2006 surveys of the Health Behaviours in School-aged Children (HBSC) Study.

Children and adolescents from ten European countries and the USA (n 158 000).

Prevalence of grades 1, 2 and 3 of thinness was higher among 11-year-old students compared with the 13- and 15-year-olds in all countries. A higher prevalence of thinness was observed in girls than in boys. Since 1998 the prevalence of thinness decreased steadily in Czech boys and girls, while it increased for French girls. In the total European sample of females, thinness decreased from 1998 to 2006 (χ2 for trend, P < 0·01). Age-adjusted logistic regression analysis showed that Czech boys and girls, and Flemish and American girls were less likely to be thin in 2006 than in 1998; while a noteworthy increment, even if borderline significant, was observed for French girls with a 41 % increase in the likelihood to be thin.

Our findings suggest that thinness is an important overlooked phenomenon with wide variation in prevalence and trends across developed countries. It deserves further longitudinal studies in a multinational context that could increase the understanding of the factors associated with thinness and contribute to developing preventive and nutritional programmes targeted at controlling obesity and chronic diseases, while monitoring thinness.

Consumers are increasingly relying on low-cost foods, although it is not clear if the nutritional quality of these foods is fully maintained. The aim of the present work was to analyse the relationship between cost and quality within a given food category.

The relationship was analysed between nutritional quality and cost for 220 food products belonging to seventeen different categories, controlling for package type and package size. Given that a summary of nutrient information was not available on the product label, a novel ingredient quality score was developed based on listed product ingredients.

Within a given category, the lowest-priced foods were not different from the equivalent branded products in terms of overall energy or total fat content. Nevertheless, a positive relationship, small but significant, was observed between the price and the ingredient quality score. On average, the branded products cost 2·5 times more than the low-cost products, for an equivalent energy and lipid content, and had a slightly higher (1·3 times) ingredient quality score.

More studies are necessary to evaluate the nutritional quality of low-cost foods. This evaluation would be facilitated if nutrition labelling was mandatory. Yet in view of the present results, it does not seem to be justified to divert consumers, especially the poorest, from low-cost foods because this may have an adverse effect on the nutritional quality of their diet, by reducing further the fraction of their food budget spent on fresh fruit and vegetables.

We investigated the relationship between the intake of fish and the risk of death from prostate cancer.

Data were derived from a prospective cohort study in Japan. Fish consumption obtained from a baseline questionnaire was classified into the two categories of ‘low intake’ and ‘high intake’. The Cox proportional hazards model was used to estimate hazard ratios (HR) and 95 % confidence intervals.

Data for 5589 men aged 30–79 years were analysed.

A total of twenty-one prostate cancer deaths were observed during 75 072 person-years of follow-up. Mean age at baseline study of these twenty-one subjects was 67·7 years, ranging from 47 and 79 years old. Results showed a consistent inverse association of this cancer between the high v. low intake groups. The multivariate model adjusted for potential confounding factors and some other food items showed a HR of 0·12 (95 % CI 0·05, 0·32) for the high intake group of fish consumption.

These results support the hypothesis that a high intake of fish may decrease the risk of prostate cancer death. Given the paucity of studies examining the association between prostate cancer and fish consumption, particularly in Asian populations, these findings require confirmation in additional cohort studies.

To describe the association between duration of exclusive breast-feeding (EBF), weight gain in infancy and childhood BMI in two populations with a long duration of EBF.

Cohort study with follow-up in childhood. Breast-feeding status was reported monthly during infancy. Weight and length were measured at birth, 2, 6 and 12 months of age, as well as in childhood at 6 or 10 years of age.

Iceland and Denmark.

Randomly selected healthy newborns from Denmark (n 85) and Iceland (n 100).

Infants exclusively breast-fed for ≤2 months gained 348 (95% CI 69, 626) g more weight from 2 to 6 months than infants exclusively breast-fed for 3–4 months (P = 0·009). Weight gain from 6 to 12 months was found to be greater among infants exclusively breast-fed for ≤2 months compared with those exclusively breast-fed for ≥5 months (P = 0·008). A greater weight change, in terms of Z-score, between the ages of 2 and 6 months was associated with higher Z-score of childhood BMI, adjusted for birth weight, country and duration of EBF (B = 0·49, se = 0·11, P < 0·001, adj. R2 = 0·15). However, the association was much stronger in the Icelandic cohort than the Danish one.

Although duration of EBF was not associated with childhood BMI in the present study it may modulate growth rate in infancy, which is related to childhood BMI. However, other factors determinative for infant growth also need to be considered when assessing the relationship of early growth and nutrition to childhood overweight, as traditions in complementary food might differ between populations.

To evaluate the effectiveness of a vitamin-fortified maize meal to improve the nutritional status of 1–3-year-old malnourished African children.

A randomised parallel intervention study was used in which 21 experimental children and their families received maize meal fortified with vitamin A, thiamine, riboflavin and pyridoxine, while 23 control children and their families received unfortified maize meal. The maize meal was provided for 12 months to replace the maize meal habitually consumed by these households.

Sixty undernourished African children with height-for-age or weight-for-age below the 5th percentile of the National Center for Health Statistics' criteria and aged 1–3 years were randomly assigned to an experimental or control group. Baseline measurements included demographic, socio-economic and dietary data, as well as height, weight, haemoglobin, haematocrit, serum retinol and retinol-binding protein (RBP). Anthropometric, blood and serum variables were measured again after 12 months of intervention. Complete baseline measurements were available for 44 children and end data for only 36. Changes in these variables from baseline to end within and between groups were assessed for significance with paired t-tests, t-tests and analysis of variances using the SPSS program, controlling for expected weight gain in this age group over 12 months. Relationships between changes in variables were examined by calculating correlation coefficients.

The children in the experimental group had a significantly (P≤0.05) higher increase in body weight than control children (4.6 kg vs. 2.0 kg) and both groups had significant (P≤0.05) but similar increases in height. The children in the experimental group showed non-significant increases in haemoglobin and serum retinol, while the control children had a significant (P = 0.007) decrease in RBP. The change in serum retinol showed a significant correlation with baseline retinol (P = 0.014), RBP (P = 0.007) and weight (P = 0.029), as well as with changes in haemoglobin (P = 0.029).

Despite a small sample size, this study showed positive effects of a vitamin-fortified maize meal on weight gain and some variables of vitamin A status in 1–3-year-old African children. The study confirmed the relationship between vitamin A and iron status. The results suggest that fortification of maize meal would be an effective strategy to address micronutrient deficiencies in small children in South Africa.

(1) To describe promotional activities, particularly student-led, targeting lower-fat à la carte foods that were conducted in secondary schools; and (2) to describe the relationships between the number and duration of total promotional activities for lower-fat à la carte foods and cafeteria sales of such foods over two years.

Promotional activities were implemented in schools that were randomised to the intervention condition of a larger, two-year, school-based, randomised, controlled nutrition intervention trial.

Ten Minnesota secondary schools.

Students and school faculty, school food-service and research staff (measured at the school level).

Over two years, 181 promotions were implemented (n = 49 in Year 1 and n = 132 in Year 2). In Year 1, the number of promotions conducted in schools was significantly associated with percentage lower-fat food sales. In Year 2, the duration of promotions was significantly associated with percentage lower-fat food sales.

Collaborative efforts among students, school food-service staff and research staff can be successful in implementing a large number of nutrition-related, school-wide promotional activities. These efforts can increase the sales of lower-fat foods in à la carte areas of school cafeterias.

Ageing and urbanization leading to sedentary lifestyles have been the major explanations proposed for a dramatic rise in diabetes worldwide and have been the variables used to predict future diabetes rates. However, a transition to Western diets has been suggested as an alternative driver. We sought to determine what socio-economic and dietary factors are the most significant population-level contributors to diabetes prevalence rates internationally.

Multivariate regression models were used to study how market sizes of major food products (sugars, cereals, vegetable oils, meats, total joules) corresponded to diabetes prevalence, incorporating lagged and cumulative effects. The underlying social determinants of food market sizes and diabetes prevalence rates were also studied, including ageing, income, urbanization, overweight prevalence and imports of foodstuffs.

Data were obtained from 173 countries.

Population-based survey recipients were the basis for diabetes prevalence and food market data.

We found that increased income tends to increase overall food market size among low- and middle-income countries, but the level of food importation significantly shifts the content of markets such that a greater proportion of available joules is composed of sugar and related sweeteners. Sugar exposure statistically explained why urbanization and income have been correlated with diabetes rates.

Current diabetes projection methods may estimate future diabetes rates poorly if they fail to incorporate the impact of nutritional factors. Imported sugars deserve further investigation as a potential population-level driver of global diabetes.

To characterise the diets of pregnant women in the Republic of Seychelles and to determine the contribution of fish to intakes of nutrients important for fetal and neonatal development.

Observational, prospective study.

Seychelles Child Development Centre, Mahé, Republic of Seychelles.

Pregnant women (n 300) were recruited at their first visit to an antenatal clinic. At 28 weeks’ gestation subjects completed a 4 d diet diary (n 273) and intakes were analysed using dietary analysis software.

Mean (sd) energy intake was 9·0 (2·5) MJ/d and fat intakes were higher than UK recommendations for almost two-thirds of the cohort. Fish consumption was lower than in previous surveys, suggesting a move towards a more Westernised diet. Low intakes of a number of nutrients important during pregnancy for fetal development (Fe, Zn, Se and iodine) were observed. However, women who met the current recommendations for these nutrients consumed significantly more fish than those who did not (97 v. 73 g/d).

The present study highlights the importance of fish in the diet of pregnant Seychellois women for ensuring adequate intakes of micronutrients important in fetal development. Dietary patterns in Seychelles, however, are in a state of transition, with a move towards a Western-style diet as evidenced by higher fat and lower fish intakes. If these dietary trends continue and fish consumption declines further, micronutrient status may be compromised. These findings suggest caution in establishing public health policies that promote limitation of fish intake during pregnancy.

To determine the prevalence of co-morbidity of two important global health challenges, anaemia and stunting, among children aged 6–59 months in low- and middle-income countries.

Secondary analysis of data from Demographic and Health Surveys (DHS) conducted 2005–2015. Child stunting and anaemia were defined using current WHO classifications. Sociodemographic characteristics of children with anaemia, stunting and co-morbidity of these conditions were compared with those of ‘healthy’ children in the sample (children who were not stunted and not anaemic) using multiple logistic models.

Low- and middle-income countries.

Children aged 6–59 months.

Data from 193 065 children from forty-three countries were included. The pooled proportion of co-morbid anaemia and stunting was 21·5 (95 % CI 21·2, 21·9) %, ranging from the lowest in Albania (2·6 %; 95 % CI 1·8, 3·7 %) to the highest in Yemen (43·3; 95 % CI 40·6, 46·1 %). Compared with the healthy group, children with co-morbidity were more likely to be living in rural areas, have mothers or main carers with lower educational levels and to live in poorer households. Inequality in children who had both anaemia and stunting was apparent in all countries.

Co-morbid anaemia and stunting among young children is highly prevalent in low- and middle-income countries, especially among more disadvantaged children. It is suggested that they be considered under a syndemic framework, the Childhood Anaemia and Stunting (CHAS) Syndemic, which acknowledges the interacting nature of these diseases and the social and environmental factors that promote their negative interaction.

The aims of the present work were to investigate whether dietary habits are associated with socio-economic status (SES), and if they modify the relationship between SES and CVD risk factors, in a sample of men and women free from known CVD.

This population-based study was carried out in the province of Attica, where Athens is a major metropolis. During 2001–2002, information from 1528 men (18–87 years old) and 1514 women (18–89 years old) was collected (75 % participation rate). Among several sociodemographic, clinical and biological factors, adherence to the Mediterranean diet was assessed by a special diet score (Mediterranean Diet Score, MDS) that incorporated the inherent characteristics of this traditional diet. CVD risk factors were examined across the participants’ educational level and annual income that defined their SES.

Low SES groups exhibited higher prevalence of CVD risk factors, such as obesity, hypertension, diabetes mellitus and hypercholesterolaemia (all P < 0·001). Low SES groups also showed less adherence to the Mediterranean diet than high SES groups (MDS: 23·6 (sd 8·1) v. 25·6 (sd 5·6), P < 0·001). Higher SES index was associated with lower likelihood of having hypercholesterolaemia (OR = 0·91; 95 % CI 0·83, 1·00) and diabetes (OR = 0·83; 95 % CI 0·72, 0·95), after adjusting for various potential confounders. However, the previously mentioned inverse relationship observed between SES and prevalence of CVD risk factors was mainly explained by the dietary habits of the participants.

Low SES groups showed less adherence to the Mediterranean diet compared with high SES groups. This finding may, in part, explain the higher CVD risk factors profile observed among low SES participants.

To evaluate long-term patterns of weight change and progression to overweight and obesity during adulthood.

Prospective study. Changes in mean BMI, waist circumference (WC) and weight were assessed over a mean 26-year follow-up (1971–1975 to 1998–2001). Mean BMI (95 % CI) and mean WC (95 % CI) of men and women in BMI and age groups were computed. Mean weight change in BMI and age categories was compared using analysis of covariance.

Framingham Heart Study Offspring/Spouse Nutrition Study.

Men and women (n 2394) aged 20–63 years.

During follow-up, increases in BMI (men: 2·2 kg/m2; women: 3·7 kg/m2) and WC (men: 5·7 cm; women: 15·1 cm) were larger in women than men. BMI gains were greatest in younger adults (20–39 years) and smallest in obese older adults (50–69 years). The prevalence of obesity doubled in men (to 33·2 %) and tripled in women (to 26·6 %). Among normal-weight individuals, abdominal obesity developed in women only. The prevalence of abdominal obesity increased 1·8-fold in men (to 53·0 %) and 2·4-fold in women (to 71·2 %). Weight gain was greatest in the youngest adults (20–29 years), particularly women. Gains continued into the fifth decade among men and then declined in the sixth decade; in women gains continued into the sixth decade.

Patterns of weight change and progression to obesity during adulthood differ in men and women. Preventive intervention strategies for overweight and obesity need to consider age- and sex-specific patterns of changes in anthropometric measures.

The present study aimed to investigate whether the visceral adiposity index (VAI) is an effective predictor to identify unhealthy metabolic phenotype by comparing normal-weight and overweight individuals.

A population-based cross-sectional study. Data were collected by interviews, anthropometric evaluation, dietetic, clinical and laboratory tests. The area under the receiver-operating characteristic curve (AUC) and prevalence ratio (PR), obtained from Poisson regression, were used to compare the predictive capacity of the obesity indicators evaluated (VAI, BMI, waist and neck circumference, waist-to-height and waist-to-hip ratios) and their association with the unhealthy metabolic phenotype. All analyses were stratified by sex and by nutritional status.

Viçosa, Minas Gerais, Brazil.

A total of 854 Brazilian adults (20–59 years old) of both sexes.

VAI was the best predictor for unhealthy metabolic phenotype among men (AUC = 0·865) and women (AUC = 0·843) at normal weight. VAI also had the best predictive capacity among overweight women (AUC = 0·903). Among overweight men, its accuracy (AUC = 0·830) was higher than that of waist-to-hip ratio. In the adjusted regression models, VAI was the indicator most strongly associated with the unhealthy metabolic phenotype, especially among those with normal weight (PR = 6·74; 95 % CI 3·15, 14·42 for men; PR = 7·14; 95 % CI 3·79, 13·44 for women).

VAI has better predictive capacity in detecting unhealthy metabolic phenotype than conventional anthropometric indicators, regardless of nutritional status and sex.

The present study aimed to evaluate the association of frequency of consuming takeaway meals and meals out with diet quality of UK adolescents.

The Diet Quality Index for Adolescents (DQI-A) tool was used to assess diet quality, where adolescents’ food intake was based on 4d diary records obtained from the UK cross-sectional National Diet and Nutrition Survey (NDNS) rolling programme Years 1–6. Models included confounders.

The DQI-A relies on three components, specifically diet quality, diversity and equilibrium, which reflect the degree of adherence of an adolescent’s diet with food-based dietary guidelines.

British (n 2045) adolescents aged 11–18 years.

Mean diet quality score for all adolescents was 20·4 % (overall DQI-A score range: −33 to 100 %). After adjusting for age, gender and equivalised household income, DQI-A% score was higher for low and moderate takeaway consumers by 7·4 % (95 % CI 5·5, 9·2; P<0·01) and 3·5 % (95 % CI 1·9, 5·1; P<0·01), respectively, v. frequent consumers. Significant differences were also observed between low, moderate and frequent takeaway consumers among all DQI-A components and sub-components (P<0·05), except for the diet adequacy sub-component (DAx). Results for frequent consumption of meals out were similar but attenuated and not statistically significant for individual components before or after adjusting for confounders.

Frequent consumption of takeaway meals may have a negative impact on adolescents’ diet quality and therefore policies to reduce the intake of takeaways should be considered in this age group.

Family meals are an important ritual in contemporary societies and many studies have reported associations of family meals with several biopsychosocial outcomes among children and adolescents. However, few representative analyses of family meals have been conducted in samples of adults, and adults may differ from young people in predictors and outcomes of family meal consumption. We examined the prevalence and predictors of adult family meals and body weight outcomes.

The cross-sectional 2009 Cornell National Social Survey (CNSS) included questions about the frequency of family meals, body weight as BMI and sociodemographic characteristics.

The CNSS telephone survey used random digit dialling to sample individuals.

We analysed data from 882 adults living with family members in a nationally representative US sample.

Prevalence of family meals among these adults revealed that 53 % reported eating family meals seven or more times per week. Predictive results revealed that adults who more frequently ate family meals were more likely to be married and less likely to be employed full-time, year-round. Outcome results revealed that the overall frequency of family meals among adults was not significantly associated with any measure of body weight. However, interaction term analysis suggested an inverse association between frequency of family meals and BMI for adults with children in the household, and no association among adults without children.

These findings suggest that family meals among adults are commonplace, associated with marital and work roles, and marginally associated with body weight only in households with children.

To evaluate the nutritional composition of worksite canteen lunches and to examine the impact of two meal serving systems on employee intake, i.e. buffet style with a fixed price for a varied number of dishes and à la carte style with a separate price for each item on the menu.

Laboratory technicians observed employees' food selection and collected identical dishes. Food items were weighed separately to calculate the content of fruit and vegetables. The content of protein, fat and ash of each dish was chemically analysed and the carbohydrate and energy content calculated.

Fifteen randomly chosen worksite canteens in Denmark: eight canteens serving buffet style and seven canteens with an à la carte line.

one hundred and eighty randomly chosen employees having lunch at the worksite canteens.

The average percentage energy from fat was 37 ± 12 among men and 33 ± 12 among women. No association was found between the meal serving system and energy intake or macronutrient composition. Eating at canteens serving buffet style, on the other hand, was associated with an increased intake of fruit and vegetables, on average 76 g, and a lower energy density of the food for both genders.

The results highlight the possibilities of promoting healthy food choices in the catering sector and the need to identify models of healthy catering practice. Serving buffet style appears to be a promising strategy in order to increase fruit and vegetable consumption in food served away from home.

To examine whether an FFQ can be used for assessing exposure to methylmercury (MeHg) by estimating MeHg intake from seafood consumption using the FFQ and confirming the accuracy of the estimated value.

Seafood consumption of pregnant women was assessed using the FFQ. Total mercury (T-Hg) concentrations of maternal red blood cells (RBC) and hair were measured as exposure indices of MeHg.

A prospective birth cohort study, the Tohoku Study of Child Development (TSCD), which has been ongoing since 2001.

The subjects were 609 pregnant Japanese women who were enrolled in the TSCD.

MeHg intake was estimated from seafood consumption determined using the FFQ and the MeHg concentrations in each type of seafood. The accuracy of the estimated value was confirmed by comparison with T-Hg in RBC and hair. Estimated MeHg intake was 42·3 μg/week, and 43·0 % of that was from large predatory fish. Compared with the Japanese tolerable weekly intake, in total 12·5 % of the subjects exceeded it. T-Hg concentrations in RBC and hair were significantly correlated with estimated MeHg intake: r = 0·325 (P < 0·0001) for RBC and r = 0·305 (P < 0·0001) for hair.

Estimated MeHg intake based on the FFQ was significantly associated with T-Hg concentrations in RBC and hair. Although the estimated value involves uncertainties, the FFQ appears to be a useful tool for assessment of exposure to MeHg.

To determine if dietary, supplemental and total vitamin D intakes in the USA are influenced by income, race/ethnicity or gender.

Cross-sectional. US vitamin D intakes were estimated by poverty income ratio (PIR), race/ethnicity and gender using 24 h dietary intake recalls and dietary supplement use questionnaires. Statistical analyses of weighted data were performed using SAS (version 9·2) to estimate means and their standard errors. Race and ethnic intake differences controlling for PIR, gender and age were assessed by ANCOVA.

Adults aged ≥19 years.

The 2007–2010 National Health and Nutrition Examination Survey, USA.

Total (dietary and supplement) vitamin D intake was greater in the high (10·0 (se 0·30) μg/d) v. the medium (7·9 (se 0·3) μg/d) or the low (8·0 (se 0·3) μg/d) PIR categories. Total vitamin D intake of non-Hispanic Whites (10·6 (se 0·4) μg/d) was greater than that of Hispanics (8·1 (se 0·3) μg/d) and non-Hispanic Blacks (7·1 (se 0·3) μg/d). Supplemental vitamin D intake was greater by females (5·3 (se 0·2) μg/d) than by males (3·3 (se 0·2) μg/d). Participants with high income were more likely to be vitamin D supplement users (33·0 %) than those with medium (22·5 %) or low (17·6 %) income. High-income non-Hispanic Whites had the lowest percentage (57 %) not meeting the Estimated Average Requirement for vitamin D. Fortified milk and milk products provided 43·7 % of the dietary vitamin D intake.

Public health efforts should expand the number of vitamin D-fortified foods and encourage the consumption of foods high in vitamin D and use of supplements.

Millions of US households experienced food insecurity in 2005. Research indicates that low wages and little social support contribute to food insecurity. The present study aimed to examine whether social support moderates the relationship between income and food insecurity.

Using a mail survey, we collected data on social support sources (social network, intimate partner and community) and social support functions from a social network (instrumental, informational and emotional). We used hierarchical logistic regression to examine the potential moderation of various measures of social support on the relationship between income and food insecurity, adjusting for potential confounding variables.

Oregon, USA.

A stratified random sample of Oregonians aged 18–64 years (n 343).

We found no evidence of an association between social support and food insecurity, nor any evidence that social support acts as a moderator between income and food insecurity, regardless of the measure of social support used.

Although previous research suggested that social support could offset the negative impact of low income on food security, our study did not find support for such an effect.