To estimate the dietary intakes of heterocyclic amines (HCAs), to examine the intakes in relation to socio-economics, lifestyle and other dietary factors and to compare the classification of subjects by intake of HCA versus intake of meat and fish.

Cross-sectional analysis within the Malmö Diet and Cancer (MDC) cohort. Data were obtained from a modified diet history, a structured questionnaire on socio-economics and lifestyle, anthropometric measurements and chemical analysis of HCAs. HCA intake was cross-classified against meat and fish intake. The likelihood of being a high consumer of HCAs was estimated by logistic regression analysis. Dietary intakes were examined across quintiles of HCA intake using analysis of variance.

Baseline examinations conducted in 1991–1994 in Malmö, Sweden.

A sub-sample of 8599 women and 6575 men of the MDC cohort.

The mean daily HCA intake was 583 ng for women and 821 ng for men. Subjects were ranked differently with respect to HCA intake compared with intake of fried and baked meat and fish (κ = 0.13). High HCA intake was significantly associated with lower age, overweight, sedentary lifestyle and smoking. Intakes of dietary fibre, fruits and fermented milk products were negatively associated with HCA intake, while intakes of selenium, vegetables, potatoes, alcohol (among men) and non-milk-based margarines (among women) were positively associated with HCA intake.

The estimated daily HCA intake of 690 ng is similar to values obtained elsewhere. The present study suggests that lifestyle factors (e.g. smoking, physical activity, fruit and vegetable intakes, and types of milk products and margarines) may confound associations between HCA intake and disease. The poor correlation between HCA intake and intakes of fried meat and fish facilitates an isolation of the health effects of HCAs.

To assess overweight and related risk factors among urban low socio-economic status (SES) African-American adolescents in an attempt to study the underlying causes of ethnicity and gender disparities in overweight.

Cross-sectional data collected on anthropometric measures, diet, physical activity and family characteristics from 498 students in grades 5–7 in four Chicago public schools were analysed to study the risk factors for overweight using stepwise regression analysis.

Only 37.2% of the students lived with two parents. Nearly 90% had a television (TV) in their bedroom, and had cable TV and a video game system at home. Overall. 21.8% (17.7% boys versus 25.1% girls) were overweight (body mass index (BMI) ≥ 95th percentile); and 39.8% had a BMI ≥ 85th percentile. Compared with national recommendations, they had inadequate physical activity and less than desirable eating patterns. Only 66.1% reported having at least 20 min vigorous exercise or 30 min of light exercise in ≥ 5 days over the past 7 days; 62.1% spent >3 h days− 1 watching TV/playing video games/computer, while 33.1% spent ≥ 5 h days− 1. Their vegetable and fruit consumption was low, and they consumed too many fried foods and soft drinks: 55.1% consumed fried food twice or more daily and 19.5% four times or more daily; 70.3% consumed soft drinks twice or more daily and 22.0% four times or more daily on average. Gender, physical activity and pocket money were significant predictors of overweight (P < 0.05).

Several factors in the students' behaviours, school and family environments may increase overweight risk among this population. There is a great need for health promotion programmes with a focus on healthy weight and lifestyle, and targeting urban low-SES minority communities.

Obesity is considered a major public health issue in most developed countries nowadays. This paper provides an overview of current population data available in Spain and the approach to develop preventive strategies in the country.

Review of population data available is based on individually measured weight and height as well as determinants. On this basis, the approach used in the country to develop preventive strategies is discussed.

According to the DORICA study, the prevalence of obesity (BMI ≥30 kg m−2) is 15.5% in Spanish adults aged 25–60 years (13.2% in men and 17.5% in women). Obesity rates are higher among women aged 45 years and older, low social class, living in semi-urban places. Population estimates for the prevalence of obesity in Spanish children and young people based on the enKid study are 13.9% for the whole group. In this study, overweight and obesity is related to absence of breastfeeding, low consumption of fruit and vegetables, high consumption of cakes, buns, softdrinks and butchery products, low physical activity levels and a positive association with time spent watching TV.

In 2005, the Spanish Ministry of Health jointly with the Spanish Agency for Food Safety and Nutrition launched the multifaceted NAOS strategy for nutrition, physical activity and the prevention of obesity. The important role of the family and the school setting as well as the responsibility of the Health Administration and Pediatric Care in the prevention of obesity is highlighted in the document. The need for environmental actions is recognised. The PERSEO programme, a multicomponent school-based intervention project is part of the strategy currently in place.

Obesity is a public health issue in Spain. A national multifaceted strategy was launched to counteract the problem. Environmental and policy actions are a priority. Young children and their families are among the main target groups.

To compare dietary diversity scores measured over a 1-day and a 3-day period, and to assess their relationships with socio-economic characteristics and the nutritional status of rural African women.

A qualitative dietary recall allowed calculation of a dietary diversity score (DDS; number of food groups consumed out of a total of nine). Body mass index (BMI) and body fat percentage (BFP) were used to assess the nutritional status of women.

A representative sample of 550 mothers in north-east Burkina Faso.

The DDS increased from 3.5 to 4.4 when calculated from a 1-day or a 3-day recall (P < 0.0001), although for the latter the DDS was affected by memory bias. The DDS calculated from a 1-day recall was higher when a market day occurred during the recall period. Both scores were linked to the sociodemographic and economic characteristics of the women. Women in the lowest DDS tertile calculated from the 1-day recall had a mean BMI of 20.5 kg m− 2 and 17.7% of them were underweight, versus 21.6 kg m− 2 and 3.5% for those in the highest tertile (P = 0.0003 and 0.0007, respectively). The DDS calculated from the 1-day recall was also linked to mean BFP; all these links remained significant after adjustment for confounders. For the 3-day period, no such relationships were found to be significant after adjustment.

The DDS calculated from a 1-day dietary recall was sufficient to predict the women's nutritional status. In such a context attention should be paid to market days.

To assess the occurrence and severity of food insecurity, and examine associations between food insecurity and measures of socio-economic status and indicators of acculturation.

Structured interviews among a non-probability sample of West African refugees at baseline and 6 months' follow-up.

Mid-sized city in north-eastern USA.

One hundred and one caregivers with children under the age of 5 years and who have been living the USA for fewer than 4 years.

Food insecurity was indicated in approximately half of households (53%). The occurrence of food insecurity was associated with measures of socio-economic status such as income, employment status and participation in the Food Stamp Program (P < 0.05). Measures of acculturation such as difficulty in the shopping environment and language difficulty were also associated with the occurrence and severity of food insecurity, as was time lived in the USA (P < 0.05). Among households who had been in the USA for 1 year or less, food insecurity was indicated in 73%, whereas among households who had been in the USA for at least 3 years food insecurity was indicted in 33%.

Refugees are a potentially vulnerable group and our results echo others in suggesting a need for more thorough monitoring of the health and well-being of recently resettled refugees. These results also suggest that reliance on employment as the sole indicator of success in the resettlement process may be too narrow an indicator. Future research should focus on a wider range of measures of health and well-being.

To determine the extent to which identified nutrient inadequacies in the dietary intakes of a sample of food-insecure women could be ameliorated by increasing their access to the ‘healthy’ foods they typically eat.

Merged datasets of 226 food-insecure women who provided at least three 24-hour dietary intake recalls over the course of a month. Dietary modelling, with energy adjustment for severe food insecurity, explored the effect of adding a serving of the woman's own, and the group's typically chosen, nutrient-rich foods on the estimated prevalence of nutrient inadequacy.

One study included participants residing in 22 diverse community clusters from the Atlantic Provinces of Canada, and the second study included food bank attendees in Toronto, Ontario, Canada. Of the 226 participants, 78% lived alone with their children.

While nutritional vulnerability remained after modelling, adding a single serving of either typically chosen ‘healthy’ foods from women's own diets or healthy food choices normative to the population reduced the prevalence of inadequacy by at least half for most nutrients. Correction for energy deficits resulting from severe food insecurity contributed a mean additional 20% improvement in nutrient intakes.

Food-insecure women would sustain substantive nutritional gains if they had greater access to their personal healthy food preferences and if the dietary compromises associated with severe food insecurity were abated. Increased resources to access such choices should be a priority.

To document the infant feeding practices of Maldivian mothers.

A cross-sectional survey of 251 Maldivian mothers recruited in 2004 from the ‘well baby’ or ‘well child’ clinics on the island of Male' and including 75 mothers from three other islands, Hura, Himmafushi and Thulusdhoo.

The full breast-feeding rate at hospital discharge was 93% but declined to 41% at 4 months. Any breast-feeding rates were high among Maldivian mothers: 100% at 1 month and 85% were still breast-feeding at 6 months. The median duration of breast-feeding was 24 months.

Breast-feeding rates are high and the average duration of breast-feeding is more than 2 years in the Maldives. Health promotion activities should be directed towards maintaining the already high ‘any breast-feeding’ rates and increasing the proportion of infants exclusively breast-fed to 6 months.

To evaluate the effect of a primary school-based intervention providing free fruit and vegetables (F&V), separately for children of Dutch and of non-Western ethnicity.

Primary schools in two regions (west and east) in The Netherlands.

Participating schoolchildren and their parents completed questionnaires at baseline and 1 year later, including questions on usual F&V intake, potential determinants and general demographics. Primary outcomes were the usual fruit intake and the usual vegetable intake as assessed by parent- and child self-reported food frequency measures. Secondary outcome measures were child- or parent-reported taste preference, knowledge of daily recommendations, availability, and accessibility for fruit intake. Multilevel regression analyses were used to assess differences at follow-up adjusted for baseline values between the control and intervention group using both child and parent reports.

Five hundred and sixty-five children of Dutch ethnicity and 388 children of non-Western ethnicity (mean age 9.9 years at baseline) and their parents.

Children of non-Western ethnicity in the intervention group reported a significantly higher vegetable intake (difference = 20.7 g day–1, 95% confidence interval (CI) = 7.6–33.7). A significant positive intervention effect was also found for fruit intake for children of Dutch ethnicity (difference = 0.23 pieces day–1, 95% CI = 0.07–0.39). No significant effects in intake were observed based on parent reports. Significant positive intervention effects were also found for perceived accessibility among children of non-Western ethnicity, as well as for parent-reported taste preference of their child among children of non-Western ethnicity and boys of Dutch ethnicity.

Providing children with free F&V had some positive effects on child-reported intakes and important correlates of intakes.

It is known that stunting and obesity affect a large proportion of children in the world, and these can be affected by the physical activity levels of the children. In the present study, we evaluated the association between physical activity, physical development and body composition in black adolescent children.

Cross-sectional study.

Black township schools in the North West Province, South Africa.

Three-hundred and thirteen grade 8 children were included in the Physical Activity in Youth study. Anthropometric measurements, body composition measures and maturity level as assessed by Tanner stages were determined in these children. In addition, Previous Day Physical Activity Recall questionnaires were administered on the children to record the various activities they undertake daily.

The demographic characteristics of the children showed a high level of homogeneity. A high prevalence of stunting (16.3%) was observed in the children, which was higher in boys than in girls (21.6 vs. 12.3%). Also prevalent was overweight/obesity (8.6%), but this was higher in girls than in boys (13.4 vs. 1.6%). The children also showed a reduction in levels of physical activity with advancement in maturity; furthermore, boys showed a more central form of fat deposition whilst girls showed more gynoid deposition.

The study revealed that physical activity plays a role in determining body composition, and further indicated that physical activity is associated with favourable body composition measures. Children who were more active were likely to have less fat deposits.

Psychosocial and demographic correlates of fruit, juice and vegetable (FJV) consumption were investigated to guide how to increase FJV intake.

Hierarchical multiple regression analysis of FJV consumption on demographics and psychosocial variables.

Houston, Texas, USA.

Boys aged 11–14 years (n = 473).

FJV preference and availability were both significant predictors of FJV consumption, controlling for demographics and clustering of Boy Scout troops. Vegetable self-efficacy was associated with vegetable consumption. The interaction of preference by home availability was a significant predictor of FJV. The interaction of self-efficacy by home availability showed a trend towards significantly predicting vegetable consumption. No significant interactions were found between body mass index and the psychosocial variables.

Findings suggest that future interventions emphasising an increase in preference, availability and efficacy may increase consumption of FJV in similar populations.

To describe perceptions of weight of adolescents and associated factors.

Cross-sectional survey in 2002.

Eight public middle schools in two distinct socio-economic areas of Jiangsu Province, China.

Eight hundred and twenty-four adolescents (aged 12–14 years) and 628 of their parents.

Self-administered questionnaires for students and their parents were used to collect the data. Height and weight of the students were measured.

One-third of the girls perceived themselves as overweight, while only 8.9% were actually overweight or obese according to the World Health Organization definition. On the other hand, 15.0% of the girls considered themselves underweight, while 5.6% were underweight according to the definition. Among the boys, one-fifth of those defined as overweight perceived their weight as normal. Furthermore, 23.9% perceived themselves as underweight when in fact only 4.9% were classified as underweight according to the definition. About one-quarter of the students dieted in the past year. Adolescents who perceived themselves to be overweight dieted and skipped breakfast more often. They also had lower intake frequencies of animal foods, Western foods and milk/yoghurt. No disparity was observed in the intake frequency of fruits and vegetables between the groups of different weight perception. Parents' weight norms seemed to favour overweight in both genders, but especially among boys.

Both overweight and underweight concerns were common among girls, while a higher body weight was favoured by normal-weight boys and their parents. Distorted weight perceptions in adolescents, as well as dieting, are problems that need appropriate intervention.

To describe the food habits and physical (in)activity patterns and to investigate the relationship with sociodemographic factors among Palestinian adolescents.

The Palestinian Health Behaviour in School-aged Children (HBSC) is a cross-sectional survey of grades 6, 8, 10 and 12. Students completed a modified version of the international HBSC questionnaire. A total of 8885 students were included in this analysis; 53% were from the West Bank and 47% from the Gaza Strip.

Adolescents in the West Bank consume more fruit, meat, chicken, sweets and soft drinks, but less vegetables than adolescents in Gaza (P < 0.01). Girls reported more daily consumption of fruit, vegetables and sweets than boys (P < 0.001), and less consumption of soft drinks, milk, meat and chicken (P < 0.01). Boys were physically more active than girls (P < 0.01), whereas girls reported doing more homework (P < 0.001). Both boys and girls reported less physical activity with increasing age (P < 0.001). Consumption of fruit and milk was positively associated with both parents' education, while consumption of meat, chicken and soft drinks was positively associated with mother's education only. Having breakfast on schooldays was positively associated with the father's education. Physical activity and television viewing were associated with the mother's education (P < 0.01). The parents' level of education had no effect on vegetable consumption and dieting status.

This study indicated that there are problems with Palestinian adolescents' eating, dieting and physical activity. Regional, gender and parental socio-economic status differences should be taken into account in developing interventions. More detailed studies are needed with more elaborate instruments about food habits and physical activity of adolescents.

Contributions of fish and other foods to variance of selenium and mercury status were studied in British adults.

Plasma and red-cell selenium and whole-blood mercury concentrations were measured during the National Diet and Nutrition Survey of Adults aged 19–64 years in mainland Britain, 2000–2001 (n = 1216). Food intake was weighed for seven consecutive days, and foods were combined in groups for data analysis. Four subsidiary groups characterised fish intakes: fried white fish, ‘other’ white fish, shellfish and oily fish.

Geometric means and 5–95% ranges were: for whole-blood mercury, 5.61 (1.30–22.2) nmol l− 1; for plasma selenium, 1.09 (0.83–1.43) μmol l− 1; for red-cell selenium, 1.64 (1.14–2.40) μmol l− 1. Twenty-eight per cent had no fish intake recorded during 7 days; the remaining 72% had a median intake of 237 g over the 7-day period, 5–95% range 45–780 g. Total fish intake was strongly and directly correlated with blood mercury, and moderately with red-cell and plasma selenium. Thus, sqrt(total fish intake) was correlated with: loge(blood Hg), t = +19.7; loge(plasma Se), t = +9.8; and loge(red-cell Se), t = +9.6, all P < 0.0001. All three biochemical (mercury and selenium) indices were strongly correlated with oily fish intake, and moderately correlated with shellfish and ‘other’ ( = non-fried) white fish, but none was significantly correlated with fried white fish. Blood mercury was strongly and directly correlated with red-cell and plasma selenium, and both increased with age.

Dietary fish, especially oily fish, is a strong predictor of blood mercury and selenium in British adults.

To describe breakfast consumption patterns, on a nutrient and food item level, in Belgian adolescents.

A 7-day estimated food record was administered in a cross-sectional survey.

Secondary schools in Ghent, Belgium.

A total of 341 adolescents (13–18 years old), multistage clustered sampling.

The energy contribution of breakfast to daily energy intake was on average 15.7% in boys and 14.9% in girls. Significantly more overweight girls and significantly more girls following vocational training were categorised as eating a low-quality breakfast. In boys, the energy contribution of polysaccharides was significantly higher in consumers of good-quality breakfasts. The intake of all selected micronutrients was significantly higher in consumers of good-quality breakfasts. In girls, the total energy intake and the proportional intake of proteins and polysaccharides were significantly higher in consumers of good-quality breakfasts, while the proportional contribution of total fat, monounsaturated and polyunsaturated fatty acids was significantly lower in these girls. The intake of all micronutrients was significantly higher in girls consuming a good-quality breakfast. In all adolescents, consumers of a good-quality breakfast had significantly higher intakes of bread, fruit, vegetables, milk and milk products, and fruit juice, while intake of soft drinks was significantly lower than in consumers of low-quality breakfasts.

Consumers of a good-quality breakfast had a better overall dietary pattern – on a nutrient and food group level – than consumers of a low-quality breakfast. A daily breakfast, including whole-grain products, fruit and (semi-) skimmed milk products or an alternative source of calcium, is recommended.

To validate a new food-frequency questionnaire (FFQ) for measuring the intake of fruit, vegetables and tea reported by women participating in the Norwegian Mother and Child Cohort Study (MoBa).

Intake of fruits, vegetables and tea estimated by the FFQ was compared with urinary flavonoid excretion, plasma carotenoid concentration and intake measured by a 4-day weighed food diary (FD). The triangular method was applied to calculate FFQ validity coefficients using two independent biomarkers.

One hundred and nineteen women participating in MoBa.

The FFQ estimate of fruit intake was significantly correlated with urine phloretin (r = 0.33), citrus fruit/juice with urine hesperetin (r = 0.44), cooked vegetables with plasma α-carotene (r = 0.37), and tea with urine kaempferol (r = 0.41) (P < 0.01 for all). On average, 60% of the participants fell into the same or adjacent quintiles when classified by FFQ and biomarkers. Significant correlations between the FFQ and FD were found for fruit (r = 0.39), vegetables (r = 0.34), juices (r = 0.50) and tea (r = 0.53). The FFQ validity coefficient was 0.65 for citrus fruit/juice and 0.59 for cooked vegetables as calculated by the triangular method.

The validation study shows that the MoBa FFQ can be used to estimate fruit, juice, vegetable and tea intake in pregnant Norwegian women, and to rank individuals within the distribution.

To measure the effects of two school-based interventions on children's intake of fruit and vegetables (F&V).

A total of six primary schools were randomly assigned to (1) a free F&V distribution programme, or (2) a multicomponent programme, consisting of a classroom curriculum and parental involvement. The two interventions were evaluated on their effects and compared with six control schools in a pre-test–post-test design. Two methods were used for dietary assessment: a pre-structured food recall and a food-frequency questionnaire including only F&V.

A total of 939 parents of children aged 4–12 years filled out the questionnaire at both pre-test and post-test. The response rate was 54%.

Multilevel analyses showed that both programmes were equally effective in increasing children's fruit consumption by 0.2 portions per day. The free F&V distribution increased vegetable intake among non-native children and the oldest age group, and the multicomponent programme among the oldest children and girls. The distribution also caused an increased 24 h fruit, juice and vegetable intake among the youngest and the oldest age groups, and the multicomponent programme among all children.

The results of this study indicate that both interventions were shown to be effective for different subgroups regarding age, gender and ethnicity. When comparing both interventions, the distribution programme was shown to be more effective, especially in increasing vegetable consumption. An important next step will be to investigate which intervention has the greatest potential to be implemented in primary schools.

To investigate the effect of observing school meals on children's dietary reports.

One hundred and twenty children randomly selected, but with half girls, from usual school-meal eaters among 312 volunteers (from all 443 fourth-grade children in six schools in one district).

Children were assigned randomly to one of 12 conditions yielded by crossing observation status (observed; not observed), target period (previous day; prior 24 hours), and interview time (morning; afternoon; evening).

Response variables included interview length, number of meals and snacks reported for the target period, and, for two school meals, number of meal components reported, importance-weighted number of items reported and kilocalories reported. These variables were transformed to principal components; two were retained (1, the school meal variables; 2, interview length and number of meals and snacks). Analyses of variance on principal component scores tested effects of observation status, target period, interview time and all interactions. Observation status did not affect scores on either retained principal component. Scores on Component 2 showed that more intake was reported in prior-24-hours interviews than in previous-day interviews.

The effect of target period on reported intake indicates that the response variables were sufficiently reliable to detect manipulations. This, together with the finding that response variables did not depend on observation status, suggests that observation of school meals does not affect fourth-grade children's dietary reports, and that conclusions about dietary reports by fourth-grade children observed eating school meals in validation studies may be generalised to dietary reports by comparable children not observed.

Infants aged 0–5 months are not systematically included in assessments of child nutritional status and are generally excluded from surveys conducted in emergencies. We estimated the impact of excluding 0–5-month-old infants on the prevalence of stunting, wasting and underweight among children under 5 years (U5) and under 3 years (U3) of age.

Comparison of the prevalence of stunting, wasting and underweight in U5 and U3 with or without inclusion of the age group 0–5 months.

Demographic and Health Surveys and Multiple Indicator Cluster Surveys from 76 developing countries and countries in transition.

Children under 3 or under 5 years of age included in the surveys.

Excluding 0–5-month-old infants resulted in an overestimation of the prevalence of stunting, wasting and underweight in U5 of 3.0, 0.3 and 2.6 percentage points, respectively, and of 4.8, 1.0 and 5.2 percentage points, respectively, in U3. The overestimation for wasting was negligible. The regions showing the highest overestimations for stunting and underweight were Asia and sub-Saharan Africa. Overall, countries with high prevalences of stunting and underweight showed especially large overestimations. The prevalence of underweight in infants aged 0–5 months was correlated with the prevalence of low maternal body mass index.

All surveys, even in situations of nutrition emergency, should include 0–5-month-old infants. Strictly comparable age ranges are essential in nutrition surveys for monitoring trends and evaluating programme impact. Greater awareness of prenatal and early child undernutrition is needed among policy-makers.