To pilot-test a brief written prescription recommending lifestyle changes delivered by general practitioners (GPs) to their patients.

The Active Nutrition Script (ANS) included five nutrition messages and personalised exercise advice for a healthy lifestyle and/or the prevention of weight gain. GPs were asked to administer 10 scripts over 4 weeks to 10 adult patients with a body mass index (BMI) of between 23 and 30 kg m− 2. Information recorded on the script consisted of patients' weight, height, waist circumference, gender and date of birth, type and frequency of physical activity prescribed, and the selected nutrition messages. GPs also recorded reasons for administering the script. Interviews recorded GPs views on using the script.

General practices located across greater Melbourne.

Nineteen GPs (63% female) provided a median of nine scripts over 4 weeks. Scripts were administered to 145 patients (mean age: 54 ± 13.2 years, mean BMI: 31.7 ± 6.3 kg m− 2; 57% female), 52% of whom were classified as obese (BMI >30 kg m− 2). GPs cited ‘weight reduction’ as a reason for writing the script for 78% of patients. All interviewed GPs (90%, n = 17) indicated that the messages were clear and simple to deliver.

GPs found the ANS provided clear nutrition messages that were simple to deliver. However, GPs administered the script to obese patients for weight loss rather than to prevent weight gain among the target group. This has important implications for future health promotion interventions designed for general practice.

To validate an estimated food record (EFR), using a weighed food record (WFR) as the reference method, for the determination of food consumption and nutrient intakes in a group of Costa Rican adults.

For the WFR, all foods consumed by subjects during seven consecutive days were weighed and recorded by nutrition students. Two EFRs (a 4-day and a 3-day record) were recorded by subjects with the use of home measures and photographs to estimate amounts.

Costa Rica.

Sixty adults: 30 men and 30 women; 30 living in urban and 30 in rural areas.

The EFR gave statistically significant lower average intake estimates for energy and 12 of the 22 nutrients examined. The correlation coefficients ranged from 0.68 (polyunsaturated fats) to 0.87 (calcium). The percentage of subjects classified into the same quartile ranged from 45.0% (polyunsaturated fats) to 68.3% (vitamin B12). For all nutrients except vitamin C, 0 or 1.7% were misclassified into extreme quartiles. For food group consumption, the EFR gave statistically significant lower estimates for six of the 17 groups and correlation coefficients ranged from 0.22 (fish) to 0.93 (beverages). Greater differences in estimates of mean energy and nutrient intakes were detected among subjects from rural areas, caused in part by a tendency to underestimate the amounts of rice and beans consumed.

Validation of the EFR using a WFR as the reference method gave results that compare favourably with those reported by other authors, and support the use of the EFR for dietary surveys among Costa Rican adults.

To examine relationships between the ratio of energy intake to basal metabolic rate (EI/BMR) and age and body mass index (BMI) among Japanese adults.

Energy intake was assessed by 4-day semi-weighed diet records in each of four seasons (16 days in total). The EI/BMR ratio was calculated from reported energy intake and estimated basal metabolic rate as an indicator of reporting accuracy.

Residents in three areas in Japan, namely Osaka (urban), Nagano (rural inland) and Tottori (rural coastal).

One hundred and eighty-three healthy Japanese men and women aged ≥30 years.

The oldest age group (≥60 years) had higher EI/BMR values than the youngest age group (30–39 years) in both sexes (1.74 vs. 1.37 for men; 1.65 vs. 1.43 for women). In multiple regression analyses, age correlated positively (partial correlation coefficient, β = 0.012, P < 0.001 for men; β = 0.011, P < 0.001 for women) and BMI correlated negatively (β = −0.031, P < 0.001 for men; β = −0.025, P < 0.01 for women) with EI/BMR.

Age and BMI may influence the relative accuracy of energy intake among Japanese adults.

To examine the efficacy and safety of foods fortified with calcium in the adult population in Finland.

A simulation study based on the FINDIET 2002 Survey, which estimated habitual food consumption, dietary supplement use and nutrient intakes using 48-hour recall and two 3-day food records, and an Internet survey of the consumption of fortified foods and dietary supplements.

Participants of FINDIET 2002 were 25–64 years old from five areas (n = 2007). Participants of the Internet-based survey (n = 1537) were over 15 years of age from all over the country.

If all potentially fortifiable foods were to be fortified with calcium, the proportion of participants with calcium intake below the recommended level (<800 mg day−1) would decrease from 20.3% to 3.0% in men and from 27.8% to 5.6% in women compared with the situation where no foods were fortified. At the same time, the proportion of participants with calcium intake above the tolerable upper intake level (UL, >2500 mg day−1) would increase from 0.6% to 12.7% in men and from 0.1% to 3.8% in women. However, in a probability-based model (11% of all fortifiable foods to be fortified with calcium) the proportion of participants with calcium intake below the recommended level would be 15.7% in men and 23.2% in women. The proportion with intake above the UL in this model would be 1.2% in men and 0.7% in women.

Food fortification would be a relatively effective and safe way to increase the calcium intake of the Finnish adult population.

This paper reports on findings from the ex-post evaluation of the Maewo Capacity Building project in Maewo Island, Vanuatu, which was funded by World Vision Australia.

To examine the extent to which the infrastructure and systems left behind by the project contributed to the improvement of household food security and health and nutritional outcomes in Maewo Island, using Ambae Island as a comparator.

Two-stage cluster survey conducted from 6 to 20 July 2004, which included anthropometric measures and 4.5-year retrospective mortality data collection.

A total of 406 households in Maewo comprising 1623 people and 411 households in Ambae comprising 1799 people.

Household food insecurity, crude mortality rate (CMR), under-five mortality rate (U5MR) and malnutrition prevalence among children.

The prevalence of food insecurity without hunger was estimated at 15.3% (95% confidence interval (CI): 12.1, 19.2%) in Maewo versus 38.2% (95% CI: 33.6, 43.0%) in Ambae, while food insecurity with hunger in children did not vary by location. After controlling for the child's age and gender, children in Maewo had higher weight-for-age and height-for-age Z-scores than children of the same age in Ambae. The CMR was lower in Maewo (CMR=0.47/10 000 per day, 95% CI: 0.39, 0.55) than in Ambae (CMR=0.59/10 000 per day, 95% CI: 0.51, 0.67) but no difference existed in U5MR. The major causes of death were similar in both locations, with frequently reported causes being malaria, acute respiratory infection and diarrhoeal disease.

Project initiatives in Maewo Island have reduced the risks of mortality and malnutrition. Using a cross-sectional 'external control group' design, this paper demonstrates that it is possible to draw conclusions about project effectiveness where baseline data are incomplete or absent. Shifting from donor-driven evaluations to impact evaluations has greater learning value for the organisation, and greater value when reporting back to the beneficiaries about project impact and transformational development in their community. Public health nutritionists working in the field are well versed in the collection and interpretation of anthropometric data for evaluation of nutritional interventions such as emergency feeding programmes. These same skills can be used to conduct impact evaluations, even some time after project completion, and elucidate lessons to be learned and shared. These skills can also be applied more widely to projects which impact on the longer-term nutritional status of communities and their food security.

To compare growth patterns and estimates of malnutrition based on the World Health Organization (WHO) Child Growth Standards (‘the WHO standards’) and the National Center for Health Statistics (NCHS)/WHO international growth reference (‘the NCHS reference’), and discuss implications for child health programmes.

Secondary analysis of longitudinal data to compare growth patterns (birth to 12 months) and data from two cross-sectional surveys to compare estimates of malnutrition among under-fives.

Bangladesh, Dominican Republic and a pooled sample of infants from North America and Northern Europe.

Respectively 4787, 10 381 and 226 infants and children.

Healthy breast-fed infants tracked along the WHO standard's weight-for-age mean Z-score while appearing to falter on the NCHS reference from 2 months onwards. Underweight rates increased during the first six months and thereafter decreased when based on the WHO standards. For all age groups stunting rates were higher according to the WHO standards. Wasting and severe wasting were substantially higher during the first half of infancy. Thereafter, the prevalence of severe wasting continued to be 1.5 to 2.5 times that of the NCHS reference. The increase in overweight rates based on the WHO standards varied by age group, with an overall relative increase of 34%.

The WHO standards provide a better tool to monitor the rapid and changing rate of growth in early infancy. Their adoption will have important implications for child health with respect to the assessment of lactation performance and the adequacy of infant feeding. Population estimates of malnutrition will vary by age, growth indicator and the nutritional status of index populations.

To assess the effectiveness of a behaviour change approach, with or without financial support, in improving vitamin A (VA) intake and serum retinol concentration through mango and liver consumption by children.

A parallel design (no control area) was used to assess changes in VA intake and serum retinol over a 15-week period.

A pilot study was implemented in the Department of Kokologho, a rural area in central west Burkina Faso. One hundred and fifty children aged 2–3 years were randomly selected and assigned to two treatment groups: PA$$ (promotional activities and financial support) and PA (promotional activities).

The intervention significantly increased (P<0.001) total VA intake by 56% in PA$$ and by 50% in PA. VA intake from liver increased significantly (P<0.001) from 12.7±23.5 to 155.3±56.3 μg retinol activity equivalents (RAE) in PA$$ and from 21.6±29.7 to 135.3±44.9 μg RAE in PA. Changes in VA intake from liver were significantly higher (P=0.004) in PA$$ compared with PA. Mean serum retinol concentration increased significantly by 26% (P<0.001) in PA$$ and 30% (P<0.001) in PA. Changes in serum retinol concentration (0.13 μmol l−1 in PA$$ vs. 0.17 μmol l−1 and in PA) did not differ significantly (P=0.455) between groups over the intervention.

Promotional activities on mango and liver intake effectively increased VA intake and serum retinol concentrations. Although an additional beneficial effect of financial support on liver intake was observed, this did not translate into a further increase in serum retinol concentration.

This study assessed the impact of changes in school food policy on student lunch consumption in middle schools

Two years of lunch food records were collected from students at three middle schools in the Houston, Texas area. During the first year, no changes occurred in the school food environment. After that school year was completed, chips and dessert foods were removed from the snack bars of all schools by the Food Service Director. Students recorded the amount and source of food and beverage items consumed. Point-of-service purchase machines provided a day-by-day electronic data file with food and beverage purchases from the snack bars during the 2-year period. Independent t-tests and time series analyses were used to document the impact of the policy change on consumption and sales data between the two years

In general, student consumption of sweetened beverages declined and milk, calcium, vitamin A, saturated fat and sodium increased after the policy change. Snack chips consumption from the snack bar declined in year 2; however, consumption of snack chips and candy from vending increased and the number of vending machines in study schools doubled during the study period. Ice cream sales increased significantly in year 2

Policy changes on foods sold in schools can result in changes in student consumption from the targeted environments. However, if all environments do not make similar changes, compensation may occur