To assess the relationship between intake of dietary folate equivalents and risk of myocardial infarction in a German cohort.

Intake of dietary folate equivalents was assessed by a validated food-frequency questionnaire. Cox proportional hazard models were used to evaluate the association between intake of dietary folate equivalents and risk of myocardial infarction.

The European Prospective Investigation into Cancer and Nutrition (EPIC)–Potsdam cohort, Germany.

Subjects were 22 245 apparently healthy non-users of vitamin supplements aged 35–64 years.

During 4.6 years of follow-up, 129 incident cases of myocardial infarction were identified. Compared with intake below the median (103 μg), higher intake of dietary folate equivalents was associated with a multivariate-adjusted hazard ratio (HR) of 0.57 (95% confidence interval (CI) 0.36–0.91). The inverse association of folate intake and myocardial infarction risk was stronger in participants with an ethanol intake equal to or above the sex-specific median (HR = 0.37, 95% CI 0.18–0.79) and attenuated in those with a low ethanol intake (HR = 0.67, 95% CI 0.37–1.22).

An increased intake of dietary folate equivalents was observed to be associated with decreased risk of myocardial infarction in a German study population, pointing towards the importance of folate intake with respect to primary prevention of myocardial infarction.

The goal of the present work was to examine the prevalence and associated risk factors of undiagnosed diabetes among urban Moroccan Sahraoui women.

Randomised sample of adult women living in the city of Laayoune in south Morocco who visited public health centres during an immunisation campaign. Body weight, height, waist and hip circumferences, blood pressure, fasting plasma glucose (FPG), triglycerides, dietary intake and physical activity were collected.

Data were obtained on 249 urban women aged 15 years and older, who were not pregnant. Only subjects identified as of Sahraoui origin were eligible for this investigation.

The prevalence of impaired fasting glucose (IFG) was 5.5% and that of undiagnosed diabetes 6.4%. Diabetes and IFG were more common among older and obese women as well as among women with hypertension or a family history of diabetes. In addition, sucrose intakes were higher in women with diabetes than in those with normal FPG. Also, physical activity estimated as the time spent in walking was negatively associated with FPG. Regression analyses showed an independent association of age, obesity, family history of diabetes and triglycerides with diabetes.

The high proportion of unknown diabetes suggests the need for increased diabetes awareness in this population. The data suggest also the involvement of obesity in diabetes and the potential importance of intervention strategies to reduce population adiposity for the prevention and management of cardiovascular risk factors.

To document the epidemiological features and influencing factors of obesity in the north-west of Iran, to provide baseline information for setting up a regional population-based centre to control and prevent obesity-related disorders in the area.

In this cross-sectional study, a total of 300 subjects were selected/studied in Tabriz, one of the major cities in Iran. Data on basic characteristics, anthropometric measurements, dietary assessment and physical activity were collected. Obesity was defined as body mass index ≥ 30 kg m− 2 for both women and men.

Total prevalence of obesity in the area was 22.4% (95% confidence interval (CI): 18.0–27.6). The prevalence of obesity was 24% (95% CI: 18.5–31.4) for women and 18% (95% CI: 12.5–25.6) for men. For both women and men obesity prevalence showed a positive association with age (P < 0.001), while there was a negative correlation of obesity with education and income (P < 0.001). Fruit consumption decreased the risk of obesity in both women and men (odds ratio (OR) = 0.60, 95% CI: 0.49–0.71 vs. OR = 0.62, 95% CI: 0.51–0.74, respectively). The same significant pattern was observed for the consumption of green vegetables (OR = 0.71, 95% CI: 0.57–0.63 vs. OR = 0.86, 95% CI: 0.77–0.98 for women and men, respectively), legumes (OR = 0.70, 95% CI: 0.59–0.84 vs. OR = 0.78, 95% CI: 0.66–0.91 for women and men, respectively) and dairy products (OR = 0.73, 95% CI: 0.61–0.91 vs. OR = 0.77, 95% CI: 0.63–0.93 for women and men, respectively).

Our study showed that educational attainment, higher income and consumption of certain food groups (i.e. vegetables, fruits, legumes and dairy products) may decrease the risk of obesity. Our findings also indicate the crucial necessity of establishing a population-based centre for obesity in the area. The essential information is now achieved to propose to local health authorities to act accordingly. However, more population-based investigations on dietary choices are needed to develop effective preventive strategies to control overweight and obesity disorders in different regions.

To fulfil a comprehensive approach to consumption, which is necessary to characterise food habits and their relationship to diseases, using a diet quality index (DQI) developed for a Mediterranean region (Med-DQI).

A cross-sectional nutritional survey provided the data for the construction of the DQI.

A representative sample made up of 964 subjects from a French Mediterranean area, Hérault département.

Foods such as olive oil, fish and cereals were used instead of nutrients to build up scores which constructed the Med-DQI. Biochemical analysis identified biomarkers used to validate the Med-DQI. Correspondence factorial analysis illustrated the characteristics of subjects with different scores given by the Med-DQI.

The subjects could be satisfactorily classified by the Med-DQI. The oldest age, less educated, overweight, manual workers, living in a rural area and male classes showed a better Med-DQI. For women, they were also from the oldest age class, but some of them were from the upper social class, with an ideal BMI and lived by the Mediterranean shore. A composite biomarker index, based on plasma carotene and vitamin E levels and the percentage of EPA and DHA in erythrocytes membranes, can identify subjects with good and poor Med-DQI.

Med-DQI G is a good instrument to identify groups at risk with regard to nutritional quality. Subjects with α+β-carotene levels > 1 mg/l, vitamin E > 30 mg/l, EPA > 0.65% and DHA > 4% of fatty acids in erythrocytes are likely to have a good diet.

We investigated whether experienced food insecurity was associated with weight control behaviour of adolescents.

A national survey of 16-year-old students with the six-item food security scale, questions concerning intentions of trying to change weight, physical activity patterns, and measurement of height and weight.

Representative sample of 29 schools in Trinidad, West Indies.

Data analysed for 1903 subjects including 1484 who were food-secure and 419 who were food-insecure.

In the whole sample, food security status did not vary by body mass index (BMI) category. ‘Trying to gain weight’ and ‘spending most free time in activities involving little physical effort’ were each associated with lower BMI. ‘Trying to gain weight’ was more frequent in food-insecure subjects (135, 32%) than in food-secure subjects (369, 25%, P=0.012). After adjustment for BMI, age, sex, ethnicity and socio-economic variables, the adjusted odds ratio (OR) of ‘trying to gain weight’ for food-insecure subjects was 1.39 (95% confidence interval (CI) 1.07–1.82, P = 0.014). Food-insecure subjects (197, 47%) were more likely than food-secure subjects (575, 39%) to report that most of their free time was spent doing things that involved little physical effort (P = 0.003). This association was not explained by adjustment for BMI, age, sex and ethnicity (OR = 1.41, 95% CI 1.13–1.76, P = 0.002) or additional socio-economic variables (OR = 1.27, 95% CI 1.02–1.57, P = 0.033).

Adolescents who experience food insecurity are more likely to intend to gain weight but engage in less physical activity than food-secure subjects with the same BMI.

To compare serum lipids and their changes during a family-based health education in children aged 6–17 years with or without the ɛ4 allele of the gene encoding apolipoprotein E (apoE).

An intervention study.

A family-based prevention of risk factors of coronary heart disease in Eastern Finland. The programme consisted of two counselling meetings at children's schools and three at children's homes.

Four hundred and thirty-nine children with a family history of cardiovascular diseases (CVD) participated in a family-based health education. The children were divided into two groups according to apoE genotype. The risk group consisted of 143 children having apoE ɛ4 allele (genotype ɛ3/4 or ɛ4/4) and the non-risk group of 296 children without apoE ɛ4 allele (ɛ2/3 or ɛ3/3). The final sample of the follow-up study included 354 (81%) children (114 and 240, respectively).

Baseline differences were found in low-density lipoprotein cholesterol (LDL-C) (P = 0.007) and LDL-C/high-density lipoprotein cholesterol (HDL-C) ratio (P = 0.030) among boys and in total cholesterol (TC)/HDL-C (P = 0.008) and LDL-C/HDL-C ratios (P = 0.006) among girls. Differences between groups in changes during the follow-up were observed only for TC/HDL-C ratio (P-value adjusted for age = 0.049) among boys.

At baseline, children with apoE ɛ4 allele had on average a more unfavourable lipid profile than those without apoE ɛ4 allele. However, the effect of about 33 months' family-based health education on plasma lipids did not depend on apoE genotype in children with a family history of CVD.

To examine consumption rates and serum ferritin (SF) concentrations (as a marker of safety) among schoolchildren (3–6 years) provided with daily and weekly micronutrients.

Micronutrients were provided for one school term (13 weeks) to a kindergarten in northern China as single-dose SprinklesTM sachets containing 30 mg of iron as encapsulated ferrous fumarate, 5 mg zinc gluconate, 50 mg vitamin C, 300 μg vitamin A, 7.5 μg vitamin D3 and 150 μg folic acid. Sixteen classrooms were randomly assigned to: (1) daily supplements for 5 days a week (daily group); (2) weekly supplements (weekly group); or (3) no supplements (control group). Consumption of sachets was monitored for each child and SF concentrations were measured at the end of study. Random effects general linear models and graphs were used to compare the groups.

A total of 415 children from 16 classrooms entered the study. At the end of the study, mean consumption rates per child were 86% (daily group; standard deviation (SD) 12%) and 87% (weekly group; SD 16%). Median SF concentrations were 71 μg l−1 (range 27–292 μg l−1; daily group), 55 μg l−1 (range 11–299 μg l−1; weekly group) and 54 μg l−1 (range 7–327 μg l−1; control group); the overall difference was not significant (P = 0.06). However, the daily group was significantly different from the control (P = 0.02); daily and weekly groups had higher SF at lower percentiles and similar SF at higher percentiles compared with the control group.

The high consumption rates and appropriate SF concentrations in the supplemented groups suggest that a short-term school programme with Sprinkles is an efficient and safe way to provide micronutrients (including iron).

To describe geographical differences and time trends in the supply of the most important food components of the traditional Mediterranean diet.

Food supply data collected from national food balance sheets for the period 1961–2001.

Selected Mediterranean countries: Spain, Italy, France, Greece, Algeria, Morocco, Tunisia and Turkey.

Differences of almost 30-fold and five-fold were found in the supply of olive oil and fruits and vegetables, respectively, among the Mediterranean countries studied during the 1960s. A favourable increasing trend for the supply of fruit and vegetables was observed in most Mediterranean countries. However, an increase in the supply of meats and dairy products and a decrease in the supply of cereals and wine were observed in European Mediterranean countries from 1961 until 2001. Only in African and Asiatic Mediterranean countries were cereals the base of food supply. During the 1990s, Greece's food supply pattern was closest to the traditional Mediterranean diet, while Italy and Spain maintained a high availability of fruits, vegetables and olive oil, but were losing the other typical components. Among African and Asiatic Mediterranean countries, only Turkey presented a traditional Mediterranean dietary pattern except with respect to olive oil, the supply of which was very low. France showed a Western dietary pattern, with a high supply of animal products and a low supply of olive oil.

Dietary supplies in the Mediterranean area were quite heterogeneous in the 1960s and have experienced a process of Westernization, especially in European Mediterranean countries.

To assess the vitamin D status of Irish postmenopausal women during wintertime, and to examine its relationship with serum parathyroid hormone (PTH) and biochemical markers of bone turnover. In addition, the determinants of wintertime serum 25-hydroxyvitamin D (25OH–D) levels in these women were investigated.

A cross-sectional observational study.

Cork City, Ireland (52°N).

Ninety-five apparently healthy, free-living postmenopausal women (aged 51–75 years), not taking any medication and free from any condition likely to affect vitamin D status or calcium/bone metabolism.

Forty-eight per cent and 7% of women had serum 25OH–D levels <50 nmol l−1 and <25 nmol l−1, respectively. 25OH–D levels in these women were positively associated with dietary calcium intake (P = 0.0002) and use of vitamin D-containing supplements (P = 0.031), and negatively associated with cigarette smoking (P = 0.027) and body mass index (BMI) (P = 0.030). Low serum 25OH-D levels (<50 nmol l−1) were associated (P <0.01) with elevated serum PTH levels. There were no significant differences in urinary pyridinium crosslinks or serum osteocalcin, biochemical indices of bone turnover, between subjects with serum 25OH–D levels above or below 50 nmol l−1.

A high proportion of Irish postmenopausal women had low vitamin D status (< 50 nmol l−1) during late wintertime, which appeared to lead to elevated levels of serum PTH but not of bone turnover markers. Use of regular low-dose supplemental vitamin D, meeting daily calcium recommendations, cessation of smoking and maintaining BMI in the normal range are important factors that could help maintain adequate vitamin D levels during wintertime in these women.

To discuss present knowledge about the relation between sexual dysfunction, metabolic factors and the Mediterranean-style diet.

Review of the literature and personal perspectives.

Sexual problems appear to be widespread in society, influenced by both health-related and psychosocial factors, and are associated with impaired quality of life. Epidemiological studies suggest that modifiable health behaviours, including physical activity and leanness, are associated with a reduced risk for erectile dysfunction (ED) among men. Data from other surveys also indicate a higher prevalence of impotence in obese men. Obesity and the metabolic syndrome may be a risk factor for ED. The high prevalence of ED in patients with cardiovascular risk factors suggests that abnormalities of the vasodilator system of penile arteries play an important role in the pathophysiology of ED. We have shown that one-third of obese men with ED can regain their sexual activity after 2 years of adopting health behaviours, including a Mediterranean-style diet associated with regular exercise.

Western societies actually spend a huge part of their health care costs on chronic disease treatment and interventions for risk factors. The adoption of healthy lifestyles can reduce the prevalence of obesity and the metabolic syndrome, and hopefully the burden of sexual dysfunction.

To estimate the burden of disease attributable to low fruit and vegetable intake in the 15 countries that were members of the European Union (EU) before May 2004 (EU-15) and the 10 countries that then joined it (EU-10).

Data on fruit and vegetable intake, target levels of intake and estimates of relative risks, deaths and disability were combined to obtain the burden of ischaemic heart disease, ischaemic stroke and four types of cancer (lung/bronchus/trachea, stomach, oesophagus, and colon/rectum) attributable to low fruit and vegetable consumption.

EU-15 and EU-10 Member States.

The number of lives potentially saved annually from the selected outcomes if fruit and vegetable intake increased to 600 g person−1 day−1 reached 892 000 and 423 000 in the EU-15 and EU-10, respectively; total disease burden could decrease by 1.9% and 3.6%, respectively. The burden of ischaemic heart disease and stroke could be reduced by up to 17% and 10%, respectively, in the EU-15 and by 24% and 15%, respectively, in the EU-10; potential reductions for the selected cancers varied from 1% to 12% in the EU-15 and from 2% to 17% in the EU-10.

The potential health gain of increased fruit and vegetable intake is particularly large in the new Member States, and particularly high for cardiovascular diseases, a main cause of health divide in Europe. This stresses the need for better nutrition programmes and policies that take account of economic, social and cultural specificities.

Antioxidant nutrients like carotenoids, tocopherols and vitamin C have been suggested to protect against allergic rhinitis and allergic sensitisation but scientific evidence is scarce. The aims of the study were to measure the plasma concentration of six carotenoids, α- and γ-tocopherol and vitamin C as biomarkers of the intake, absorption and subsequent metabolism of these nutrients, and to assess their association with allergic rhinitis and sensitisation.

Data from a cross-sectional study on representative dietary and lifestyle habits of the population of Bavaria, Germany, were analysed. The plasma levels of six carotenoids (α-carotene, β-carotene, lycopene, lutein/zeaxanthin, canthaxanthin and cryptoxanthin) as well as of α-tocopherol, γ-tocopherol and vitamin C were measured in 547 adults aged between 19 and 81 years. Participants with specific serum immunoglobulin E ≥700 U l−1 were categorised as sensitised. The association of plasma antioxidant levels, allergic rhinitis and allergic sensitisation was assessed by means of unconditional logistic regression models.

We observed a negative association between plasma total carotenoids and the prevalence of allergic rhinitis, with odds ratio (95% confidence interval) of 1.13 (0.54–2.39) for the second, 0.72 (0.33–1.58) for the third and 0.44 (0.19–1.03) for the fourth quartile of total carotenoids concentration (P for trend = 0.0332); results for lycopene failed to reach statistical significance (P = 0.0608). Other single carotenoids, tocopherols and vitamin C were unrelated to allergic rhinitis. Allergic sensitisation was negatively associated with plasma γ-tocopherol, with odds ratio (95% confidence interval) of 0.92 (0.51–1.65) for the second, 1.00 (0.56–1.80) for the third and 0.45 (0.23–0.88) for the fourth quartile of plasma γ-tocopherol concentration (P for trend = 0.0410). No other antioxidant was significantly related to allergic sensitisation.

High plasma carotenoid concentrations reflecting a diet high in various fruits and vegetables might have a protective effect on allergic rhinitis in adulthood.

To investigate the association between the weight status of first–year female students (FYFS) and various weight management–related characteristics to identify possible components of a weight management programme for students.

Cross‐sectional study.

Female residences at a South African university.

A total of 360 FYFS.

Mean (± standard deviation (SD)) body mass index (BMI) of the FYFS was 21.8 ± 2.6 kg m−2, with 7.2% being underweight, 81.9% normal‐weight, 10.0% overweight and 0.8% obese. Underweight, normal–eight and overweight students differed with regard to their perception of their weight (P < 0.001), weight goals (P < 0.001) and previous weight–loss practices (P < 0.001). Mean ± SD score on the 26-item Eating Attitudes Test (EAT–26) was 8.5 ± 9.0 with 8.4% classified as high scorers. Mean ± SD score on the 34-item Body Shape Questionnaire (BSQ) was 87.7 ± 32.2, with 76.1% classified as low, 11.9% as medium and 11.9% as high scorers. The self-concept questionnaire indicated that 36.7% had a high, 43.9% a medium and 19.4% a low self-concept. Higher BMI correlated with a higher BSQ score (P < 0.001), a lower self-concept (P = 0.029) and a higher EAT-26 score (P < 0.001). Smoking was prevalent amongst 13.1% of students, and 51.2% used vitamin and/or mineral supplements. Students who quitted smoking had higher (P = 0.006) BMI (22.7 ± 2.9 kg m-2) than those who never smoked before (21.6 ± 2.5 kg m−2). Normal-weight students were more physically active than underweight or overweight students (P = 0.038).

The specific weight management-related needs of FYFS include information about supplement use, smoking, realistic weight goals, safe and sound weight-loss methods, weight cycling, body-shape perceptions, eating attitudes and behaviours, self-concept and physical activity. Interventions aimed at correcting these problems should target all students, regardless of their BMI.

To compare the ability of waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) to predict cardiovascular risk factors in an urban adult population of Tehranian women.

Population-based cross-sectional study.

Tehran, the capital of Iran.

This study was conducted on 5073 women aged 18–74 years, participants of the Tehran Lipid and Glucose Study. Demographic data were collected. Anthropometric indices were measured according to standard protocols. Cut-off points of BMI, WC, WHR and WHtR were considered as 25 kg m−2, 80 cm, 0.8 and 0.5, respectively. Blood pressure was measured and hypertension was defined based on the sixth report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Biochemical analyses were conducted on fasting blood samples. Diabetes was defined as fasting plasma glucose ≥126 mg dl−1 or 2-hour plasma glucose ≥200 mg dl−1 and dyslipidaemia based on the third report of the National Cholesterol Education Program Expert Panel. The presence of ‘at least one risk factor’ from the three major cardiovascular risk factors (hypertension, dyslipidaemia and diabetes) was also evaluated.

Mean (±standard deviation) age of women was 39.9 ± 14.6 years; mean BMI, WC, WHR and WHtR were 27.1 ± 1.5 kg m−2, 86.5 ± 13.5 cm and 0.83 ± 0.08 and 0.55 ± 0.08, respectively. Of the four anthropometric measures, WC had the highest sensitivity and specificity to identify subjects with risk factors in both the 18–39 year and the 40–74 year age categories. WC was seen to have a higher percentage of correct prediction than BMI, WHR and WHtR.

It is concluded that WC is the best screening measure for cardiovascular risk factors, compared with BMI, WHR and WHtR, in Tehranian adult women.

To determine if participants would be interested in consuming soy foods to lower cholesterol in primary and secondary prevention of heart disease, and to identify the role physicians and registered dietitians have in providing dietary advice, about soy foods or other foods, for participants with elevated cholesterol.

Qualitative data from 12 focus groups were gathered from a convenience sample of 74 adults, aged 18–91 years, with and without high cholesterol (total cholesterol >200 mg dl−1). Participants were recruited from Minneapolis/St. Paul mainstream and natural foods grocery stores. Focus group interviews were taped and transcribed verbatim. Common themes were identified, coded and compared using NVivo computer software.

Participants believed diet, lifestyle and genetics were the cause of high cholesterol and cardiovascular disease (CVD). Few participants were aware of the Food and Drug Administration health claim for soy protein, yet many were willing to consume soy as part of lifestyle modification to prevent CVD. They reported preferring food and exercise over medication to treat high cholesterol. Few participants had ever received dietary advice from physicians on treating high cholesterol or CVD, and most doubted the accuracy of such advice. They believed registered dietitians were the most credible source of nutrition counselling and expressed an interest in physician referrals to dietitians.

A collaboration and referral system between physicians and registered dietitians could increase CVD patients' consumption of soy foods as a means potentially leading to a reduced risk of heart disease in participants.

The Healthy Eating Index (HEI), designed to assess adherence to the Dietary Guidelines for Americans and the Food Guide Pyramid, was previously associated with only a small reduction in major chronic disease risk in US adult men and women. We assessed whether an alternate index would better predict risk.

Dietary intake reported by men and women from two prospective cohorts was scored according to an a priori designed Alternate Healthy Eating Index (AHEI). In contrast with the original HEI, the AHEI distinguished quality within food groups and acknowledged health benefits of unsaturated oils. The score was then used to predict development of CVD, cancer or other causes of death in the same population previously tested.

67 271 women from the Nurses' Health Study and 38 615 men from the Health Professionals' Follow-up Study.

Men and women with AHEI scores in the top vs. bottom quintile had a significant 20% and 11% reduction in overall major chronic disease, respectively. Reductions were stronger for CVD risk in men (RR = 0.61, 95% CI 0.49–0.75) and women (RR = 0.72, 95% CI 0.60–0.86). The score did not predict cancer risk.

The AHEI was twice as strong at predicting major chronic disease and CVD risk compared to the original HEI, suggesting that major chronic disease risk can be further reduced with more comprehensive and detailed dietary guidance.

To provide an overview of methodological issues in the design, delivery and evaluation of childhood obesity prevention programmes.

Review of existing literature.

International.

Interventions have varied considerably with regard to their design, subject selection criteria, sample size, attrition rates, intervention components and duration of both the intervention and the follow-up phases. However, overall, there is only a limited body of consistent, high-quality evidence on which valid and generalisable conclusions can be drawn about best practices for the prevention of childhood obesity.

Although the rationale for targeting children and adolescents through primary prevention is now compelling, effective obesity prevention remains elusive. There is increasing consensus that prevention of childhood obesity necessitates multifaceted health promotion interventions based on population health principles. By definition, such interventions should have a range of outcome indicators of effectiveness, generalisability and sustainability, not just the traditional ones focused on individual lifestyle behaviour change. Given the complexity and intricacy of population-based intervention programmes, multiple methods of data collection which combine both qualitative and quantitative approaches will need to be fully exploited in order to move towards evidence-based practice in the future.

To investigate the prevalence of anaemia and subclinical vitamin A deficiency among adolescent schoolboys in Dhaka City, Bangladesh, and to identify factors related to anaemia and vitamin A status.

A cross-sectional study.

Government high schools in Dhaka City, Bangladesh.

A total of 381 boys, aged 11–16 years, from 10 schools in Dhaka City participated in the study. Socio-economic, anthropometric and dietary data were collected. Haemoglobin and serum retinol (vitamin A) concentrations were determined.

Seven per cent of the boys were anaemic and 22% had serum vitamin A levels below the adequate level of 1.05 μmol l−1, with only 1.5% having subclinical vitamin A deficiency (<0.70 μmol l−1). Food frequency data revealed poor dietary habits. Multiple regression analysis showed that age, body mass index (BMI), parents' occupation, serum vitamin A level and frequency of intakes of meat and fruit were significantly independently related to haemoglobin level. The overall F-ratio (13.1) was highly significant (P< 0.000) and the adjusted R2 was 0.192. For serum vitamin A, BMI, father's education, per capita expenditure on food, haemoglobin concentration and frequency of intake of vitamin A-rich fruit were found to be significantly independently related. The overall F-ratio (14.5) was highly significant (P< 0.000) and the adjusted R2 was 0.186.

The data show that adolescent schoolboys in Dhaka City have anaemia and inadequate vitamin A status, although the extent of the problems is lower than in other population groups in the country. Sociodemographic and dietary factors appear to have important relationships with anaemia and vitamin A status of these boys.

To evaluate the relationship between dietary diversity score (DDS) and cardiovascular risk factors in Tehranian adults.

In this population-based cross-sectional study, a representative sample of 581 subjects (295 males and 286 females) aged over 18 years, residents of Tehran, participated. Hypercholesterolaemia, hypertriglyceridaemia and low high-density lipoprotein cholesterol were defined according to the Adult Treatment Panel III guidelines of the National Cholesterol Education Program. Diabetes was defined as fasting plasma glucose concentration ≥ 126 mg dl−1 or 2-h post challenge glucose concentration ≥ 200 mg dl−1. Hypertension was defined on the basis of the sixth report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Dietary diversity was defined according to the Diet Quality Index revised.

Mean (±standard deviation) DDS was 6.15 ± 1.02. The probability of having diabetes (odds ratio (OR) among quartiles: 1.45, 1.26, 1.11 and 1.00, respectively; P for trend = 0.04) and hypertriglyceridaemia (OR = 1.41, 1.23, 1.05 and 1.00, respectively; P for trend = 0.04) decreased with increasing quartile of the diversity score for whole grains. The probability of having obesity (OR among quartiles: 1.39, 1.06, 1.03 and 1.00, respectively; P for trend = 0.03), hypercholesterolaemia (OR = 1.46, 1.28, 1.11 and 1.00, respectively; P for trend = 0.03), hypertension (OR = 1.32, 1.17, 1.13 and 1.00, respectively; P for trend = 0.03) and high low-density lipoprotein cholesterol (LDL-C) (OR = 1.25, 1.12, 1.07 and 1.00, respectively; P for trend = 0.04) decreased with increasing quartile of the diversity score for vegetables. The probability of having hypercholesterolaemia, high LDL-C, hypertension and diabetes decreased with quartile of the DDS. But the probability of being obese increased with quartile of the DDS (P for trend = 0.03).

DDS was inversely associated with cardiovascular risk factors in this cross-sectional study. Increased diversity scores of diets, to increase the variety score for vegetables, may be emphasised in programmes attempting to bring about changes in lifestyle.

The aim of the present study was to determine the interaction of and association between frequency of goitre detected by palpation, nutritional status evaluated by anthropometric indices and socio-economic status in school-aged children.

One thousand and eighteen prepubertal and pubertal children (aged 6–14 years) attending primary schools in an urban area were included in this study.

All subjects were evaluated for the presence of goitre and nutritional status. Thyroid size was assessed using the World Health Organization's (WHO) palpation system (1960). Severity of protein–energy malnutrition (PEM) was based on WHO criteria. Children were grouped into four categories of socio-economic status.

Eight per cent of children were detected to have goitre by palpation. Body mass index and weight-for-height were significantly lower in children who had palpable goitre than in children who did not have goitre (P < 0.05). Frequencies of having palpable goitre and being stunted and underweight were especially higher in children with very low socio-economic status (P = 0.016, 0.01 and 0.01, respectively). Frequency of being stunted, underweight and wasted in children with palpable goitre did not change significantly according to socio-economic status (P>0.05). In logistic regression analyses, the most important factor in detection of palpable goitre was socio-economic status (B = 0.517, P = 0.004). Fathers' education and occupation were found to be most significant (P = 0.031 and 0.020, respectively).

Children detected to have palpable goitre were thinner. However, nutritional disorders were not more frequent among children with palpable goitre compared with children without goitre. Goitre and nutritional deficiencies were more common in children with lower socio-economic status but the frequency of nutritional disorders in children with palpable goitre did not change according to socio-economic status.