Epidemiological studies have shown that adults tend to underestimate their weight and overestimate their height. This may lead to a misclassification of their BMI in studies based on self-reported data. The aim of the present study was to assess the validity of self-reported weight and height in Austrian adults.

Data on weight, height, health behaviour and sociodemographic characteristics of adults were collected in a standardized procedure via a self-filling questionnaire and a medical examination including measurements of weight and height.

A publicly accessible out-patient clinic in southern Austria.

Austrian residents (n 473) aged 18 years and older who attended a health check participated in the study.

The mean difference between reported and measured BMI was not significant in younger adults (<35 years: mean difference −0·21 kg/m2; P < 0·08) but increased significantly with age (≥55 years: mean difference −0·68 kg/m2; P < 0·001). The prevalence of normal weight (BMI = 18·5–24·9 kg/m2) and overweight (BMI = 25·0–29·9 kg/m2) was overestimated based on the self-reported data on BMI, while that for underweight (BMI < 18·5 kg/m2) and obesity (BMI ≥ 30·0 kg/m2) was underestimated (P < 0·001). The self-reported data showed an obesity prevalence of 12·5 %, while measurement showed a prevalence of 15·4 % (P < 0·001).

Our results indicate that prevalence rates of obesity are probably underestimated for Austrian adults when using self-reported weight and height information. The deviations from the measured data clearly increased with age. Analyses based on self-reported data should therefore be adjusted for the age dependency of the validity.

The present research aimed to analyse the nutrient density (ND), nutrient adequacy score (NAS) and energy density (ED) of Indonesian foods and to formulate a balanced diet using linear programming.

Data on typical Indonesian diets were obtained from the Indonesian Socio-Economic Survey 2008. ND was investigated for 122 Indonesian foods. NAS was calculated for single nutrients such as Fe, Zn and vitamin A. Correlation analysis was performed between ND and ED, as well as between monthly expenditure class and food consumption pattern in Indonesia. Linear programming calculations were performed using the software POM-QM for Windows version 3.

Republic of Indonesia, 2008.

Public households (n 68 800).

Vegetables had the highest ND of the food groups, followed by animal-based foods, fruits and staple foods. Based on NAS, the top ten food items for each food group were identified. Most of the staple foods had high ED and contributed towards daily energy fulfillment, followed by animal-based foods, vegetables and fruits. Commodities with high ND tended to have low ED. Linear programming could be used to formulate a balanced diet. In contrast to staple foods, purchases of fruit, vegetables and animal-based foods increased with the rise of monthly expenditure.

People should select food items based on ND and NAS to alleviate micronutrient deficiencies in Indonesia. Dietary formulation calculated using linear programming to achieve RDA levels for micronutrients could be recommended for different age groups of the Indonesian population.

Previous studies focused on a limited number of determinants of food label use. We therefore tested a comprehensive model of food label use consisting of sociodemographic, health-related and motivating variables. These three predictor groups were chosen based on the previous literature and completed with new predictors not yet examined in a comprehensive study of frequency of label use.

We sent questionnaires to a random sample of households in the German-speaking part of Switzerland.

The respondents filled in the questionnaire at home and returned it by mail.

We analysed the data of 1162 filled-in questionnaires (response rate = 38 %). Of the respondents, 637 were women (55 %), and their mean age was 53·54 (sd 15·68) years.

Health-related variables were the most important group of predictors of label use, followed by motivating factors and sociodemographic variables. Placing importance on health, healthy eating and nutritional value of food, perceived vulnerability for diet-related diseases, nutrition knowledge, numeracy and gender were positively associated with frequency of food label use whereas shopping habits and seeing eating as something positive were negative predictors of frequency of label use.

People's health consciousness should be raised in order to increase the frequency of food label use. Furthermore, it should be stressed that reading labels and keeping a healthy diet do not contradict ‘good eating’, and that both of these aspects can be combined with the help of food labels.

The aim of the present study was to assess anthropometric status in South African children and women in 2005 in order to document temporal trends in selected anthropometric parameters.

Heights and weights were measured in a cross-sectional study of children aged 1–9 years and women aged 16–35 years. The WHO reference values and BMI cut-off points were used to determine weight status.

South Africa, representative sample based on census data.

Children (n 2157) and women (n 2403).

Stunting was the most common nutritional disorder affecting 21·7 % of children in 1999 and 20·7 % in 2005. The difference was not statistically significant. Underweight prevalence remained unchanged, affecting 8·1 % of children, whereas wasting affected 5·8 % of children nationally, a significant increase from 4·3 % of children in 1999. Rural children were most severely affected. According to the international BMI cut-off points for overweight and obesity, 10 % of children nationally were classified as overweight and 4 % as obese. The national prevalence of overweight and obesity combined for women was 51·5 %. The prevalence of overweight in children based on weight-for-height Z-score did not change significantly (8·0 % to 6·8 %, P = 0·138), but the combined overweight/obesity prevalence based on BMI cut-off points (17·1 % to 14·0 %, P = 0·02) decreased significantly from 1999 to 2005.

The double burden of undernutrition in children and overweight among women is evident in South Africa and getting worse due to increased childhood wasting combined with a high prevalence of obesity among urban women, indicating a need for urgent intervention.

Dietary sodium reduction is a cost-effective public health intervention to reduce chronic disease. In response to calls for further research into front-of-pack labelling systems, we examined how alternative sodium nutrition label formats and nutrition claims influenced consumers’ choice behaviour and whether consumers with or without a diagnosis of hypertension differed in their choice patterns.

An anonymous online experiment in which participants viewed ten choice sets featuring three fictitious brands of baked beans with varied label formats and nutritional profiles (high and low sodium) and indicated which brand in each set they would purchase if shopping for this product.

Participants were recruited from New Zealand's largest online nationwide research panel.

Five hundred people with self-reported hypertension and 191 people without hypertension aged 18 to 79 years.

The addition of a front-of-pack label increased both groups’ ability to discriminate between products with high and low sodium, while the Traffic Light label enabled better identification of the high-sodium product. Both front-of-pack formats enhanced discrimination in the presence of a reduced salt claim, but the Traffic Light label also performed better than the Percentage Daily Intake label in moderating the effect of the claim for the high-sodium product.

Front-of-pack labels, particularly those with simple visual cues, enhance consumers’ ability to discriminate between high- and low-sodium products, even when those products feature nutrition claims.

We aimed to establish associations of duration of breast-feeding with mean BMI and waist circumference, as well as the likelihood of being overweight/obese, during early childhood.

Cross-sectional, population-based study. Height, weight and waist circumference were measured and BMI calculated. Interviewer-administered questionnaire determined whether the child was ever breast-fed and the duration of breast-feeding.

Sydney, Australia.

Infants and pre-school children (n 2092) aged 1–6 years were examined in the Sydney Paediatric Eye Disease Study during 2007–2009.

Of the children aged 1–6 years, 1270 had been breast-fed compared with 822 who were never breast-fed. After multivariable adjustment, 1–6-year-old children who were ever breast-fed compared with those who were not had significantly lower BMI, 16·7 (se 0·1) kg/m2v. 17·1 (se 0·2) kg/m2 (P = 0·01). Decreasing BMI was associated with increasing duration of breast-feeding (Ptrend = 0·002). After multivariable adjustment, each month increase in breast-feeding was associated with an average BMI decrease of 0·04 kg/m2 (P = 0·002) and 0·03 kg/m2 (P = 0·03) among children aged 1–2 years and 3–4 years, respectively. In 1–2-year-old children, each month increase in breast-feeding duration was associated with a 0·06 cm decrease in waist circumference (P = 0·04). Significant associations were not observed among 5–6-year-old children. Children who were ever breast-fed v. those never breast-fed were less likely to be overweight/obese (multivariable-adjusted OR = 0·54; 95 % CI 0·36, 0·83).

We demonstrated a modest influence of breast-feeding on children's BMI during early childhood, particularly among those aged less than 5 years.

A few studies link out-of-home eating to higher energy consumption, overweight and obesity in both adults and children. The present study was undertaken to investigate the nutritional value of meals available in a university cafeteria, in order to develop a target nutritional tool to help consumers make a more conscious nutritional choice.

A cross-sectional study.

In a university cafeteria in Pavia, northern Italy, the recipes and ingredients of each meal served during the whole year were obtained from the cooks. Energy, protein, fat, carbohydrate and fibre contents were computed for each meal standardized portion. Thirteen pyramid figures, subdivided into three coloured levels, were used to depict the energy and nutrient content of each meal.

Four hundred randomly selected customers were interviewed on the cafeteria nutritional proposal.

Foods available in the cafeteria consisted of 216 items and were distributed in the pyramids according to their energy content: the lowest ones at the bottom (green level) and the highest ones at the top (red level), passing through an orange level in the middle. Energy values ranged from 460 kJ (110 kcal) for a portion of dressed vegetables to 5021 kJ (1200 kcal) for a pizza. The depicted pyramids were displayed in the cafeteria, so that customers could choose their meal according to its nutritional value. The meals’ nutritional content information was perceived very helpful for customers’ nutritional choices.

Availability of nutrition information in the cafeteria was well accepted by the customers who could plan their meals according to a more balanced diet.

To investigate the food intake of Slovenian adolescents and to compare it with food-based dietary guidelines developed for children and adolescents, named the Optimized Mixed Diet (OMD). The OMD is a useful tool for the evaluation of food intake of adolescents.

All adolescents completed an FFQ at a regional health centre; a subgroup also completed a 3 d weighed dietary protocol at home.

This study is a part of the first national representative study on the dietary habits of Slovenian adolescents.

This cross-sectional study included a representative sample of 2813 Slovenian adolescents entering high school, aged 14–17 years, from all ten geographical regions of Slovenia.

The greatest deviations from the recommended intakes of the main food groups in the OMD were significantly lower intakes of (P < 0·001, mean): vegetables (179 and 163 g/d in boys and girls, respectively), bread/cereals (271 and 226 g/d), potatoes/rice/pasta (212 and 163 g/d); in boys also a significantly lower intake of fruits (mean: 321 g/d, P < 0·001) and a significantly higher intake of meat/meat products (mean: 126 g/d, P < 0·001). Additionally, the results show too high intake of sugar-sweetened beverages and too low intakes of fish and plant oils in both genders.

The food intake pattern of Slovenian adolescents deviates markedly from a healthy eating pattern. Nutrition education and interventions are needed for Slovenian adolescents.

We assessed serum homocysteine (tHcy) and folate concentrations among US adolescents before and after fortification of cereal-grain products with folic acid, and associations with demographic, behavioural and physiological factors.

Observational study conducted among participants of a randomized trial.

The Child and Adolescent Trial for Cardiovascular Health (CATCH) study.

Adolescents (n 2445) in grades 8 (pre-fortification, mean age 14 years) and 12 (post-fortification, mean age 18 years).

Average serum concentrations of tHcy, folate and vitamin B6 increased by 17 %, 16 % and 14 %, respectively, while serum concentrations of vitamin B12 decreased by 11 % post-fortification. Folic acid fortification provided, on average, an additional intake of 118 μg folate/d. Male sex (P < 0·0001) and white race (P = 0·0008) were associated with significantly greater increases in tHcy concentration, while increases in BMI (P = 0·006) and serum folate concentration (P < 0·0001) were associated with significant decreases in tHcy concentration. Female sex (P < 0·0001), non-smoking (P < 0·0001), use of multivitamins (P < 0·0001) and higher dietary intake of folate (P = 0·001) were associated with significantly greater increases in serum folate concentrations. From grade 8 to grade 12, the upward age trend in serum tHcy concentration was uninterrupted in its course (P > 0·50); whereas serum folic acid concentration showed a downward trend that incurred a discrete jump upward (17 % higher; P < 0·0001) with fortification. These trends differed significantly for males v. females (P < 0·001 for interaction).

Fortification had a significant impact on improving folate status but not serum tHcy concentrations among US adolescents.

Food insecurity is the limited or uncertain availability or access to nutritionally adequate, culturally appropriate and safe foods. Food insecurity may result in inadequate dietary intakes, overweight or obesity and the development of chronic disease. Internationally, few studies have focused on the range of potential health outcomes related to food insecurity among adults residing in disadvantaged locations and no such Australian studies exist. The objective of the present study was to investigate associations between food insecurity, sociodemographic and health factors and dietary intakes among adults residing in disadvantaged urban areas.

Data were collected by mail survey (n 505, 53 % response rate), which ascertained information about food security status, demographic characteristics (such as age, gender, household income, education) fruit and vegetable intakes, takeaway and meat consumption, general health, depression and chronic disease.

Disadvantaged suburbs of Brisbane city, Australia, 2009.

Individuals aged ≥ 20 years.

Approximately one in four households (25 %) was food insecure. Food insecurity was associated with lower household income, poorer general health, increased health-care utilisation and depression. These associations remained after adjustment for age, gender and household income.

Food insecurity is prevalent in urbanised disadvantaged areas in developed countries such as Australia. Low-income households are at high risk of experiencing food insecurity. Food insecurity may result in significant health burdens among the population, and this may be concentrated in socio-economically disadvantaged suburbs.

To produce study-specific portion sizes for 11-year-old children in a population-based birth cohort and to compare these study-specific portion sizes with previously published children's portion sizes, to assess their relevance today.

Two multiple-pass 24 h dietary recalls were taken. The Food Standard Agency's photographic food atlas was used to quantify intakes. Study-specific food portion sizes were calculated for each food group. Portion sizes were calculated for all children and separately for boys and girls. The nutrient intake from the 24 h dietary recalls was analysed using study-specific and published portion sizes for individual participants. Agreement was assessed using Pearson's correlation, intra-class correlation coefficients and the Bland–Altman method.

Birth cohort study, UK.

Children (mean age 11·3 years, n 264) and parents/guardians.

A total of 124 food portion sizes were calculated. Differences in portion weights between boys and girls were seen only for seven food items. There was a significant positive relationship (P < 0·001) between intakes of each nutrient as determined by the two sets of portion sizes. Correlation coefficients ranged from 0·77 (protein) to 0·98 (β-carotene). The intra-class correlation coefficients showed good agreement between nutrient intakes determined by the study-specific and published portion sizes (P < 0·001).

Nutrient intakes calculated using portion sizes from our population were similar to those calculated from portion size data collected in a national survey, despite being collected over a decade later. The present study adds to the small amount of evidence regarding portion sizes in UK children and shows agreement with previously published paediatric portion sizes.

Nutritionists in the UK are at the start of an exciting time of professional development. The establishment of the Association for Nutrition in 2010 has presented an opportunity to review, revitalize and expand the UK Voluntary Register of Nutritionists. In the UK and elsewhere, there is a need for a specialist register of nutritionists with title protection as a public safeguard.

The new structure will base professional registration on demonstration of knowledge and application in five core competencies. Initially, there will be five specialist areas: animal; public health; nutritional scientist; food; sports and exercise. The wording and requirements linking the specialist areas to the competencies have been carefully defined by leading individuals currently on the existing register in these specialist areas. These have been evaluated by a random sample of existing registrants to check for accuracy of definitions and examples. Other work aims to establish a clear quality assurance framework in nutrition for workers in the health and social care sectors (UK Public Health Skills and Career Framework Levels 1–4) who contribute to nutrition activity, such as community food workers, nutrition assistants and pharmacists. Students, co-professional affiliates and senior fellows will also find a place in the new Association. The title ‘nutritionist’ is not currently legally protected in the UK and it is used freely to cover a range of unregulated practice.

The establishment of a professional register to protect the public and to provide a clear identity for nutritionists is a vital step forward.

To examine associations of education and occupation, as indicators of socio-economic position (SEP), with dietary intake and diet quality in a sample of Chinese immigrant women.

Cross-sectional. Data collection included four days of dietary recalls and information on education and current occupation for participants and their spouses.

Philadelphia, PA, USA.

Chinese immigrant women (n 423) recruited from October 2005 to April 2008.

In multivariate models, both higher education level and occupation category were significantly associated with higher energy density and intake of energy and sugar. Education was additionally associated with intake of sugar-sweetened beverages (P = 0·01) and lower dietary moderation (P = 0·01). With joint categorization based on both education and occupation, we observed significant trends indicating higher energy density (P = 0·004) and higher intake of energy (P = 0·001) and sugar (P = 0·04), but less dietary moderation (P = 0·02) with higher SEP.

In this sample of US Chinese immigrants, higher SEP as indicated by education level and occupation category was associated with differences in dietary intake and with less dietary moderation. While higher SEP is typically linked to healthier diet in higher-income nations, in these immigrants the association of SEP with diet follows the pattern of their country of origin – a lower-income country undergoing the nutrition transition.

We explored the use of feedback in interactive web-based questionnaires for collecting data on lifestyle factors in epidemiological studies.

Here we report from a cohort study on lifestyle factors and upper respiratory tract infections among 1805 men and women. We introduced interactivity in the form of personalized feedback and feedback on a group level regarding dietary intake, physical activity and incidence of infections in web-based questionnaires as incentives for the respondents to continue answering questions and stay in the study.

The study was performed in Sweden.

All participants were randomly selected from the population registry.

Personalized feedback was offered in the baseline questionnaire and feedback on a group level in the five follow-up questionnaires. In total, 88 % of the participants actively chose to get personalized feedback at least once in the baseline questionnaire. The follow-up questionnaires were sent by email and the overall compliance at each follow-up was 83–84 %, despite only one reminder. In total, 74 % completed all five follow-ups. However, the compliance was higher among those who chose feedback in the baseline questionnaire compared with those who did not choose feedback.

The results show that it is possible to use feedback in web questionnaires and that it has the potential to increase compliance. The majority of the participants actively chose to take part in the personalized feedback in the baseline questionnaire and future research should focus on improving the design of the feedback, which may ultimately result in even higher compliance in research studies.

To evaluate the first phase of a specialist weight management programme provided entirely within the UK National Health Service.

Prospective cohort study using multiple logistic regression analysis to report odds of ≥5 kg weight loss in all referrals and completers, and odds of completion, with 95 % confidence intervals. Anxiety and depression ‘caseness’ were measured by the Hospital Anxiety and Depression Scale.

Glasgow and Clyde Weight Management Service (GCWMS) is a specialist multidisciplinary service, with clinical psychology support, for patients with BMI ≥35 kg/m2 or BMI ≥30 kg/m2 with co-morbidities.

All patients referred to GCWMS between 2004 and 2006.

Of 2976 patients referred to GCWMS, 2156 (72·4 %) opted into the service and 809 completed phase 1. Among 809 completers, 35·5 % (n 287) lost ≥5 kg. Age ≥40 years, male sex (OR = 1·39, 95 % CI 1·05, 1·82), BMI ≥ 50 kg/m2 (OR = 1·70, 95 % CI 1·14, 2·54) and depression (OR = 1·81, 95 % CI 1·35, 2·44) increased the likelihood of losing ≥5 kg. Diabetes mellitus (OR = 0·55, 95 % CI 0·38, 0·81) and socio-economic deprivation were associated with poorer outcomes. Success in patients aged ≥40 years and with BMI ≥50 kg/m2 was associated with higher completion rates of the programme. Patients from the most deprived areas were less likely to lose ≥5 kg because of non-completion of the programme.

Further improvements in overall effectiveness might be achieved through targeting improvements in appropriateness of referrals, retention and effective interventions at specific populations of patients.

To assess current beverage consumption patterns and anticipated reaction to an added 20 % tax on these products.

A random-digit dialled telephone interview lasting 20 min was administered to assess demographics, beverage consumption behaviours and intentions regarding consumption of sugar-sweetened beverages in the event of an additional tax on these beverages.

Respondents were recruited throughout the USA.

The study included 592 adults.

Sixty-nine per cent of respondents reported consuming at least one pre-packaged sugar-sweetened beverage in the past week; those who consumed sugar-sweetened beverages averaged seven pre-packaged beverages per week. Ninety-one per cent knew that frequent consumption of soft drinks increases risk of obesity. Thirty-six per cent supported a tax on sugar-sweetened beverages with greatest support among those aged 18–24 years, those with BMI < 30 kg/m2 and those with higher levels of education (P < 0·05). Over one-third of respondents said that they would cut back on their sweetened beverage consumption in the event of an added 20 % tax on these beverages.

Our findings suggest that an added tax on these beverages could influence some to cut down on their consumption, reducing their risk of obesity and related illnesses.

To identify children's iodine nutrition and goitre status in areas with mildly excessive iodine in drinking water.

A cross-sectional survey. Probability proportional to size sampling was employed to randomly select children from thirty townships where the median iodine content in drinking water ranged from 150 to 300 μg/l; their urinary iodine concentrations were determined and their thyroid volumes were measured by ultrasound. Drinking water samples and salt samples from the villages where the children lived were collected using a systematic sampling method.

Hebei Province of China.

A total of 1259 children aged 8–10 years (621 boys and 638 girls).

Children's median urinary iodine concentration was found to be 418·8 μg/l, and the iodine concentration was >300 μg/l for 68·3 % (248/363) of the urine samples. Children's median urinary iodine concentration in villages with median salt iodine >10 mg/kg was significantly higher than that in villages with median salt iodine <5 mg/kg (442·9 μg/l v. 305·4 μg/l, P ≈ 0). The goitre rate of 1259 children examined by ultrasound was 10·96 %.

The iodine intake of children living in areas with mildly excessive iodine in drinking water in Hebei Province was found to be excessive. The measured iodine excess in the sampled children is exacerbated by consumption of iodized salt. Goitre was identified in these areas; however, due to the limitation of the current criteria for children's thyroid volume, a comprehensive assessment of the prevalence of goitre in these regions could not be made and further study is required.

To experimentally compare the effects of eating or skipping breakfast on energy expenditure, activity levels and dietary habits.

A randomised cross-over trial, lasting 2 weeks. Participants were provided breakfast during one week and were required to fast until mid-day during the other week.

University campus.

Forty-nine participants (twenty-six female and twenty-three male participants) were recruited. Food intake was monitored using food diaries, and energy expenditure was assessed using pedometers and heart rate monitors. Morningness–eveningness, physical activity and health were assessed using validated questionnaires.

Across all participants, daily energy expenditure did not differ between the two experimental conditions. Total energy intake over 24 h did not vary with condition (male participants: 8134 (sd 447) kJ/d and 7514 (sd 368) kJ/d; female participants: 7778 (sd 410) kJ/d and 7531 (sd 535) kJ/d, for the breakfast and no-breakfast conditions, respectively). However, when comparing habitual breakfast eaters with those with irregular or breakfast-skipping habits, it was found that male non-habitual breakfast eaters consumed significantly (P = 0·029) more energy during the breakfast condition. Furthermore, female participants who were habitual breakfast eaters were found to eat significantly (P = 0·005) more and later in the day under the no-breakfast condition.

Although the suggestion that breakfast is a behavioural marker for appropriate dietary and physical activity patterns is not refuted by the present findings, our data suggest that the effect of breakfast may vary as a function of gender and morning eating habits, and thus there may be other mechanisms that link BMI and breakfast consumption behaviour.

To assess the impact of the complex survey design used in the 2007 Australian National Children's Nutrition and Physical Activity Survey (ANCNPAS07) on prevalence estimates for intakes of groups of foods in the population of children.

The impacts on prevalence estimates were determined by calculating design effects for values for food group consumption. The implications of ignoring elements of the sample design including stratification, clustering and weighting are discussed.

The ANCNPAS07 used a complex sample design involving stratification, a high degree of clustering and estimation weights.

Australian children aged 2–16 years.

Design effects ranging from <1 to 5 were found for the values of mean consumption and proportion of the population consuming the food groups. When survey weights were ignored, prevalence estimates were also biased.

Ignoring the complex survey design used in the ANCNPAS07 could result in underestimating the width of confidence intervals, higher mean square errors and biased estimators. The magnitude of these effects depends on both the parameter under consideration and the chosen estimator.