To analyse trends in energy and nutrient intakes and nutritional adequacy from 1992 to 2003.

Two consecutive cross-sectional studies carried out on random samples of the Catalan population ENCAT 1992–93 and ENCAT 2002–03. Dietary intake was assessed by means of two 24-hour recalls on non-consecutive days. Spanish food consumption tables were used. Energy and nutrient data were adjusted for intraindividual variability, and the Spanish recommend nutrient intakes (RNIs) were used in the analysis.

Catalonia region, North Eastern Spain.

Analysis is based on a total of 4701 individuals; 2641 from ENCAT 1992–93 (1210 men and 1431 women) and 2060 from ENCAT 2002–03 (954 men and 1106 women), aged 10–75 years.

No relevant changes in energy intake trends were observed, although a decrease was observed in the daily consumption of proteins (−7 g), cholesterol (−56 mg), potassium (−245 mg), vitamin A (−283 RE μg), retinoids (−71 μg), carotenoids (−1520 μg), niacin (−29 mg), folates (−15 μg), vitamin B12 (−1.6 μg) vitamin D (−0.5 μg), fibre and iron, and an increase in the consumption of calcium (+57 mg) and a slight increase in lipids and fatty acids (% energy). In general, the most outstanding trends were those of vitamin A (as a result of the decreased consumption of offal), proteins, vitamin D and B12 (due to the decreased consumption of meat and fish) and calcium (as a consequence of the increased consumption of dairy products).

No changes were observed in the energy intake of males or females; therefore, the obesity changes may possibly be attributed to changes in physical activity patterns. However, an increase in energy sources of a poorer nutritional profile has been identified, especially for between meal snacks.

To describe the Food Standards Agency's (FSA) Food Acceptability & Choice and Food Choice Inequalities research programmes and the context for the FSA seminar on peer-led approaches to dietary change held in July 2006.

The aims of the FSA's food choice research programmes are to identify the social, psychological and physical barriers to achieving a healthier diet and how they might be addressed. Results of the research provide the scientific basis for some FSA advice on healthy eating. An important element of both programmes is the output of practical tools and resources that can be used by health professionals, nutritionists, teachers and others to encourage people to eat a healthy diet. The FSA held a seminar in July 2006 in order to identify the specific and general learning points from three peer-led intervention studies and to discuss how these could best be communicated to various audiences, including practitioners, researchers and policy-makers.

The seminar provided a useful forum for discussion. The FSA will ensure that lessons learned from these peer-led intervention studies are taken account of in the planning, appraisal and management of future research projects, in the communication of project results and in the dissemination of resources.

To describe a cost-efficient method for estimating energy and nutrient availability using household budget survey (HBS) data.

Four different approaches were tested and the results were compared with published nutrient intake data. The selected method was exemplarily applied in German and Greek data.

Germany, 1998; Greece, 1998/99.

Nationally representative HBSs.

Comparisons showed that HBS-based estimates were generally close to intake data when results were presented as contributions to daily energy intake. Daily energy and protein availabilities were similar in Germany and Greece. Differences were observed in the availability of carbohydrates (German households reported a 5 percentage points higher contribution to daily energy availability) and lipids (Greek households recorded higher values for total fat, but lower values for saturated fat). Meat, added lipids and potatoes were important energy suppliers in Germany, whereas in Greece the first three energy suppliers were added lipids, cereals and meat. In both countries, meat, cereals, milk and cheese were important protein sources and cereals, potatoes, fruits and nuts contributed more than 60% of the daily carbohydrate availability. Added lipids were the major source of fat in the daily diet of both countries, but their contribution amounted to less than one-third in Germany and two-thirds in Greece.

National HBS data can be used for monitoring and comparing nutrient availability among representative population samples of different countries. The ground is set for the development of a harmonised food composition table to be applied to HBS food data at international level.

To explore socio-economic factors associated with rising rates of overweight among Vietnamese adults.

The study was based on three national surveys of socio-economic factors and health conducted over a 10-year period. The studies were: the Vietnamese Living Standard Survey 1992–1993 (11 982 participants); the Vietnamese Living Standard Survey 1997–1998 (15 975 participants); and the Vietnamese National Health Survey 2001–2002 (94 656 participants).

Male and female adults >18 years old were stratified by gender, age group, area of residence, occupation, education and relative food expenditures. Overweight was defined using body mass index (BMI) ≥ 25 kg m− 2.

Overweight rates in Vietnam more than doubled between 1992 and 2002 (from 2.0 to 5.7%). Significant increases were observed for men and women, in urban and rural areas, and for all age groups. In univariate analyses, both age and higher socio-economic status were associated with higher rates of overweight. Using the most recent survey, urban populations were more likely to be overweight than rural ones (odds ratio (OR) = 1.79), white-collar workers were more likely to be overweight than manual labourers (OR = 1.95) and persons in the top level of food expenditures were more likely to be overweight than persons in the bottom level (OR = 4.96) after adjustment for other factors. Education was inversely associated with overweight after adjusting for covariates.

Economic growth and improved standard of living are associated with higher rates of overweight in nations in early stages of economic development. In Vietnam, higher rates of overweight were observed among the higher income and occupation groups.

To examine whether the occurrence of seasonal food insecurity was related to ethnicity, household wealth and perceived social support, and to assess whether social support was more efficacious in protecting against food insecurity in wealthier households. Secondary objectives were to assess the association between past food insecurity, current dietary intake and perceived health.

A sample of 208 randomly selected mothers from two ethnic groups living in the same villages in rural Tanzania participated in a cross-sectional survey.

Food insecurity was highly prevalent in this area, particularly among the poorer ethnic group. Half of ethnically Sukuma households fell into the most food-secure category, compared with only 20% of ethnically Pimbwe households. Among both groups, measures of household wealth and social support were strongly associated with food security. Interestingly, social support appeared to be more effective among the wealthier ethnic group/community. Past food insecurity was also related to current indicators of dietary intake and women's self-perceptions of health.

Greater social support is associated with food security, suggesting that it may protect against the occurrence of seasonal food insecurity. Social support also interacts with wealth to offer greater protection against food insecurity, suggesting that increasing wealth at the community level may influence food insecurity through both direct and indirect means. Seasonal food insecurity also appears to have lasting effects that likely create and reinforce poverty.

To undertake secondary analyses of the 1997 National Diet and Nutrition Survey of Young People aged 4–18 years in order to describe the contribution of school meals to daily food and nutrient intakes; and to compare the findings from 1997 with data collected in English primary and secondary schools in 2004–2005.

Cross-sectional analysis of 7-day weighed inventory food consumption data according to age, sex, household income, free school meals and breakfast consumption. Comparison of food consumption with the Balance of Good Health and of nutrient intake data with the Caroline Walker Trust (CWT) guidelines.

United Kingdom.

One thousand four hundred and fifty-six UK schoolchildren aged 4–18 years, 7058 English primary-school pupils and 5695 English secondary-school pupils.

Pupils' school meal choices in 1997 did not accord with the Balance of Good Health. Food choices in school were less healthy than choices outside school. School meals failed to make good the shortfalls in daily intakes of non-starch polysaccharides and zinc in primary-school pupils, and of calcium, iron, zinc, vitamin A and non-starch polysaccharides in secondary-school pupils, nor excess daily intakes of saturated fatty acids, non-milk extrinsic sugars and sodium at all ages. School meals typically failed to meet CWT guidelines. They were more likely to meet CWT guidelines when choice of foods was restricted.

School meals need substantial improvement to meet CWT guidelines for healthy eating. The introduction of food-based guidelines for school meals in England in 2001 did not improve the food choices in school meals.

To compare the sociodemographic characteristics, health status and health service use of vegetarians, semi-vegetarians and non-vegetarians.

In cross-sectional data analyses of the Australian Longitudinal Study on Women's Health in 2000, 9113 women (aged 22–27 years) were defined as non-vegetarians if they reported including red meat in their diet, as semi-vegetarians if they excluded red meat and as vegetarians if they excluded meat, poultry and fish from their diet.

The estimated prevalence was 3% and 10% for vegetarian and semi-vegetarian young women. Compared with non-vegetarians, vegetarians and semi-vegetarians were more likely to live in urban areas and to not be married. Vegetarians and semi-vegetarians had lower body mass index (mean (95% confidence interval): 22.2 (21.7–22.7) and 23.0 (22.7–23.3) kg m− 2) than non-vegetarians (23.7 (23.6–23.8) kg m− 2) and tended to exercise more. Semi-vegetarians and vegetarians had poorer mental health, with 21–22% reporting depression compared with 15% of non-vegetarians (P < 0.001). Low iron levels and menstrual symptoms were also more common in both vegetarian groups. Vegetarian and semi-vegetarian women were more likely to consult alternative health practitioners and semi-vegetarians reported taking more prescription and non-prescription medications. Compared with non-vegetarians, semi-vegetarians were less likely and vegetarians much less likely to be taking the oral contraceptive pill.

The levels of physical activity and body mass indices of the vegetarian and semi-vegetarian women suggest they are healthier than non-vegetarians. However, the greater reports of menstrual problems and the poorer mental health of these young women may be of clinical significance.

To characterise plasma and red-blood-cell (RBC) folate status among pregnant women in an area with an extremely high prevalence of neural tube defects, and to compare them with those of women from a low prevalence area.

A cross-sectional survey conducted in 2003.

One county and one city from each of the high prevalence area and the low prevalence area in China.

Five hundred and sixty-two women in their first trimester of pregnancy in the high prevalence area and 695 pregnant women in the low prevalence area.

Women in the high prevalence area had less than half the plasma and RBC folate concentrations (12.2 and 440.0 nmol l− 1, respectively) of women in the low prevalence area (33.5 and 910.4 nmol l− 1, respectively). In the high prevalence area, 40% of rural women were deficient in RBC folate and 50% were deficient in plasma folate; 20% of urban women were deficient in RBC folate and 30% deficient in plasma folate. In contrast, only 4% (RBC folate) and 6% (plasma folate) of rural women, and 2% (RBC folate) and 1% (plasma folate) of urban women, were folate-deficient in the low prevalence area. Less than 10% of rural and about 26% of urban women in the high prevalence area took folic acid periconceptionally, compared with 70% and 60% of women in the low prevalence area.

Blood folate deficiency is highly prevalent among pregnant women in an area of China with a very high prevalence of neural tube defects.

Nutrient profiling can be defined as the ‘the science of categorising foods according to their nutritional composition’. The purpose of the present paper is to describe a systematic and logical approach to nutrient profiling.

A seven-stage decision-making process is proposed and, as an illustration of how the approach might operate in practice, the development of a nutrient profiling model for the purpose of highlighting breakfast cereals that are ‘high in fat, sugar or salt’ is described.

The nutrient profile model developed for this paper calculates scores for foods using a simple equation. It enables breakfast cereals to be compared with each other and with other foods eaten at breakfast.

Nutrient profiling is not new, but hitherto most nutrient profiling models have been developed in an unsystematic and illogical fashion. Different nutrient profiling models are needed for different purposes but a key requirement should be that they are developed using a systematic, transparent and logical process. This paper provides an example of such a process; approaches to validating nutrient profiling models are described elsewhere.

To evaluate the trends of overweight and obesity prevalences in the population of Catalonia, Spain, aged 18–75 years, and the influence of socio-economic determinants on these prevalence trends.

Analysis based on data from two representative population-based cross-sectional surveys.

Data from the two Evaluations of Nutritional Status in Catalonia (ENCAT 1992–93 and ENCAT 2002–03), Spain. Weights and heights were obtained by direct measurement in standardised conditions by trained interviewers. Overweight and obesity were defined using body mass index (BMI) and waist circumference (WC), categorised according to WHO criteria.

In total, 1015 men and 1233 women from ENCAT 1992–93, and 791 men and 924 women from ENCAT 2002–03.

Mean BMI and mean WC were higher in males in 2002–03 as compared to 1992–93, while for females mean BMI was lower except for the youngest group, and mean WC was higher. In men, overall BMI overweight prevalence remained stable (from 44.1% to 43.7%), while obesity increased (from 9.9% to 16.6%); total WC overweight remained stable (from 21.7 to 23.8%), while WC obesity increased (from 13.1% to 24.4%). In women, overall BMI overweight increased (from 29.1% to 30.1%), whereas BMI obesity remained stable (from 15.0% to 15.2%); total WC overweight decreased (from 21.8% to 17.7%), while WC obesity increased (from 24.5% to 31.1%). The socio-economic and education variables had an influence on BMI and WC overweight and obesity rates mainly on females in both surveys and on the youngest men only in the 1992–93 survey.

Ten-year trends indicate that Catalan males are getting bigger overall (BMI) and around the waistline (WC), while Catalan females only have bigger waistlines (WC). BMI male obesity prevalence has overtaken that of females. WC obesity continues to be more prevalent among females than males.

This study examines the relationship between family–work conflicts with food habits and physical activity, and whether the relationship is dependent on family structure and work-related factors.

Cross-sectional postal surveys were carried out in 2001 and 2002 among employees of the City of Helsinki, Finland, aged 40–60 years (n = 5346, response rate 66%; for women 70% and for men 60%). Dependent variables in logistic regression analyses were nationally recommended food habits and physical activity. Independent variables were work–family conflicts and family–work conflicts. Covariates included age, marital status, number of children, occupational class, working hours, time travelling to work, and physical and mental work load.

Women reporting strong work–family conflicts were more likely to follow recommended food habits (odds ratio (OR) and 95% confidence intervals 1.49 (1.19–1.86)), but this relationship weakened when adjusting for work-related factors (OR 1.20 (0.93–1.55)). Women and men with strong family–work conflicts were less likely to report recommended food habits after adjusting for family structure and work-related factors (women OR 0.75 (0.61–0.92), men OR 0.57 (0.34–0.96)). Women and men with strong work–family conflicts were less likely to follow the recommended amount of physical activity (women OR 0.76 (0.60–0.96), men OR 0.54 (0.34–0.87)). Additionally, women with strong family–work conflicts were less likely to follow the recommended amount of physical activity (OR 0.77 (0.63–0.94)). Adjusting for family and work-related factors did not affect these associations.

Conflicts between paid work and family life are likely to constitute barriers for a physically active lifestyle and possibly also for healthy food habits. Improving the balance between work and family may provide a route for promoting health-related behaviours.

To examine the socio-economic and lifestyle determinants of cooking oil choice in Costa Rica during the last decade (1994–2004).

Cross-sectional study. Subjects (total n = 2274) belonged to the control population of a large case–control study; they were recruited yearly. Data about type of oil used for cooking, dietary intake, socio-economic and demographic characteristics were collected.

A dietitian visited all subjects and conducted the interviews at their homes; all subjects lived in the Costa Rican central valley region.

Adult, free-living, rural and urban Costa Ricans with no history of myocardial infarction and physical or mental disability.

The odds of choosing soybean over palm oil increased significantly each year (P < 0.05) and was determined by high socio-economic status (SES) and variables that suggest health awareness (self-reported history of hypertension, high cholesterol, multivitamin use and intake of green leafy vegetables). The odds of choosing other unsaturated oils, namely corn and sunflower, over soybean oil also increased yearly (P < 0.05) and was associated with the same two factors (high SES and health awareness). Palm oil users remained in the lowest SES tertile and were more likely to live in rural areas. Across all SES tertiles, high health awareness determined the odds of choosing other unsaturated oils over palm oil, and soybean oil (P < 0.05).

These data show that, in addition to SES, health awareness is associated with the selection of unsaturated oils over palm oil in a developing country undergoing transition. These data should be considered when targeting nutrition messages and policies that promote better dietary choices.

Paternal smoking is highly prevalent in Asia, and tobacco may account for a large proportion of household expenditures among poor families. We sought to characterise the relationship between paternal smoking, child malnutrition and food expenditures.

Data on smoking, household expenditures and child malnutrition were examined in a stratified multistage cluster sample of households in the Indonesia nutrition surveillance system. Main outcome measures were child wasting (weight-for-height Z-score < − 2), underweight (weight-for-age Z-score < − 2) and stunting (height-for-age Z-score < − 2), and severe wasting, underweight and stunting (defined by respective Z-scores < − 3).

In total, 175 583 households from urban slum areas in Indonesia.

Children 0–59 months of age.

The prevalence of paternal smoking was 73.8%. After adjusting for child gender and age, maternal age and education, and weekly per capita household expenditures, paternal smoking was associated with child stunting (odds ratio (OR) = 1.11, 95% confidence interval (CI) 1.08–1.14, P < 0.0001), severe wasting (OR = 1.17, 95% CI 1.03–1.33, P = 0.018) and severe stunting (OR = 1.09, 95% CI 1.04–1.15, P < 0.001). In households where the father was a smoker, tobacco accounted for 22% of weekly per capita household expenditures, with less money spent on food compared with households in which the father was a non-smoker.

Among poor families in urban slum areas of Indonesia, paternal smoking diverts household money from food to tobacco and exacerbates child malnutrition.

This study aimed to assess mother's/caregiver's understanding, practical application and cultural acceptability of a preliminary set of South African food-based dietary guidelines (FBDGs) for children aged 6–12 months living in the Little Karoo area of the Western Cape Province.

An observational, descriptive and cross-sectional study design was followed. Focus group interviews, recorded on videotape, were analysed for qualitative data. Quantitative questionnaires measured knowledge and comprehension of guidelines, perceived constraints to compliance with and importance of guidelines as well as socio demographic data prior to the focus group interviews.

Afrikaans-, English- and Xhosa-speaking communities of the Little Karoo area of the Western Cape Province of South Africa, including the urban areas of Oudtshoorn, Bongulethu, Bridgton, Toekomsrus and the adjacent rural areas of Dysselsdorp, Calitzdorp, Uniondale, Ladismith and Zoar.

Sixty-four mothers or caregivers to infants 6–12 months of age were included in the sample.

Information obtained through the questionnaires supported what was said during discussions. Although perceived as important by the majority of respondents, some of the guidelines were not well understood without prior explanation. Such guidelines were those pertaining to meal frequency and cup feeding, while application of the guideline to prolonged breast-feeding seemed the most problematic.

The FBDGs for this age group will have to be supported by extensive and appropriate educational material to be effective when introduced to the public. The fact that the applicability of the guideline to prolonged breast-feeding seemed to be the most problematic is a cause for concern.