To ascertain the breakfast habits of 10–15-year-old schoolchildren and to assess the quality of this meal as well as its relationship to the food consumption pattern for the full day.

Cross-sectional survey.

Eight hundred and two schoolchildren, boys and girls, aged 10–15 years, belonging to different urban schools located in Secunderabad, Andhra Pradesh, India.

The breakfast eating patterns of the children were studied and their impact on growth was assessed, using dietary recalls and anthropometric measurements.

Only 42.8% of the children ate breakfast regularly. Over half of the children skipped breakfast, ranging from daily to once in two weeks. The energy and protein composition of breakfasts eaten by the children indicated that those who did not skip breakfast met one-quarter to one-third of their total daily energy and protein requirements. Mean nutrient intakes calculated from 24-hour recalls revealed that the children's diets were inadequate compared with the recommended values for energy and protein. The inadequate energy intake was reflected in a high incidence of malnutrition in both boys and girls; 40.3% of the boys and 32.1% of the girls studied were found to be underweight. Protein intake was also inadequate among boys and girls, although a higher percentage of children met their protein requirements.

Over half of the schoolchildren studied skipped breakfast frequently, the main reason being getting up late. Children who consumed breakfast had higher daily intakes of energy and protein than children who skipped breakfast. These data confirm the importance of breakfast to overall dietary quality and adequacy in school-aged children.

To determine the difference in the nutritional status of elderly people depending on their consumption of fruits and vegetables, and to study the possible association between the consumption of these foods and different cardiovascular risk factors, especially total plasma homocysteine (t-Hcys) levels.

A cross-sectional study in 152 institutionalised older people from Madrid aged ≥ 65 years. Food and nutrient intakes were recorded over 7 days using the ‘precise individual weighing’ method. The weight, height, and waist and hip circumferences of all subjects were recorded, as were their α-erythrocyte glutathione reductase, serum B6, B12 and folate levels, erythrocyte folate levels, t-Hcys levels, serum lipids and blood pressure. The experimental population was then divided into tertiles depending on the serving intake of fruit and vegetables (T1, < 2.29 servings day− 1; T2, 2.29–2.79 servings day− 1; and T3, >2.79 servings day− 1).

Compared with T1 subjects, T3 subjects showed consumptions of cereals, pulses, meat, fish and eggs closer to those recommended (P < 0.05). In addition, the contribution of their diet towards covering the recommended daily intake of vitamin B1, niacin, vitamin B6, folic acid, vitamin C, B12, vitamin A, and P, Mg, Zn and Fe was higher. The intake of fibre increased with consumption of fruit and vegetables (r = 0.6839, P < 0.001). T3 subjects also had better serum and erythrocyte folate levels than T1 and T2 subjects (P < 0.05). A positive correlation was found between the consumption of fruit and vegetables and serum folate (r = 0.2665, P < 0.01) and with erythrocyte folate levels (r = 0.2034, P < 0.05), and a negative correlation with t-Hcys (r = − 0.2493, P < 0.01).

Greater consumption of fruit and vegetables is associated with better food habits, increased vitamin and mineral intakes and lower t-Hcys levels. Considering that the fruit and vegetable intake in Spanish elderly people is very low, it is recommended that the consumption of fruits and vegetables by elderly people be increased.

To assess whether interview mode (telephone vs. in-person) affects the results of surveys that measure food security.

Responses given by households interviewed by telephone and in-person in recent US Current Population Survey Food Security Supplements (CPS-FSS) were compared. Statistical methods based on the Rasch measurement model were used to assess whether response patterns differed between the two interview modes. Multivariate logistic regression analysis was then used to gauge the effect of interview mode on the measured household prevalence rates of food insecurity and very low food security while controlling for income, employment, household structure, and other household characteristics that affect food security.

Response patterns to the indicators that comprise the food security scale did not differ substantially between interview modes. Prevalence rates of food insecurity and very low food security estimated from the two interview modes differed by only small proportions after accounting for differences in the socio-economic characteristics of households.

Findings suggest that effects of interview mode on food security measurement in the CPS-FSS are small, or at most modest. Prevalence estimates may be biased upwards somewhat for households interviewed in-person compared with those interviewed by telephone. The extent to which these results can be generalised may depend, to some extent, on survey characteristics other than interview mode, such as surveyor name recognition and respondents’ trust and confidence in the surveyor.

To evaluate the effects of a comprehensive physical activity (PA) promotion programme in elementary schools on children's total PA levels, leisure-time PA, physical fitness and psychosocial correlates of PA.

A pre-test–post-test design over two school years.

Sixteen elementary schools (764 children, mean age: 11.2 ± 0.7 years) were randomly assigned to the intervention condition (n = 8) and the control condition (n = 8). The intervention included a health-related physical education programme, an extracurricular PA promotion programme and classroom-based PA education lessons. In the total sample, leisure-time PA, psychosocial correlates of PA and physical fitness were measured using a PA questionnaire and the Eurofit test battery. In a sub-sample, total PA levels were measured using an accelerometer.

According to accelerometer data, children's moderate PA and moderate-to-vigorous PA (MVPA) levels decreased less in the intervention schools than in the control schools (P < 0.01). The average time spent on MVPA decreased by 9 min per day in the intervention schools compared with 33 min per day in the control schools. Children in the intervention schools reported significantly more moderate PA in leisure time than the controls (P < 0.05). No overall improvement of physical fitness and no effects on the psychosocial correlates of PA were found.

The comprehensive PA promotion programme was successful in preventing a decline in children's total activity levels. Furthermore, the intervention increased children's PA engagement in leisure time. Therefore, implementation needs to be encouraged.

To examine the nature of the link between food advertising in UK magazines aimed at children and young people and Internet food marketing, to establish whether consideration should be given to tightening existing controls.

A review and descriptive analysis of food advertising found in a sample of the top five magazine titles aimed at a range of ages of children and young people between November 2004 and August 2005 and of the Internet food marketing sites to which readers were directed.

Food advertising appeared as ‘cover-mount’ free gifts and as part of the main bound issue. Children aged 6–10 years were the most frequent recipients of food-based free gifts, all of which were confectionery. No food advertising was found in magazines aimed at pre-school children and it formed a small percentage of total advertising in the magazines aimed at children of school age and above. Most food advertisements were for ‘less healthy’ foods, although advertisements for ‘healthier’ food products did appear infrequently. Almost half of food advertisements directed readers towards Internet food marketing sites. We found evidence that these sites are using at least some of the ‘marketing tricks’ which have been identified as a cause for concern.

Proposed restrictions on broadcast media may lead to more food advertising via other non-broadcast means. We suggest monitoring the effect of such changes in print and online advertising and that consideration be given to restricting marketing techniques used on websites aimed at children and young people.

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 compare therapeutic feeding programme coverage for severely malnourished children achieved by a community-based therapeutic care (CTC) programme and a therapeutic feeding centre (TFC) programme operating in neighbouring districts in Malawi.

Two surveys were implemented simultaneously one in each of the two programme areas. Each survey used a stratified design with strata defined using the centric systematic area sample method. Thirty 100 km2 quadrats were sampled. The community or communities located closest to the centre of each quadrat were sampled using a case-finding approach. Cases were defined as children aged under 5 years with ≤ 70% of the weight-for-height median or bilateral pitting oedema. Receipt of treatment was ascertained by the child's presence in a therapeutic feeding programme or by documentary evidence. Coverage in each quadrat was estimated in two ways, a period estimate that provides an estimation of coverage for the recent period preceding the survey and a point estimate that provides an estimation of coverage at the exact point in time of the survey.

Overall the period coverage was 24.55% (95% confidence interval (CI) = 17.8–31.4%) in the TFC programme and 73.64% (95% CI = 66.0–81.3%) in the CTC programme. The point coverage was 20.04% (95% CI = 13.8–26.3%) in the TFC programme and 59.95% (95% CI = 51.4–68.5%) in the CTC programme.

In this context, CTC gave substantially higher programme coverage than a TFC programme. Given effective treatment, this enabled higher impact of CTC on severe malnutrition in this population.

To examine the influence of eating location on the quality of the diets of Irish children and to compare intakes at home with intakes at other people's homes and intakes outside the home, and to compare intakes at various locations outside the home.

Food intake was measured using a 7-day weighed diary in 594 children from the Republic of Ireland (aged 5–12 years). Details of where the food was prepared or obtained were also recorded.

Eighty-nine per cent of all eating occasions occurred at home; < 6% occurred at both other people's homes and outside the home (takeaway, restaurant, shop, other). The percentage of food energy from fat was above the recommended 35% at other people's homes and outside the home, specifically at takeaways and restaurants. Fibre and micronutrient intakes (per 10 MJ) were significantly higher at home than at the other locations (P < 0.05). Within the ‘out’ locations, fibre and micronutrient intakes were generally higher at restaurants and lower at shops. High consumers of foods outside the home had a statistically significant, but relatively small decline in nutrient intakes compared with non- or low consumers. Chips and processed potatoes, meat products, savouries, sugars and confectionery, and savoury snacks made the greatest contribution to foods consumed outside the home.

The main focus of nutrition policies to improve the diets of Irish children should be the home environment rather than the food service sector. However, guidelines could call for better food choices outside the home to improve nutrient intakes.

To evaluate the effectiveness of a school nutrition programme on the weight gain and growth of Vietnamese schoolchildren.

A proximate cluster evaluation of children in seven schools, in which fortified milk and biscuits supplying 300 kcal of energy were being given on school days, compared with children in 14 nearby schools with no feeding. All children were dewormed.

Twenty-one primary schools in Dong Thap Province, Vietnam.

A cohort of 1080 children in grade 1 of 21 primary schools, and a cross-sectional interview of 400 children in grade 3.

The programme gave children the equivalent of 90 kcal day− 1 over 17 months. t-Tests showed a small but statistically significant difference between groups in their average gain in weight and height: 3.19 versus 2.95 kg (P < 0.001) and 8.15 versus 7.88 cm (P = 0.008). A multiple-level model showed that the programme was statistically significant after controlling for clustering of children in schools, sex, age and initial underweight (P = 0.024). A significant impact on height was also seen in a regression model, but not when controlling for school. The most undernourished children tended to gain the least weight. There was no evidence of substitution.

The programme had a small but significant effect on weight gain, but the most undernourished children benefited the least. Methods need to be developed to target them. This design may offer a means of estimating the impact of school feeding on growth in other programme settings.

To determine iodine levels in salt and iodine deficiency prevalence in school-aged children in 16 districts in Tanzania with previous severe iodine deficiency.

A cross-sectional study in schoolchildren. Systematic probability sampling was used to select schools and subjects for goitre assessment and urinary iodine determination.

Sixteen districts randomly selected from the 27 categorised as severely iodine-deficient in Tanzania.

The study population was primary-school children aged 6–18 years who were examined for goitre prevalence and urinary iodine concentration (UIC). Salt samples from schoolchildren's homes and from shops were tested for iodine content.

The study revealed that 83.3% of households (n = 21 160) in the surveyed districts used iodised salt. Also, 94% of sampled shops (n = 397) sold iodised salt, with a median iodine level of 37.0 ppm (range 4.2–240 ppm). Median UIC in 2089 schoolchildren was 235.0 μg l− 1 and 9.3% had UIC values below 50 μg l− 1. The overall unweighted mean visible and total goitre prevalence was 6.7% and 24.3%, respectively (n = 16 222). The age group 6–12 years had the lowest goitre prevalence (3.6% visible and 18.0% total goitre, n = 7147). The total goitre prevalence had decreased significantly in all districts from an unweighted mean of 65.4% in the 1980s to 24.3% in 1999 (P < 0.05). We believe this difference was also biologically significant.

These findings indicate that iodine deficiency is largely eliminated in the 16 districts categorised as severely iodine-deficient in Tanzania, and that the iodine content of salt purchased from shops is highly variable.

It is hypothesised that mothers' social networks can positively affect child nutrition through the sharing of health knowledge and other resources. The present study describes the composition of mothers' networks, examines their association with child nutrition, and assesses whether health knowledge is shared within networks.

Cross-sectional data for mothers of young children from Andhra Pradesh (south India) were combined with existing data from the Young Lives study, in which the mothers were participating (n = 282).

The composition of social networks varied between urban and rural areas, with urban networks being larger, more female, more literate and with a greater proportion of members living outside the household and being non-family. There was a positive association between child's height-for-age Z-score and mother's network size and network literacy rate. The association with network literacy was stronger among the poorest households. Women commonly reported seeking or receiving health advice from network members.

Big and literate social networks are associated with better child nutrition, especially among the poor. The dissemination of health knowledge between network members is a plausible way in which social networks benefit child nutrition in India. Further research into the underlying mechanisms is necessary to inform the development of interventions that channel health information through word of mouth to the most excluded and vulnerable families.

Public health professionals continue to see the benefits of fruit and vegetable consumption on population health. While studies that evaluate the availability of produce are sparse in the medical literature, disparities in availability may explain the disproportional intake of produce for some people. Therefore, the purpose of this study was to evaluate the availability and variety of produce located in two racially and economically diverse urban neighbourhoods.

A cross-sectional study was conducted in which 50% of the supermarkets, small grocery stores, delicatessens, and fruit and vegetable markets located in specific neighbourhoods were randomly sampled and surveyed between September 2004 and July 2005. Food stores were evaluated for the availability of 20 types of fresh fruits and 19 types of fresh vegetables, as well as their varieties and whether they were canned, frozen or previously prepared. 2000 US Census information was used to determine characteristics of the geo-coded census tracts where the food stores were located.

Brooklyn, New York.

A supermarket was located in approximately every third census tract in predominantly white areas (prevalence = 0.33) and every fourth census tract in racially mixed areas (prevalence = 0.27). There were no supermarkets located in the predominantly black areas. With the exception of bananas, potatoes, okra and yucca, a lower proportion of predominantly black area stores carried fresh produce, while supermarkets carried the largest variety of produce types. Canned and frozen fruits and vegetables were found in the majority of stores, whereas prepared and organic produce was limited to predominantly white area stores.

These data demonstrate that the availability and variety of fresh produce is associated with neighbourhood racial composition and may be a factor contributing to differences in intake among residents.

To estimate the prevalence of the metabolic syndrome (MS) in a population of patients with overweight and obesity of the A Coruña and Granada health areas, using the definitions of the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (ATP III) and of the International Diabetes Federation (IDF).

During a period extending from 1996 to 2003, only those patients attending endocrinology outpatient clinics for whom all the anthropometric and biochemical parameters used to define the MS, both according to the ATP IIII and the IDF, were available were selected. The final study sample consisted of 285 patients, 198 females (69.5%) and 87 males (30.5%).

The prevalence of the MS was 29.8% when the ATP III definition was applied, and 41.1% according to the IDF criteria. Prevalence by sex was 32.2% in men and 28.8% in women according to the ATP III, and 42.5% and 40.4%, respectively, according to the IDF.

In a patient population with overweight or obesity, the prevalence of the MS is higher when the IDF criteria, instead of the ATP III criteria, are used. These findings may have significant implications when it comes to addressing early diagnosis of cardiovascular disease and diabetes mellitus in these patients, in order to perform therapeutic measures at the initial stages and thereby reduce metabolic and cardiovascular complications.

To evaluate compliance with the World Health Organization's International Code of Marketing of Breast-milk Substitutes in primary care, after the introduction of strict local infant feeding guidelines.

An audit form was sent to all community-based health professionals with an infant feeding remit. Walking tours were conducted in a random sample of community care facilities.

Greater Glasgow Primary Care Division.

(1) Primary-care staff with an infant feeding remit; (2) community health-care facilities.

Contact with manufacturers of breast-milk substitutes (BMS) and BMS company personnel, free samples or incentives, and advertising of BMS.

Contact with company personnel was minimal, usually unsolicited and was mainly to provide product information. Free samples of BMS or feeding equipment were rare but childcare or parenting literature was more prevalent. Staff voiced concerns about the lack of relevant information for bottle-feeding mothers and the need to support the mother's feeding choice. One-third of facilities were still displaying materials non-compliant with the Code, with the most common materials being weight conversion charts and posters.

Contact between personnel from primary care and BMS companies was minimal and generally unsolicited. The presence of materials from BMS companies in health-care premises was more common. Due to the high level of bottle-feeding in Glasgow, primary-care staff stated a need for information about BMS.

Children's fruit/vegetable intake is still below recommended levels. This study applied Internet-tailored advice for schoolchildren and Internet-supported brief dietary counselling (with child and parent) within preventive health care to promote fruit/vegetable intake.

The study involved 30 seventh-grade classes (16 in the intervention group and 14 in the control group) with a total of 675 children aged 9–12 years, of whom 495 were allowed to participate.

A cluster-randomised baseline–post-test experimental design was applied. During school hours, all children completed Internet-administered questionnaires on fruit/vegetable intake and related determinants. Children in the intervention group received immediate online individually tailored nutrition feedback. For each child in the intervention group, a nurse received information concerning the assessment of fruit/vegetable intake via the Internet to support a 5 min counselling protocol to promote fruit/vegetable intake. Children completed a similar post-test questionnaire 3 months after the first assessment. Intention-to-treat analyses were conducted using multilevel regression analyses.

A total of 486 children (98% of 495) participated (263 in the intervention group, 223 in the control group); 240 child–parent couples in the intervention group attended the counselling. Awareness of inadequate fruit intake (odds ratio (OR) = 3.0; 95% confidence interval (CI) = 1.8–5.3) and knowledge of recommended vegetable intake levels (OR = 2.7; 95% CI = 1.8–4.1) were significantly more likely at post-test in the intervention group than in the control group. No significant effects were found on intake or other determinants.

A compact, integrated two-component intervention can induce positive changes in knowledge and awareness of intake levels of fruit/vegetables among schoolchildren. To induce changes in intake levels, more comprehensive interventions may be needed.

To describe the physical activity profile of Saudi adults living in Riyadh, using the International Physical Activity Questionnaire (IPAQ) short-version telephone format.

Physical activity was assessed using the official Arabic short form of IPAQ, intended for use in telephone interview. The instrument asks for times spent in walking, moderate- and vigorous-intensity physical activity of at least 10 min duration. The sample consisted of 1616 Saudis, between 15 and 78 years of age, living in Riyadh. Participants were drawn from a list of names in the telephone book using a simple random method. Telephone interviews were administered during the spring of 2003 by trained male interviewers.

The final sample size was 1064 Saudi males and females (response rate of 66%), with males comprising about 66% of the respondents. Over 43% of Saudis did not participate in any type of moderate-intensity physical activity lasting for at least 10 min. More than 72% of the sample did not engage in any type of vigorous-intensity physical activity lasting for at least 10 min. The proportion of Saudis who walked for 150 min or more per week was 33.3%. Females were engaged more in moderate physical activity than males, whereas males participated more in vigorous activity compared with females. Activity levels did not show significant relationships with education level or job hours per week. Based on the three activity categories established by IPAQ, 40.6% of Saudis were inactive, 34.3% were minimally active and 25.1% were physically active. Physical inactivity increased with advancing age.

The data suggest that the prevalence of physical inactivity among Saudis adults is relatively high. Efforts are needed to encourage Saudis to be more physically active, with the goal of increasing the proportion of Saudis engaging in health-enhancing physical activity.

The aims of this study were to assess the changes that have occurred in food patterns in Europe over the last 40 years based on food availability data and to compare the stability of the traditional Mediterranean diet in the south of Europe in this period.

An ecological study carried out on the basis of Food and Agriculture Organization food balance sheets for three geographical areas of Europe (Mediterranean, north and east) over two time periods: 1961–1963 and 1998–2000. The average availability of total energy, energy provided from macronutrients and food groups was calculated for each area and each period studied.

Over the last 40 years total energy availability and energy availability from lipids have increased considerably in the three European areas, while the percentage of energy from carbohydrates has fallen. The greatest changes have occurred in Mediterranean Europe, with an increase of 20.1% in total energy availability, an increase of 48.1% in energy availability from lipids and a fall of 20.5% from carbohydrates. Moreover, Mediterranean Europe showed a significant fall in the energy supplied by cereals (29.9%) and wine (55.2%), while the contribution of milk (77.8%) and dairy products (23.6%) increased.

The results of this study suggest that European Mediterranean countries should take nutrition policy action to maintain their traditional healthy food pattern, with a cultural added value. This implies actions at all levels, including raising awareness of consumers, collaboration with the food sector and a call to set the agenda of the concerned politicians and stakeholders.

To measure rates of hunger and food insecurity among young US-born Latino children with Mexican immigrant parents (Latinos) compared with a non-immigrant non-Latino population (non-Latinos) in a low-income clinic population.

A repeated cross-sectional survey of 4278 caregivers of children < 3 years of age in the paediatric clinic of an urban county hospital for a 5-year period from 1998 to 2003. A total of 1310 respondents had a US-born child with at least one parent born in Mexico. They were compared with a reference group comprised of non-Latino US-born participants (n = 1805). Child hunger and household food insecurity were determined with the US Household Food Security Scale.

Young Latino children had much higher rates of child hunger than non-Latinos, 6.8 versus 0.5%. Latino families also had higher rates of household food insecurity than non-Latinos, 53.1 versus 15.6%. Latino children remained much more likely to be hungry (odds ratio (OR) = 13.0, 95% confidence interval (CI) = 5.9–28.7, P < 0.01) and in household food-insecure households (OR = 6.6, 95% CI = 5.2–8.3, P < 0.01) than non-Latinos after controlling for the following variables in multivariate analysis: child's age, sex, maternal education level, single-headed household status, family size, young maternal age ( < 21 years), food stamp programme participation, TANF (Temporary Assistance to Needy Families, or ‘welfare’) programme participation and WIC (Women, Infants, and Children) usage, and reason for clinic visit (sick visit versus well-child).

Young children in Mexican immigrant families are at especially high risk for hunger and household food insecurity compared with non-immigrant, non-Latino patients in a low-income paediatric clinic.