To examine the association between 24 h urinary water-soluble vitamin levels and their intakes in free-living Japanese schoolchildren.

All foods consumed for four consecutive days were recorded accurately by a weighed food record. A single 24 h urine sample was collected on the fourth day, and the urinary levels of water-soluble vitamins were measured.

An elementary school in Inazawa City, Japan.

A total of 114 healthy, free-living, Japanese elementary-school children aged 10–12 years.

The urinary level of each water-soluble vitamin was correlated positively to its mean intake in the past 2–4 d (vitamin B1: r = 0·42, P < 0·001; vitamin B2: r = 0·43, P < 0·001; vitamin B6: r = 0·49, P < 0·001; niacin: r = 0·32, P < 0·001; niacin equivalents: r = 0·32, P < 0·001; pantothenic acid: r = 0·32, P < 0·001; folic acid: r = 0·27, P < 0·01; vitamin C: r = 0·39, P < 0.001), except for vitamin B12 (r = 0·10, P = NS). Estimated mean intakes of water-soluble vitamins calculated using urinary levels and recovery rates were 97–102 % of their 3 d mean intake, except for vitamin B12 (79 %).

The results show that urinary levels of water-soluble vitamins, except for vitamin B12, reflected their recent intakes in free-living Japanese schoolchildren and could be used as a potential biomarker to estimate mean vitamin intake.

To examine the associations between maternal education level and diet in 10-year-old children.

Three-day diet diaries (child completed with parental help) were collected. Height and weight were measured in research clinics. Maternal education level was derived from a questionnaire completed during pregnancy and classified into low, medium or high. One-way ANOVA was undertaken to compare maternal education groups for nutrient intakes and the Kruskal–Wallis test used for food consumption.

Avon Longitudinal Study of Parents and Children (ALSPAC), Bristol, UK.

Children (n 7474) who provided dietary data at age 10 years.

A large proportion (60 %) of the sample was classified as plausible reporters, with under-reporting accounting for 36 %. No clear differences were found for intakes of energy or macronutrients between maternal education groups for plausible reporters. However, there were marked differences in micronutrient intakes especially for vitamin C, retinol equivalents and folate, highlighting lower diet quality with lower maternal education level. Intakes of fruit and vegetables showed a positive gradient with increasing maternal education (57 % v. 79 % consumed fresh fruit in low and high educational groups, respectively). A trend towards higher intake in the lower educated group was shown for less healthy foods (meat pies P < 0·001; sausages, burgers and kebabs P < 0·001).

The quality of children's diet at 10 years was related to maternal education level. Lower maternal education was associated with less healthy food choices that could be detrimental to health. Further research is needed to establish if these associations can be explained by other socio-economic factors.

To assess the prevalence of high blood pressure (BP) and the association of overweight and obesity with high BP among adolescents in Aracaju, Brazil.

Cross-sectional study. The main outcome measure was the proportion of adolescents with high BP (sex-, age- and height-specific ≥95th percentile). The main predictor variables were overweight and obesity defined according to the criteria of the International Obesity Task Force. Other covariates included age, socio-economic status and leisure-time physical activity.

Aracaju, Brazil, capital city of Sergipe State, north-eastern Brazil.

A random sample of 1002 adolescents (442 boys and 560 girls) aged 12–17 years selected from twenty public schools and ten private schools were studied.

The prevalence of high BP was 16·9 % (95 % CI 13·1, 21·7) in boys and 12·9 % (95 % CI 9·0, 18·0) in girls. After adjusting for age, socio-economic status and leisure-time physical activity in both boys and girls, overweight (prevalence ratio (PR) = 1·93, 95 % CI 1·08, 3·48; PR = 4·34, 95 % CI 2·58, 7·30, respectively) and obesity (PR = 4·87, 95 % CI 2·35, 10·11; PR = 5·18, 95 % CI 2·67, 10·06, respectively) were found to be associated with high BP.

These findings indicate a high prevalence of high BP in both boys and girls in Aracaju, Brazil. Overweight and obesity were strongly associated with high BP. These findings underscore the urgent need for public health measures to prevent increasing high BP in adolescents in Brazil. Targeting intervention in adolescence may be a critical method for preventing high BP in later life.

To investigate whether children in households involved in a participatory agriculture and nutrition intervention had improved growth compared to children in matched comparable households and whether the level of involvement and length of time in the project had an effect on child growth.

A prospective quasi-experimental study comparing baseline and follow-up data in ‘intervention’ villages with matched subjects in ‘comparison’ villages. Mixed model analyses were conducted on standardized child growth scores (weight- and height-for-age Z-scores), controlling for child age and testing for effects of length of time and intensity of village involvement in the intervention.

A participatory agriculture and nutrition project (the Soils, Food and Healthy Communities (SFHC) project) was initiated by Ekwendeni Hospital aimed at improving child nutritional status with smallholder farmers in a rural area in northern Malawi. Agricultural interventions involved intercropping legumes and visits from farmer researchers, while nutrition education involved home visits and group meetings.

Participants in intervention villages were self-selected, and control participants were matched by age and household food security status of the child. Over a 6-year period, nine surveys were conducted, taking 3838 height and weight measures of children under the age of 3 years.

There was an improvement over initial conditions of up to 0·6 in weight-for-age Z-score (WAZ; from −0·4 (sd 0·5) to 0·3 (sd 0·4)) for children in the longest involved villages, and an improvement over initial conditions of 0·8 in WAZ for children in the most intensely involved villages (from −0·6 (sd 0·4) to 0·2 (sd 0·4)).

Long-term efforts to improve child nutrition through participatory agricultural interventions had a significant effect on child growth.

To investigate the association between eating behaviour and metabolic risk in the broader population.

The association between metabolic risk factors (overweight, hypertension, hyperglycaemia, hypertriacylglycerolaemia, low HDL cholesterol, hyperuricaemia and fatty liver) and various eating behaviours were compared for four groups defined by subjective reporting: not eating until feeling full and not eating rapidly (G1); eating until feeling full only (G2); eating rapidly only (G3); and eating both rapidly and until feeling full (G4).

A medical centre for health examinations in Tokyo, Japan.

Men (n 8240) and women (n 2955) who underwent health examinations.

The distribution of participants in G1 to G4 was 49·8 %, 11·5 %, 26·3 % and 12·4 % among men and 55·3 %, 15·0 %, 19·0 % and 10·7 % among women, respectively. Compared with G1, the age-adjusted OR (95 % CI) for overweight were significantly higher in G2 to G4, being respectively 1·85 (1·58, 2·17), 1·98 (1·76, 2·23) and 3·46 (2·99, 4·01) for men and 2·20 (1·62, 2·97), 2·59 (1·97, 3·39) and 3·12 (2·27, 4·26) for women. The age-adjusted OR were also significantly higher for hypertriacylglycerolaemia, hyperuricaemia and fatty liver in G2 and for all risks in G3 and G4 among men; and for hyperuricaemia in G2, for hyperglycaemia, hypertriacylglycerolaemia and fatty liver in G3 and for hypertriacylglycerolaemia and fatty liver in G4 among women.

Both eating until feeling full and eating rapidly increase metabolic risk factors. Although the mechanism between rapid eating and metabolic risk requires further exploration, eating slowly and ending meals shortly before feeling full are important public health messages for reducing metabolic risk factors.

To identify Greek families in which all members were overweight or obese (XXL families) and to describe their profile with regard to their socio-economic status and their eating behaviours and practices.

A prospective cohort study.

The metropolitan area of Kavala.

We recruited children aged 11 and 12 years from twelve primary schools, and their parents, from volunteers. Auxologic measurements of the children included height and weight. A structured questionnaire pertaining to information on the socio-economic status of the family, anthropometric values and educational status of parents, dietary habits and the availability of various food products and beverages at home, as well as dietary intake, physical activity, time spent sleeping and time spent watching television, was filled in by one of the parents of each child. A total of 331 families finally participated.

In sixty-one families (18·43 %) both parents and child were either overweight or obese (XXL family), and in seven of these families all members were obese. Only twenty-eight families (8·46 %) had all members with a normal BMI. The XXL family was associated with lower educational status of both parents, whereas a higher percentage of XXL families resided in rural areas and had lower income. Skipping breakfast and spending more than 3 h in front of a screen every day were more frequently observed in XXL families. With regard to the availability of various food products and beverages at home, no significant differences were observed between XXL families and the rest of the studied families.

Greek XXL families have lower educational status and lower annual income.

The present paper presents a synthesis of available evidence to support action on the interventions that can effectively address the main drivers of child undernutrition in developing countries. It also discusses how interventions should be designed and identifies policy-relevant areas for further research.

A structured literature review of fifty-eight controlled evaluations and studies in developing countries were selected because they are methodologically sound, recent (reported within the past 10 years), report on nutritional status, cover a wide range of interventions and are implemented by a range of different agencies.

Indirect interventions in developing countries, which address the underlying and basic causes of child undernutrition and can potentially be implemented in the short to medium term.

Children under 5 years of age and their mothers across a range of developing countries.

Evidence has now accumulated to guide action on a range of indirect interventions that can reduce child undernutrition, but for all these interventions context is all-important. There is less evidence on how these interventions can be effectively implemented on a large scale.

Efforts should be directed towards improving implementation of effective interventions on a large scale. Donors need to keep commitments both in dollar terms and in terms of the Paris Declaration so that the push for improved nutrition does not become donor driven. At the country level, there is a need for enabling governance structures, institutions and evidence-based decision making. Within countries there is a need for well-trained personnel with delegated authority, accountable to local people. It is essential for chains of accountability to be transparent and for active involvement of households in decision-making processes.

To identify major meal and snack eating patterns, and examine their relationships with sleep duration.

The analyses included 27 983 participants in a prospective cohort study of women aged 35 to 74 years in the USA or Puerto Rico.

The principal component analysis of eight meal and snack frequency items at different times across the day yielded two major eating patterns: (i) eating during conventional eating hours (defined as times from breakfast to dinner); and (ii) dominance of snacks over meals. Comparing the identified eating patterns among women with varying sleep duration (<5, 5–5·9, 6–6·9, 7–7·9, 8–8·9, 9–9·9 and ≥10 h daily), the tendency for eating during conventional eating hours decreased with decreasing sleep duration: adjusted mean score of −0·54 (95 % CI –0·68, –0·41) in women sleeping for <5 h daily v. 0·08 (95 % CI 0·06, 0·11) among those with 7–7·9 h of sleep daily. The extent of snack dominance over meals increased in women with shorter sleep. Women with long (≥10 h) sleep duration had eating patterns similar to those with short (<6 h) sleep duration. Lower tendency for eating during conventional eating hours and greater snack dominance over meals were also related to higher intakes of fat and sweets for energy and lower intakes of fruits and vegetables.

Disrupted eating patterns and diet of poor nutritional quality may exacerbate the development of obesity and metabolic diseases in habitual short and very long sleepers.

To estimate the extent of under- and over-reporting, to examine associations with misreporting and sociodemographic and lifestyle characteristics and mental health status and to identify differential reporting in micro- and macronutrient intake and quality of diet.

A health and lifestyle questionnaire and a semi-quantitative FFQ were completed as part of the 2007 Survey of Lifestyle, Attitudes and Nutrition. Energy intake (EI) and intake of micro- and macronutrients were determined by applying locally adapted conversion software. A dietary score was constructed to identify healthier diets. Accuracy of reported EI was estimated using the Goldberg method. ANOVA, χ2 tests and logistic regression were used to examine associations.

Residential households in Ireland.

A nationally representative sample of 7521 adults aged 18 years or older.

Overall, 33·2 % of participants were under-reporters while 11·9 % were over-reporters. After adjustment, there was an increased odds of under-reporting among obese men (OR = 2·01, 95 % CI 1·46, 2·77) and women (OR = 1·68, 95 % CI 1·23, 2·30) compared to participants with a healthy BMI. Older age, low socio-economic status and overweight/obesity reduced the odds of over-reporting. Among under-reporters, the percentage of EI from fat was lower and overall diet was healthier compared to accurate and over-reporters. The reported usage of salt, fried food consumption and snacking varied significantly by levels of misreporting.

Patterns in differential reporting were evident across sociodemographic, lifestyle and mental health factors and diet quality. Consideration should be given to how misreporting affects nutrient analysis to ensure sound nutritional policy.

To investigate the food shopping habits of older adults in the UK and explore their potential associations with selected health-related indicators.

A cross-sectional study including objectively measured physical activity levels, BMI, physical function and self-reported health status and dietary intake.

Bristol, UK.

A total of 240 older adults aged ≥70 years living independently.

Mean age was 78·1 (sd 5·7) years; 66·7 % were overweight or obese and 4 % were underweight. Most (80·0 %) carried out their own food shopping; 53·3 % shopped at least once weekly. Women were more likely to shop alone (P < 0·001) and men more likely to shop with their spouse (P < 0·001). Men were more likely than women to drive to food shopping (P < 0·001), with women more likely to take the bus or be driven (P < 0·001). Most reported ease in purchasing fruit and vegetables (72·9 %) and low-fat products (67·5 %); 19·2 % reported low fibre intakes and 16·2 % reported high fat intakes. Higher levels of physical function and physical activity and better general health were significantly correlated with the ease of purchasing fresh fruit, vegetables and low-fat products. Shopping more often was associated with higher fat intake (P = 0·03); higher levels of deprivation were associated with lower fibre intake (P = 0·019).

These findings suggest a pattern of food shopping carried out primarily by car at least once weekly at large supermarket chains, with most finding high-quality fruit, vegetables and low-fat products easily accessible. Higher levels of physical function and physical activity and better self-reported health are important in supporting food shopping and maintaining independence.

Assessment of vitamin D status in a cohort of healthy 10-year-old urban children and the factors that influence vitamin D status in these children.

A cross-sectional study. Blood samples were collected across four seasons of the year for the biochemical determination of serum 25-hydroxyvitamin D [25(OH)D]. Anthropometric measurements (height and weight), BMI and total fat and lean mass (determined by the dual energy X-ray absorptiometry) were measured. 25(OH)D concentrations were assessed by chemiluminescent assay.

Study of children in the Greater Johannesburg area of South Africa who form the Bone Health sub-cohort of the longitudinal Birth to Twenty cohort.

Three hundred and eighty-five children who form the Bone Health sub-cohort of the longitudinal Birth to Twenty cohort.

White children had significantly higher 25(OH)D than their black peers (120·0 (sd 36·6) nmol/l v. 93·3 (sd 34·0) nmol/l, respectively). Seasonal variations in 25(OH)D levels were found only in white children, with 25(OH)D levels being significantly higher in white than in black children during the autumn and summer months. In multiple regression analysis, season, ethnicity, sex and total fat mass were the factors found to have an influence on 25(OH)D. Vitamin D deficiency (7 %) and insufficiency (19 %) were uncommon among the 10-year-old children.

Vitamin D supplementation or fortification is not warranted in healthy children living in Johannesburg. However, further studies need to confirm this in other regions of the country, especially in those living further south and with less sunshine during the winter months.

To evaluate the association between overweight and the occurrence of asthma and atopy in a cohort of children of 4–12 years of age living in the city of Salvador in 2005.

Cross-sectional study nested in a cohort.

The metropolitan region of Salvador, Bahia, Brazil.

The study included 1129 children of 4–12 years age who presented complete information on the variables used here. Skin tests for allergy, spirometry, faecal parasitology, serum IgE and anthropometric surveys were conducted. Poisson's multivariate regression was adopted.

Wheezing was found in 29·1% and asthma in 22·8% of children, both conditions being more common in those under 6 years of age and 34% more common in overweight children (prevalence ratio (PR) = 1·34; 95% CI 1·07, 1·67) following adjustment. The ratio between forced expiratory volume in 1s and forced vital capacity was associated with overweight (PR = 1·35; 95% CI 1·11, 1·61). No statistically significant association was found between overweight and allergen-specific IgE or with wheezing.

These results are in agreement with the hypothesis that overweight is associated with asthma and pulmonary function, even following adjustment for intervening variables known to be associated with the pathogeny of asthma.

The aim of the present study was to investigate whether fruit and vegetables should be treated as separate groups in health promotion programmes by examining consumption levels, barriers, knowledge and the association between stage of change and potential predictors of fruit and vegetable intake.

Computer-assisted telephone interview survey of the target population.

Hunter and New England regions of New South Wales, Australia.

A total of 1403 parents and carers of primary-school-aged children.

Consumption levels and knowledge of recommended intakes and serving size were greater for fruit than for vegetables. There were some differences in the main barriers to the consumption of fruit compared with those cited for vegetables. There was little congruence between the stages of change for fruit consumption and those for vegetable consumption. For fruit, knowledge of serving size and recommended intake, perceptions of adequate consumption, changes made to family intake and educational attainment were all correlated with stage of change categorisation. For vegetables, knowledge of recommended intake, perceptions of adequate consumption and changes made to family intake were correlated with stage of change categorisation.

Significant differences in consumption levels, barriers, knowledge and stages of readiness for change can be shown when fruit and vegetables are treated as separate groups. Health promotion planners may need to consider interventions that focus on improving vegetable consumption in preference to fruit consumption. Messages about the recommended number of servings and serving size must be simplified and this may be achieved by targeting messages towards vegetable consumption.

Dietary n-3 (omega-3) and n-6 (omega-6) PUFA have significant implications in health and disease prevention. Marine life is rich in long-chain n-3 PUFA. Children and adults in North America are reluctant fish eaters; canned tuna is a common fish in children's diets. Although a multitude of tuna products are available, their respective PUFA contents have not been well described. The aim of the present study was to compare the fatty acid (FA) profiles of different commercially available US tuna products.

Fat and FA composition of eight products randomly selected from two US suppliers were analysed with capillary GC after lipid extraction.

Large north-eastern US grocery store chain.

Canned tuna.

Energy from fat varied from 3 to 33 % and the essential FA (EFA) linoleic acid (18 : 2n-6) and α-linolenic acid (18 : 3n-3) varied tenfold. DHA varied between 90 and 770 mg/serving. The n-6:n-3 ratio was 3:1–4:1 in oil-packaged products, 2:1–7:1 in packaged tuna salads and 1:3–1:7 in water-packaged products. A similar magnitude of differences was seen in the ratio between arachidonic acid (20 : 4n-6) and DHA.

Light tuna canned in water may be a better choice of providing n-3 PUFA to individuals in a healthy population, whereas oil-packaged products may be preferable for those individuals with a need for increased EFA, such as for patients with cystic fibrosis. Awareness regarding PUFA content may aid in consumer product choices and health-care provider advice.

The present study aimed to scrutinize the food nutrition labelling practice in China before the Chinese Food Nutrition Labeling Regulation (CFNLR) era.

Nutrition information of pre-packaged foods collected from a supermarket between December 2007 and January 2008 was analysed and compared with findings from a survey conducted in Beijing.

Information collected from a supermarket in Shanghai.

A total of 850 pre-packaged foods.

In the Shanghai survey, the overall labelling rate was 30·9 %, similar to that found in the Beijing study (29·7 %). While only 20·5 % of the snacks in Shanghai had nutrition labelling, the percentage of food items labelled with SFA (8·6 %), trans fatty acid (4·7 %) or fibre (12·1 %) was very low. Of those food items with nutrition labels, a considerable proportion (7–15 %) did not label energy, fat, carbohydrate or protein. Food products manufactured by Taiwan and Hong Kong companies had a lower labelling rate (13·6 %) than those manufactured by domestic (31·6 %) or international manufacturers (33·8 %).

The very low food nutrition labelling rate among products sold in large chain supermarkets in major cities of China before CFNLR emphasizes the need for such critical regulations to be implemented in order to reinforce industrial compliance with accurate nutrition labelling.

To explore socio-economic differences in use of staff canteens and whether frequent use of staff canteens is associated with different food patterns and obesity.

Cross-sectional study using three self-administered questionnaires, two of them including food frequency questions. Factor analysis was used to explore food patterns.

Oslo, Norway, 2000–2001.

In total 8943 adult, working Oslo citizens.

Frequent (≥3 times/week) use of staff canteens was most likely among men, younger workers and those in the highest education and income groups. However, after adjustment for demographic, socio-economic and lifestyle factors, those with highest education were least likely to use staff canteens frequently. Frequent eating in staff canteens was positively associated with a Western food pattern (based on fat-rich food, fast food and red meat) and inversely associated with a traditional food pattern (based on boiled potatoes and gravy, and less rice, pasta and oil) in multivariate analyses. Unadjusted, frequent eating in staff canteens was also inversely associated with a prudent food pattern (based on fruit, vegetables, fish, legumes and oil). The likelihood of being obese (BMI ≥ 30 kg/m2) increased significantly with frequent eating in staff canteens, also when adjusted for demographic and socio-economic variables. Adjustment for the food patterns attenuated this relationship, but it was still significant.

Frequent eating in staff canteens was negatively related to socio-economic position and positively associated with unhealthy dietary habits. This partly explained higher odds for obesity among frequent users of staff canteens. Future research should assess the availability and food options of staff canteens.

To investigate the prevalence and characteristics of metabolic syndrome (MetS) in a healthy elderly Croatian population.

Cross-sectional study consisting of a health check including anthropometric measures and food questionnaires as well as analysis of biochemical parameters related to MetS. The diagnostic criteria of the International Diabetes Federation (IDF) were used for diagnosis of MetS.

Four centres in continental (Virovitica and Zagreb) and Adriatic coast (Split and Omiš) regions of Croatia.

Free-living elderly persons aged 70–90 years (n 320).

Significantly lower MetS prevalence was found among participants from small urban centres compared with those from large urban centres (59·1 % v. 69·6 %; P = 0·051). Participants without MetS consumed wine more frequently (P = 0·05) than those with MetS. Compared with their peers with HDL cholesterol (HDL-C) <1·03 mmol/l, more male participants with HDL-C ≥1·03 mmol/l consumed wine (P = 0·04) or pelagic fish (P = 0·03). The prevalence of participants with TAG ≥1·7 mmol/l was higher in wine non-consumers (P = 0·05) than in wine consumers. Multivariate analysis with age and gender as covariates showed a significant inverse association of wine consumption with total cholesterol (P < 0·001), a positive association with HDL-C (P < 0·001) and a marginally inverse association with TAG (P = 0·06). In the male population, alkaline phosphatase and γ-glutamyl transferase activities were higher in participants with MetS (P < 0·05).

High MetS prevalence was observed in an elderly Croatian population. Data showed that moderate consumption of wine and/or pelagic fish has a protective role against MetS in the population studied.

Home-delivered nutrition programmes that are federally subsidized by the US Administration on Aging seek to ensure that socially isolated older adults who are unable to purchase and prepare their own food have nutritious meals delivered to them regularly by both employed and volunteer staff. Unfortunately, there are long waiting lists in some neighbourhoods that are often due to a shortage of volunteers. The present paper describes a theoretically driven community-based project designed to increase volunteer participation in serving Meals on Wheels (MOW) clients.

A Support Team model was applied in the project wherein existing social capital among religious faith communities, and social networks within those organizations, was joined with a local MOW programme to create a sustainable meal delivery route to vulnerable homebound older adults.

The programme participants were in one underserved neighbourhood in Birmingham, Alabama, an urban city in the south-eastern USA.

The subjects under consideration are both MOW clients and volunteers. MOW clients are those individuals aged 60 years and above who qualify for the service; the volunteers are from community churches.

One volunteer route, comprising six congregations that delivered meals to sixteen homebound older adults, was created. The route served more than 2000 meals in 2006 (the year the programme began) and continues to serve clients today.

The programme’s successful implementation provides evidence that reliance on theory is critical in planning and developing effective community-based programme interventions.

Both stunting and overweight are present in children across China. Seemingly paradoxical, these two conditions can also coexist in the same child. The aim was to examine the associations between dietary food/nutrient intake and plasma lipid profiles related to stunting and overweight status.

The 2002 China National Nutrition and Health Survey was a family-based nationally representative cross-sectional study.

Thirty-one provinces, autonomous regions and municipalities.

The study included 13 770 children aged 2–17 years. The sample size for the four exposure groups was 10 814 for children of normal height and weight, 2128 for stunted, 729 for overweight and 99 for stunted overweight.

Compared with children of normal height and weight, stunted and stunted overweight children consumed more high-energy-dense foods with a lower dietary diversity score, less protein, polyunsaturated fat and Fe, and a higher molar ratio of phytate to Ca. On the contrary, overweight children tended to consume significantly less carbohydrates and more protein and fat. Overall, stunted overweight children consumed lower amounts of vegetables, fruit, white meat (poultry and fish) and more milk. The OR for prevalent dyslipidaemia were 1·32 (95 % CI 1·13, 1·53), 1·76 (95 % CI 1·48, 2·09) and 2·59 (95 % CI 1·65, 4·07) among stunted, overweight and stunted overweight children, respectively, compared with children of normal height and weight. In addition, being overweight was significantly associated with high glucose concentrations, whereas stunting was significantly associated with having anaemia.

Limited dietary diversity and intake of high-energy-dense foods were notably observed among stunted overweight children. Furthermore, being stunted and/or overweight was associated with an increased likelihood of unhealthy lipid profiles.

To assess parents’ responses to common, potentially misleading strategies for marketing energy-dense and nutrient-poor (EDNP) child-oriented foods.

Between-subjects online experiment to test whether nutrient claims and sports celebrity endorsements on the front of packs of EDNP products lead parents to prefer and rate these foods more favourably.

Australia.

A total of 1551 parents of children aged 5–12 years, who were the main household grocery buyers.

Inclusion of nutrient claims or sports celebrity endorsements on EDNP products led parents to perceive these products to be more nutritious than if they did not include such promotions. When asked to choose between a pair of different products (EDNP v. healthier), 56 % of parents did not read a nutrition information panel (NIP) before making their choice and this did not differ by promotion condition. These parents were more likely to choose an EDNP product if it included a nutrient claim (OR = 1·83, 95 % CI 1·31, 2·56; P < 0·001) or sports celebrity endorsement (OR = 2·37, 95 % CI 1·70, 3·32; P < 0·001). Sports celebrity endorsements also enhanced parent's perceptions of typical consumers of the product, perceptions of product healthiness and quality, as well as purchase intentions.

Nutrient claims and sports celebrity endorsements tip consumer preferences towards EDNP products bearing such promotions, especially among the majority who do not read the NIP. As parents largely determine what foods are available to children at home, it is critical that initiatives aimed at reducing the persuasive impact of food marketing include this target group.