To assess key experts’ opinion regarding essential competencies required for effective public health nutrition practice within the health-care system of Iran.

Qualitative study using the modified Delphi technique through an email-delivered questionnaire.

Iran.

Fifty-five experts were contacted through email. The inclusion criterion for the study panel was being in a relevant senior-level position in nutrition science or public health nutrition in Iran.

In the first round, forty-two out of fifty-five experts responded to the questionnaire (response rate=76 %). A sixty-five-item questionnaire was designed with nine competency areas, including ‘nutrition science’, ‘planning and implementing nutritional interventions’, ‘health and nutrition services’, ‘advocacy and communication’, ‘assessment and analysis’, ‘evaluation’, ‘cultural, social and political aspects’, ‘using technology’ and ‘leadership and management’. All experts who had participated in the first round completed a modified version of the questionnaire with seventy-seven items in the second round. The experts scored ‘nutrition science’ as the most essential competency area, while more applied areas such as ‘management and leadership’ were less emphasized. In both rounds, the mean difference between the opinions of the necessity of each area was 5·6 %.

The Iranian experts had general agreement on most of the core competency areas of public health nutritionists. The results indicated the need for capacity building and revisions to educational curricula for public health nutritionist programmes, with more emphasis on skill-based competency development.

Figs are a rich source of several different minerals and fibres. We studied the effect of the consumption of dried California Mission figs on mineral and nutrient levels, as well as the effect of the addition of figs to a self-selected habitual diet on dietary patterns.

A crossover randomized controlled trial study design in which participants with a mean of age of approximately 56 years were randomly assigned to eat either their usual diet for 5 weeks or to add dried California Mission figs (120 g/d) to their usual diet for 5 weeks, after which they crossed over to the other group for an additional 5 weeks. Six 24 h dietary recalls and four blood samples were obtained from each participant.

Loma Linda University School of Public Health, USA.

A follow-up study using data collected from eighty-eight American males and females from September to December 2008.

Diets reported in the 24 h dietary recall during the fig-supplemented diet period were significantly higher in Ca and K in the dietary and total phase (P value<0·05). Nevertheless, data on mineral levels in the body gathered by means of biochemical analyses from blood samples were nearly the same for both the figs-added and the participants’ standard diet. The estimated displacement suggests that eating figs resulted in the elimination of 4 % of desserts, 5 % of vegetables, 10 % of dairy products, 23 % of grain products and 168 % of beverages from other sources that participants would otherwise consume.

Based on 24 h dietary recalls, the daily consumption of figs may increase the intake of several different minerals. However, mineral levels in blood samples were not altered significantly.

We investigated whether a higher number of fast-food outlets in an individual’s home neighbourhood is associated with increased prevalence of type 2 diabetes mellitus and related risk factors, including obesity.

Cross-sectional study.

Three UK-based diabetes screening studies (one general population, two high-risk populations) conducted between 2004 and 2011. The primary outcome was screen-detected type 2 diabetes. Secondary outcomes were risk factors for type 2 diabetes.

In total 10 461 participants (mean age 59 years; 53 % male; 21 % non-White ethnicity).

There was a higher number of neighbourhood (500 m radius from home postcode) fast-food outlets among non-White ethnic groups (P<0·001) and in socially deprived areas (P<0·001). After adjustment (social deprivation, urban/rural, ethnicity, age, sex), more fast-food outlets was associated with significantly increased odds for diabetes (OR=1·02; 95 % CI 1·00, 1·04) and obesity (OR=1·02; 95 % CI 1·00, 1·03). This suggests that for every additional two outlets per neighbourhood, we would expect one additional diabetes case, assuming a causal relationship between the fast-food outlets and diabetes.

These results suggest that increased exposure to fast-food outlets is associated with increased risk of type 2 diabetes and obesity, which has implications for diabetes prevention at a public health level and for those granting planning permission to new fast-food outlets.