Most research on diet and exercise has focused on these health behaviours as proximate causes of disease, rather than examine the context of how diet and exercise are developed and maintained. This study examined religion and social support in relationship to fat intake and physical activity.

Data from surveys of 546 adults aged 17–91 years, residing in one upstate New York county, were analysed.

Most relationships between the multiple facets of religion, fat intake and physical activity were not statistically significant. After controlling for demographics and social support, Conservative Protestant women and women specifying an ‘Other’ religious affiliation reported higher fat intakes than did Catholic women. There were no relationships between religion and fat intake in men. In women, religious commitment was associated with greater moderate and vigorous physical activity, whereas in men, divine social support was associated with greater moderate physical activity. Social support did not substantially change the magnitude of the relationships between religion, diet and physical activity.

Overall, there were few relationships between religion, fat intake and physical activity, suggesting that in contemporary US society religion may play a small role in the context of how diet and exercise are developed and maintained. The limited range of religiosity in the sample, however, may have underestimated the role of religion. Significant relationships between religion and physical activity in women suggest that further research is needed to more clearly delineate religion's relationship with health behaviours.

The aim of this study was to validate the EAR cut-point method for assessing the prevalence of nutrient inadequacy at the population level.

Different methods for estimating the prevalence of inadequate intake were compared: the cut-off point method, with cut-off points at the Recommended Dietary Allowance (RDA), 0.66 RDA, 0.50 RDA and the Estimated Average Requirement (EAR); the probability approach; and a Monte Carlo simulation. In total, 591 men and 674 women, aged 20–55 years, were included in the analyses.

The prevalence of inadequate intake as estimated by the EAR cut-point method was similar to the prevalence of inadequacy estimated by both probabilistic methods. The cut-point method with RDA, 0.66 RDA and 0.50 RDA as cut-off limits induced an over- or an underestimation of the real prevalence of inadequacy.

Probabilistic methods consider both the intake variability and the requirement variability, and, as a result, their estimation should be closer to the real prevalence of inadequacy. The use of the EAR cut-point method yields a good estimation of the prevalence of inadequate intake, comparable to the probability approach, and limits over- and underestimation of the prevalence induced by other cut-off points.

To determine the prevalence of overweight and obesity in British young people (4–18 years) in 1997.

Cross-sectional analysis of the National Diet and Nutrition Survey of young people.

Great Britain.

Nationally representative sample of 1836 young people (age 4–18 years).

The prevalence of obesity based on body mass index (weight/height2) and the International Obesity Task Force cut–offs was 4.0%, with a further 15.4% identified as overweight. Asians were almost four times as likely to be obese as white subjects (13.6 vs. 3.5%, P < 0.001). Among white subjects there was no significant difference in the prevalence of obesity between girls and boys, or with age. The risk of obesity was significantly higher in subjects from social classes IV and V than from social classes I–III (6.5 vs. 2.7%, P = 0.003). Subjects living in Scotland and Wales were significantly more likely to be obese than those in England (7.6 and 6.5 vs. 2.9%, respectively, P < 0.01). Multiple logistic regression showed that, among white subjects, those in social classes IV and V living in Wales and Scotland were three times more likely to be obese than the other children in the survey (odds ratio 3.3, 95% confidence interval 1.1–9.8).

These data provide information on the national prevalence of overweight and obesity in Great Britain and baseline data from which to monitor future trends. This analysis provides important demographic information on those most at risk of obesity, which may be used to inform public health strategies to prevent obesity in young people.

To investigate the relationships between nutritional and lifestyle factors and bowel movement frequency.

Cross-sectional analysis using data from a prospective study. Mean numbers of bowel movements were calculated in relation to a range of factors. In addition, individuals were categorised according to frequency of bowel movements: fewer than 7 per week (‘less than daily’) versus 7 or more per week (‘daily’), and odds ratios were calculated from logistic regression models. Results for each factor were adjusted for the other factors under consideration.

The European Prospective Investigation into Cancer and Nutrition, Oxford cohort (EPIC–Oxford), UK.

In total, 20,630 men and women aged 22–97 years at recruitment. Thirty per cent of the subjects were vegetarians or vegans.

Women had fewer bowel movements on average than men, and were less likely to have daily bowel movements. Mean bowel movement frequency was higher in vegetarians (10.5 in men, 9.1 in women) and especially in vegans (11.6 in men, 10.5 in women) compared with participants who ate meat (9.5 in men, 8.2 in women). There were also significant positive associations between bowel movement frequency and body mass index (BMI), intakes of dietary fibre and non-alcoholic fluids, for both men and women. Vigorous exercise was positively associated with bowel movement frequency in women although results for men were less clear. Alcohol intake was positively associated with bowel movement frequency in men but not in women.

Being vegetarian and especially vegan is strongly associated with a higher frequency of bowel movements. Moreover, having a high intake of dietary fibre and fluids and a high BMI are associated with an increase in frequency of bowel movements.

Energy intake determined from self-reported dietary assessment methods may be underreported. Therefore, it is important that such methods be validated against another with known validity for energy intake or energy expenditure.

We investigated potential underestimation of energy intake obtained from our semi-quantitative food-frequency questionnaire (FFQ) administered between 2000 and 2001 in the metropolitan area of Montreal, Canada. The study population included 246 adults aged 18 to 82 years. The ratio of energy intake to estimated basal metabolic rate (EI/BMR) was used to assess underreporting and physical activity was determined from self-administered questions. Comparison of the EI/BMR ratio with the Goldberg statistical cut-off allowed us to detect individuals who were low energy reporters (LERs). LERs and non-LERs were compared to determine if they differed on sociodemographic, anthropometric and lifestyle variables.

The EI/BMR ratio was 1.26 for men and 1.32 for women. LERs represented 43% of the sample of individuals. Male LERs accounted for 54% compared with 35% among females. Underreporting of energy intake was highest in men and individuals who were older, heavier, with higher body mass index and lower education level. A higher proportion of male LERs perceived their financial situation as adequate while a greater proportion of female LERs considered themselves poor.

Our data suggest that underreporting of energy intake from the FFQ was considerable and may bias dietary interpretation. As this was uneven across the sample, it is crucial to recognise the characteristics of LERs in order to increase the validity of reported energy intake.

To test the hypothesis that many foods with reduced-fat (RF) claims are relatively energy-dense and that high-fat (HF) vegetable-based dishes are relatively energy-dilute.

Nutrient data were collected from available foods in Melbourne supermarkets that had an RF claim and a full-fat (FF) equivalent. Nutrient analyses were also conducted on recipes for HF vegetable-based dishes that had more than 30% energy from fat but less than 10% from saturated fat. The dietary intake data (beverages removed) from the 1995 National Nutrition Survey were used for the reference relationships between energy density (ED) and percentage energy as fat and carbohydrate and percentage of water by weight.

Linear regression modelled relationships of macronutrients and ED. Paired t-tests compared observed and predicted reductions in the ED of RF foods compared with FF equivalents.

Both FF and RF foods were more energy-dense than the Australian diet and the HF vegetable-based dishes were less energy-dense. The Australian diet showed significant relationships with ED, which were positive for percentage energy as fat and negative for percentage energy as carbohydrate. There were no such relationships for the products with RF claims or for the HF vegetable-based dishes.

While, overall, a reduced-fat diet is relatively energy-dilute and is likely to protect against weight gain, there appear to be two important exceptions. A high intake of products with RF claims could lead to a relatively energy-dense diet and thus promote weight gain. Alternatively, a high intake of vegetable-based foods, even with substantial added fat, could reduce ED and protect against weight gain.

To explore the effect of BRAC (formerly Bangladesh Rural Advancement Committee) initiatives towards promoting gender and social equity in health among children of poor mothers who are BRAC members.

A cohort of 576 children from the prospective study of a BRAC– International Centre for Diarrhoeal Disease Research, Bangladesh joint research project was analysed. Data were collected three times during 1995–1996 with approximately 4-month intervals. Stunting, defined as height-for-age below minus two standard deviations from the reference median, was the outcome health measure. The study children were stratified into three groups according to their mother's social and BRAC membership status: poor and BRAC member (BM), poor non-member (TG) and non-poor non-member (NTG).

Matlab, rural area of Bangladesh.

Children aged 6–72 months.

The overall prevalence of stunting was 76%; the highest prevalence was found among TG (84.6%) children and no significant difference was observed between BM and NTG children (67.3% and 69.4%, respectively). In all groups, a significantly larger proportion of girls was stunted compared with boys in the first round. Group-level analysis showed that stunting decreased among all children except BM boys at the end of third round, with the largest decline among BM girls. In contrast, stunting prevalence increased among BM boys. A similar trend was found in the individual-level analysis, where a larger proportion of BM girls recovered from stunting compared with other groups and no recovery was observed among BM boys. At the end of the third round, the nutritional status of BM girls was almost equal to that of the BM boys, while gender inequity remained large among TG and NTG children.

The BRAC initiative appeared to contribute to a significant equity gain in health for girls, as well as to decreased differences in ill health between the poor and the non-poor.

To identify effects of revision of the Japanese food composition tables from the fourth version to the fifth version on nutrient intake estimation.

A database on 783 samples of 24-hour food duplicate portions was re-visited. Nutrients in the duplicate portions were estimated by use of the fourth and fifth versions of the Japanese food composition tables in parallel, together with supplemental use of other databases. The two sets of estimates were subjected to comparison.

The sample collection was conducted at 31 sites all over Japan.

The sample donors were 783 women aged 20–78 years.

Compared with the estimates by use of the fourth version of the tables, the estimates by the fifth version were substantially higher for intakes of energy, carbohydrate, dietary fibre, vitamin A and niacin, and lower for iron intake. The increase in carbohydrate intake estimates was more evident in older women than in young women, whereas the decrease in the intake estimation of iron and the increase in that of dietary fibre were more marked in young women than in older women.

The recent revision of food composition tables in Japan induced substantial changes in the estimation of nutrient intakes, i.e. an increase in energy, carbohydrate, dietary fibre, vitamin A and niacin, and a decrease in iron. The extent of the changes varied depending on age.

To assess the level of consensus amongst an international panel of public health nutrition leaders regarding the essential competencies required for effective public health nutrition practice.

A modified Delphi study involving three rounds of questionnaires.

A panel of 20 public health nutrition experts from seven countries in the European Union, the USA and Australia.

Expert panellists completed three rounds of the study relating to competencies. A literature review conducted as a prelude to the expert panel survey identified common competency units from the fields of public health, health promotion, nutrition and dietetics, and health education. These were categorised into seven competency areas including analytical, socio-cultural and political, public health service, communication, management and leadership, nutrition science and professional competency categories. There was strong initial agreement (≥90% of panellists at Round 1) that developing internationally recognised competencies for public health nutrition specialists was a priority. Twenty-six of an initial listing of 52 competency units were rated as essential competencies by ≥80% of the panellists after Round 1. Iteration rounds resulted in the addition of five extra competency units suggested by panellists after Round 1 and an increase by 13 in the number of competencies rated as essential to consensus levels. From a total of 57 competency units rated after the final survey round, 41 competency units were rated as essential competencies by ≥80% of the panellists (consensus), with 21 of these unanimously rated as essential competencies.

There is strong international agreement amongst public health nutrition leaders in Europe, the USA and Australia about a range of competencies required for effective public health nutrition practice. Essential competency units identified can be used to develop and review competency standards for public health nutrition.

To determine whether parentally reported habitual intake of specific foods differed between children with diagnosed Campylobacter jejuni infection and children of a comparison group without diagnosed infection.

Information was collected from the parents or primary caregivers of South Australian children aged 1–5 years with diagnosed C. jejuni (cases, n=172) and an age- and gender-matched group of uninfected children (controls, n=173). Frequency of consumption of 106 food and drink items was determined for the preceding two months by food-frequency questionnaire. Four children in the control group had recorded diarrhoeal episodes during the assessment period and were excluded, so 169 responses were evaluated for this group. Information was gathered on possible confounders including socio-economic status. Response frequencies were classified into three levels of consumption (rarely, weekly or daily) and statistical comparison was made by frequency of consumption of foods versus the ‘rarely’ classification for cases and controls, respectively.

Frequency of consumption of most foods, including starchy foods and fruits and vegetables, did not differ between cases and controls. However, reported consumption of eight food items (block and processed cheese (slices and spread), salami/fritz (a form of processed sausage), chicken nuggets, pasteurised milk, fish (canned or fresh) and hot French fries) was significantly higher by controls.

The hypothesis that reported consumption of starchy foods was lower by cases than by controls was not supported by the data. However, consumption of some processed and unprocessed foods was higher by controls. Some of these foods have established bactericidal actions in vitro that may indicate a possible mechanism for this apparent protection.

To document knowledge, attitudes, beliefs and eating habits of health professionals with respect to obesity, nutrition and weight management.

A self-complete questionnaire postal survey.

Primary care and dietetic practice in Scotland.

A systematic stratified sample of 2290 subjects incorporated general practitioners (n = 1400), practice nurses (n = 613) and all practising dietitians (n = 360) who were members of the British Dietetic Association.

The overall response rate was 65%. All professionals showed a clear understanding of nutrition and health. Understanding of obesity as a disease and of the effectiveness of weight management using low-energy diets was limited. Below 10% had carried out audit to determine the incidence of obesity and overweight, and most were uncertain about their own effectiveness in delivering weight management advice.

This study confirms that health professionals have some knowledge of nutrition and weight management but are unclear how to deliver effective weight management advice. Further training is justified to ensure the effective provision of nutritional advice to patients.

To assess vitamin D status and the impact of three fish meals consisting of cod liver and fresh cod-liver oil on the plasma level of vitamin D metabolites in an area with high consumption of cod liver and cod-liver oil.

Experimental field study.

Thirty-two volunteers from the Skjervøy (70°N) municipality in northern Norway were recruited to consume three traditional mølje meals, consisting of cod, cod liver, fresh cod-liver oil and hard roe, in one week. The liver and fresh cod-liver oil consumed by the participants were weighed and recorded. Blood samples were collected before the first meal, and subsequently 12h and 4 days after the last meal. The blood samples were analysed for the vitamin D metabolites 25-hydroxyvitamin D (25(OH)D) and 1,25-dihydroxyvitamin D (1,25(OH)2D). All participants answered a semi-quantitative food-frequency questionnaire, which was used to estimate usual daily nutrient intake. The study was carried out in the last part of March 2001.

The median daily vitamin D intake estimated from the questionnaire was 9.9μg. The proportion of subjects with baseline 25(OH)D level below 50nmoll−1 was 15.4% and none were below 37.5nmoll−1. Only ‘mølje consumption’ and ‘time spent in daylight’ were significantly associated with baseline log 25(OH)D. The mean total intake of vitamin D in the three servings was 272μg (standard deviation 94μg), ranging from 142 to 434μg. Relative to baseline plasma concentration, the mean level of 25(OH)D decreased slightly in both post-consumption samples (P≤0.03), while 1,25(OH)2D peaked 12h after the final meal (P = 0.03).

Three mølje meals provided, on average, an amount of vitamin D equal to 54 times the recommended daily dose. Subjects with food consumption habits that included frequent mølje meals during the winter sustained satisfactory vitamin D levels in their blood, in spite of the long ‘vitamin D winter’ (i.e. absence of ultraviolet-induced vitamin D production in the skin).

The study aimed to evaluate the homocysteine and cobalamin status of German vegans and determine whether the intake of very small amounts of foods of animal origin can improve this status.

Cross-sectional study, Germany.

The dietary and nutritional intakes of 131 vegans (73 women, 58 men; a range: 20.2–82.1 years) were evaluated using a general questionnaire and two food–frequency questionnaires.

The prevalence of inadequate cobalamin status in volunteers of the German Vegan Study was 28.2%, and that of hyperhomocysteinaemia, 38.1%. Moderate vegans were affected to a lesser extent than were strict vegans. Duration of veganism and cobalamin concentration were inversely correlated (Spearman's r = -0.175, P = 0.047). Folate concentration and erythrocyte aspartic acid aminotransferase activity were not correlated with plasma homocysteine concentration, but duration of veganism correlated positively with homocysteine concentration (Spearman's r = 0.319, P < 0.001). Cobalamin and homocysteine concentrations were inversely correlated (when controlling for duration of veganism; r = -0.602, P < 0.001).

Cobalamin status needs to be improved in order to minimise the risk of hyperhomocysteinaemia.

Recent research on access to food among low-income populations in industrialised countries has begun to focus on neighbourhood food availability as a key determinant of dietary behaviour. This study examined the relationship between various measures of food store access and household fruit and vegetable use among participants in the Food Stamp Program, America's largest domestic food assistance programme.

A secondary data analysis was conducted using the 1996–97 National Food Stamp Program Survey. The survey employed a 1-week food inventory method, including two at-home interviews, to determine household food use. Separate linear regression models were developed to analyse fruit and vegetable use. Independent variables included distance to store, travel time to store, ownership of a car and difficulty of supermarket access. All models controlled for a full set of socio-economic variables.

A nationally representative sample of participants (n = 963) in the Food Stamp Program.

After controlling for confounding variables, easy access to supermarket shopping was associated with increased household use of fruits (84 grams per adult equivalent per day; 95% confidence interval 5, 162). Distance from home to food store was inversely associated with fruit use by households. Similar patterns were seen with vegetable use, though associations were not significant.

Environmental factors are importantly related to dietary choice in a nationally representative sample of low-income households, reinforcing the importance of including such factors in interventions that seek to effect dietary improvements.

To investigate the feasibility of using commercially available data on household food consumption to carry out food and nutritional surveillance.

Taylor Nelson Sofres (TNS) collects information on foods brought home for consumption among a representative quota sample of the British population. In total, 33 177 households and 105 667 individuals provided data between 1991 and 2000. These were used to investigate sociodemographic, geographical and temporal trends in purchase patterns of the main macronutrients and four groups of marker products.

Sociodemographic characteristics of the TNS sample were broadly consistent with those of the British population. Estimated energy intakes were slightly low (1667±715 kcal) in comparison with other national data. However, percentage energy contributions were consistent with national trends: e.g. consumption of alcohol in the home increased between 1991 and 2000 with higher intakes among more affluent households, while fat intakes decreased slightly over the same period. Significant temporal, geographic and socio-economic trends were found for all nutrients (P < 0.0001). Intakes of marker products were sparse (purchased by <4% of households), but significant variations were detected in the proportion of households purchasing some or all of the marker products across temporal, geographic and socio–economic strata.

A prospective nutrient surveillance system could be used to trace consumption patterns of foods or nutrients to inform nutritional surveillance. However, existing data sources would require a number of modifications to increase their suitability for such a project. Increasing surveillance to consider ingredients would require the development of a central coding system, with electronically linked barcode, ingredient and nutrient information.

(1) To determine the reliability and validity of a food-frequency questionnaire (FFQ) for use in epidemiological research in postmenopausal women; and (2) to compare the volume estimation (VE) and weight estimation (WE) method of administration of this questionnaire.

An initial list of foods was derived and modified after pre-testing in 22 subjects. Test-retest reliability was assessed in 21 subjects who had repeat administrations of the questionnaire 14 days apart (FFQ1, FFQ2). The validity of the FFQ was assessed by comparing nutrient intakes with those from a 4-day food record.

Chengdu, People's Republic of China.

Twenty-two postmenopausal women (50–70 years) were recruited from The Second University Hospital, West China University of Medical Sciences, Chengdu and participated in the pre-test. Another 21 women (50–70 years) were randomly selected from the general population of all five districts of Chengdu and participated in the reliability and validity sub-studies.

Energy, protein, carbohydrate, magnesium and sodium intakes in this sample were less than the Recommended Dietary Allowances (RDAs) for 45–70-year-old women in China. Intake of non-cooking fat was higher than the Chinese RDA. Pearson correlation coefficients and intra-class correlation coefficients (ICCs) for reliability of the VE FFQ ranged from 0.51 to 0.85 and from 0.51 to 0.81, respectively; for the WE FFQ, they ranged from 0.22 to 0.86 and from 0.21 to 0.81. Correlation coefficients and ICCs for validity of the WE FFQ ranged from 0.36 to 0.69 and from 0.34 to 0.57, respectively; corresponding values for the VE FFQ were −0.30 to 0.65 and −0.14 to 0.65.

Both the VE and WE FFQs were reliable and valid except for sodium intake. The VE FFQ provided more valid estimates of nutrient intakes than did the WE FFQ.

To assess the prevalence and identify the predictors of food insecurity among households in Los Angeles County with incomes below 300% of the federal poverty level.

The Six-Item Short Form of the US Department of Agriculture's Household Food Security Scale was used as part of a 1999 county-wide, population-based, telephone survey.

The prevalence of food insecurity was 24.4% and was inversely associated with household income. Other independent predictors of food insecurity included the presence of children in the household (odds ratio (OR) 1.7, 95% confidence interval (CI) 1.2–2.3) and a history of homelessness in the past five years (OR 5.6, 95% CI 3.4–9.4).

Food insecurity is a significant public health problem among low–income households in Los Angeles County. Food assistance programmes should focus efforts on households living in and near poverty, those with children, and those with a history of homelessness.

To evaluate the ratio of energy intake to basal metabolic rate (EI/BMR) among young female Japanese adults, and to compare the lifestyle and dietary characteristics between relatively low and high reporters.

Dietary intakes were assessed over a 1-month period with a validated, self-administered, diet history questionnaire, and lifestyle variables were assessed by a second questionnaire designed for this survey. The ratio of EI/BMR was calculated from reported energy intake and estimated basal metabolic rate.

In total, 1889 female Japanese university students aged 18–20 years who were enrolled in dietetics courses.

Ninety-five per cent of the subjects were classified into a non-obese group (body mass index (BMI) <25 kg m−2; mean±standard deviation (SD): 20.8±2.6 kg m−2). EI/BMR was 1.43±0.40 (mean±SD). Sixty-eight per cent of the subjects showed an EI/BMR level below the possibly balanced value of 1.56, 37% showed EI/BMR below the minimum survival value of 1.27 and 2% of the subjects showed EI/BMR exceeding the maximum value for a sustainable lifestyle of 2.4. BMI, body weight and BMR decreased significantly with the increase in EI/BMR (P<0.001). The percentage of energy from carbohydrate was significantly higher, whereas those from fat and protein were significantly lower, among the lower EI/BMR groups. As for food groups, a significantly declining trend from the lowest to the highest EI/BMR groups was observed for cereals.

Underreporting, rather than overreporting, of energy intake was predominant in this relatively lean Japanese female population. BMI was the most important factor affecting the reporting accuracy of energy intake.

To examine dietary iodine sources and to estimate the dietary iodine intake of the Norwegian population.

Food iodine analyses carried out in Norway during the last 10 years were compiled, and iodine intake calculated on the basis of food intake data from nation-wide dietary surveys among children and adults. The food intake of adults was measured by a self-administrated food-frequency questionnaire, which covered habitual diet during the past year. The food intake of children was measured by dietary record during four consecutive days.

Neither household nor industrial iodisation of salt is mandatory in Norway, but some brands of table salt have 5 μg of iodine added per gram of NaCl. In spite of this, the population has been considered iodine-replete for decades, i.e. having an iodine intake well above the Recommended Dietary Allowance of 150 μg day−1. This assumption has not been substantiated by dietary surveys.

The adults included 1374 females and 1298 males aged 16–79 years. The children included 185 girls and 206 boys aged 4 years, 411 girls and 404 boys aged 9 years, and 517 girls and 492 boys aged 13 years.

The calculated iodine intake was in the range of 100–250 μg day−1 in the majority of the adult population. The mean iodine intake was 136 μg day−1 (170 μg I/10 MJ) among women and 176 μg day−1 (161 μg I/10 MJ) among men. For children the iodine intake was in the range of 100–120 μg day−1. Milk and dairy products contributed approximately 55% and 70% of the dietary iodine intake in adults and children, respectively. Fish contributed more than 20% of the iodine intake in adults and about 10% in children. The iodine contribution of drinking water was negligible.

While fish has the highest natural concentration of iodine and as such is an excellent iodine source, milk and diary products are the main determinants of iodine intake in the Norwegian population. Iodisation of cow fodder has been mandatory in Norway since 1950 and provides an efficient alternative to universal salt iodisation. Our results show that the dietary iodine intake of adults is in the range considered to be sufficient. The dietary intake of iodine was at recommended levels among the youngest children; however, it decreased among adolescents, especially among girls.