To assess the energy and nutrient intakes of healthy infants from low-income families and to compare intakes with current recommendations.

We interviewed mother–infant pairs longitudinally when the infants were 3, 6, 9, 12, 18 and 24 months old. Food intake data were obtained by 24-hour dietary recalls. Selected nutrient intakes were calculated and compared with the Recommended Dietary Allowances (RDAs).

Infants (n = 200) were the offspring of low-income, pregnant women recruited at the Albany County Department of Health, New York for the Albany Pregnancy and Infancy Lead Study, a prospective investigation of factors related to blood lead levels, including nutrition. Interviews were conducted during paediatric clinic visits.

Means and standard deviations were used to describe energy and micronutrient intakes for age groups. The probability approach was utilised to examine the prevalence of inadequate intakes.

Mean energy and nutrient intakes generally met or exceeded the RDA. The exceptions were vitamin D and zinc for which observed means were below the RDA at several data points. Protein consumption was exceptionally high in this sample. The highest estimated prevalences of inadequate intakes were observed for iron, zinc and vitamin D at the older ages.

This study identified several potential concerns about the diets of infants during the transition from infant food and formula to table foods. Low intakes of vitamin D, zinc and iron, especially at 12 and 18 months, were observed. High protein intakes were noted at all ages.

To evaluate whether there was food and nutrient equality across occupational social classes and geographical region for members of the 1946 British birth cohort at age 4 years.

Cross-sectional analysis of selected food groups, energy and nutrients from one-day recall diet records.

England, Scotland and Wales in 1950.

Nationally representative sample of 4419 children aged 4 years in 1950 from the MRC National Survey of Health and Development (NSHD) (1946 Birth Cohort).

Significant food and nutrient inequalities occurred by region and occupational social class of the father. Disparity in fruit and vegetable consumption primarily led to the nutrient differences, especially with respect to lower vitamin C and carotene intakes in children from Scotland and from a manual social class background. Lower energy intake in Scottish children was attributable to inequality in the consumption of foods providing fat, and also to the retention of the traditional Scottish diet that included porridge and soups. Consumption of some rationed foods – bacon, orange juice and tea – was inequitably distributed by father's social class, but others, in particular meat and spreading fats, were consumed more uniformly. In contrast to fruits and vegetables, which showed marked sociodemographic disparities, other non-rationed foods such as bread and potatoes were consumed universally.

Local cultural norms may have played as strong a part in sociodemographic differences in the diet of children in the early 1950s as did the strict, post-war food rationing that prevailed. In consequence, nutritional equality was not achieved, and the relatively low intake of antioxidant vitamins during early childhood in certain population groups may have compromised health in the long term.

To determine the dietary intake, practices, knowledge and barriers to dietary compliance of black South African type 2 diabetic patients attending primary health-care services in urban and rural areas.

A cross-sectional survey. Dietary intake was assessed by three 24-hour recalls, and knowledge and practices by means of a structured questionnaire (n=133 men, 155 women). In-depth interviews were then conducted with 25 of the patients to explore their underlying beliefs and feelings with respect to their disease. Trained interviewers measured weight, height and blood pressure. A fasting venous blood sample was collected from each participant in order to evaluate glycaemic control.

An urban area (Sheshego) and rural areas near Pietersburg in the Northern Province of South Africa.

The sample comprised 59 men and 75 women from urban areas and 74 men and 80 women from rural areas. All were over 40 years of age, diagnosed with type 2 diabetes for at least one year, and attended primary health-care services in the study area over a 3-month period in 1998.

Reported dietary results indicate that mean energy intakes were low (<70% of Recommended Dietary Allowance), 8086–8450 kJ day−1 and 6967–7382 kJ day−1 in men and women, respectively. Urban subjects had higher (P<0.05) intakes of animal protein and lower ratios of polyunsaturated fat to saturated fat than rural subjects. The energy distribution of macronutrients was in line with the recommendations for a prudent diet, with fat intake less than 30%, saturated fat less than 10% and carbohydrate intake greater than 55% of total energy intake. In most respects, nutrient intakes resembled a traditional African diet, although fibre intake was low in terms of the recommended 3–6 g/1000 kJ. More than 90% of patients ate three meals a day, yet only 32–47% had a morning snack and 19–27% had a late evening snack. The majority of patients indicated that they followed a special diet, which had been given to them by a doctor or a nurse. Only 3.4–6.1% were treated by diet alone. Poor glycaemic control was found in both urban and rural participants, with more than half of subjects having fasting plasma glucose above 8 mmol l−1 and more than 35% having plasma glycosylated haemoglobin level above 8.6%. High triglyceride levels were found in 24 to 25% of men and in 17 to 18% of women. Obesity (body mass index ≥30 kgm−2) was prevalent in 15 to 16% of men compared with 35 to 47% of women; elevated blood pressure (≥160/95 mmHg) was least prevalent in rural women (25.9%) and most prevalent in urban men (42.4%).

The majority of black, type 2 diabetic patients studied showed poor glycaemic control. Additionally, many had dyslipidaemia, were obese and/or had an elevated blood pressure. Quantitative and qualitative findings indicated that these patients frequently received incorrect and inappropriate dietary advice from health educators.

To determine whether socio-economic groups differ in their fruit and vegetable consumption, and the variety eaten, and whether socio-economic differences are similar for adolescents and adults. The study also examined whether socio-economic groups vary in their reported desire to increase the amount of fruit and vegetables consumed, and the perceived barriers to achieving this.

Design, setting and subjects: The 1995 Australian National Nutrition Survey collected fruit and vegetable intake data from adolescents aged 13–17 years (n = 654) and adults 18–64 years (n = 7695) using a 24-hour dietary recall. Gross annual household income was used to measure socio-economic position.

Approximately 44% of males and 34% of females did not consume fruit in the 24 hours preceding the survey, and 20% of males and 17% of females did not consume vegetables. Among adolescents and adults, fruit and vegetable consumption was positively related to income. The only exception was vegetable consumption among adolescent males, which did not vary by income Lower-income adults consumed a smaller variety of fruits and vegetables than their higher-income counterparts. Fruit and vegetable variety did not vary by income among adolescents. Lower-income adults expressed less desire to increase their fruit and vegetable consumption, and were more likely to report that price and storage were barriers to doing so. Socio-economic differences in consumption and variety were more apparent for adults than for adolescents.

In addition to increasing the consumption of fruits and vegetables among the general population, nutrition interventions, programmes and policy aiming to improve diet should target adolescents and adults from low socio-economic groups. Strategies should address price and storage barriers.

To assess the validity of self-reported height and weight by comparison with measured height and weight in a sample of middle-aged men and women, and to determine the extent of misclassification of body mass index (BMI) arising from differences between self-reported and measured values.

Analysis of self-reported and measured height and weight data from participants in the Oxford cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC–Oxford).

Four thousand eight hundred and eight British men and women aged 35–76 years.

Spearman rank correlations between self-reported and measured height, weight and BMI were high ( r <0.9, P >0.0001 ). Height was overestimated by a mean of 1.23 (95% confidence interval (CI) 1.11–1.34) cm in men and 0.60 (0.51–0.70) cm in women; the extent of overestimation was greater in older men and women, shorter men and heavier women. Weight was underestimated by a mean of 1.85 (1.72–1.99) kg in men and 1.40 (1.31–1.49) kg in women; the extent of underestimation was greater in heavier men and women, but did not vary with age or height. Using standard categories of BMI, 22.4% of men and 18.0% of women were classified incorrectly based on self-reported height and weight. After correcting the self-reported values using predictive equations derived from a 10% sample of subjects, misclassification decreased to 15.2% in men and 13.8% in women.

Self-reported height and weight data are valid for identifying relationships in epidemiological studies. In analyses where anthropometric factors are the primary variables of interest, measurements in a representative sample of the study population can be used to improve the accuracy of estimates of height, weight and BMI.

To investigate food sources and intakes of iron, and dietary factors associated with serum ferritin levels in 6–24-month-old children.

A cross-sectional survey employing proportionate cluster sampling was conducted in 1998/1999. Dietary intakes were assessed using a non-consecutive 3-day weighed food record. Serum ferritin and C-reactive protein were analysed from non-fasting venepuncture blood samples and general sociodemographic data were collected.

Cities of Christchurch, Dunedin and Invercargill, New Zealand.

Randomly selected healthy 6–24-month-old non-breast-feeding children (n=226).

Total iron intakes (±standard deviation (SD)) among non-breast-feeding infants (<12 months old; n=42) and toddlers (≥12 months old; n=184) were 8.4±2.9 mg day−1 and 5.0±2.5 mg day−1, respectively. Fifteen per cent of infants and 66% of toddlers were at risk of inadequate iron intakes. Main sources of dietary iron were infant formula (60%) for infants and cereals (31%) for toddlers. Meat contributed on average 2% and 10% of dietary iron in the infant and toddler diets, respectively. Dietary factors positively associated with serum ferritin were intakes of iron and vitamin C, whereas intakes of calcium and dietary fibre were negatively associated. For each 1% increase in percentage of energy from iron-fortified formula concomitant with a 1% decrease from dairy products, there was a 4.2% increased odds of replete iron stores (ferritin ≥20 μg l−1).

Toddlers were at higher risk of sub-optimal iron intakes than infants. Results suggest that a diet high in bioavailable iron is important for optimising the iron stores of young children in New Zealand.

To describe the emergence of the nutrition transition, and associated morbidity shifts, in the Islamic Republic of Iran.

Review and analysis of secondary data relating to the socio-political and nutritional context, demographic trends, food utilisation and consumption patterns, obesity, and diet-related morbidity.

The nutrition transition in Iran is occurring rapidly, secondary to the rapid change in fertility and mortality patterns and to urbanisation. The transition is occurring against the backdrop of lack of sustained economicgrowth. There is considerable imbalance in food consumption with low nutrient density characterising diets at all income levels, over-consumption evident among more than a third of households, and food insecurity among 20% of the population. Obesity is an emerging problem, particularly in urban areas and for women, and both diabetes and other risk factors for heart disease are becoming significant problems.

The aim of this study was to describe the variation of soy product intake in 10 European countries by using a standardised reference dietary method. A subsidiary aim was to characterise the pattern of soy consumption among a sub-group of participants with a habitual health-conscious lifestyle (HHL), i.e. non-meat eaters who are fish eaters, vegetarians and vegans.

A 24-hour dietary recall interview (24-HDR) was conducted among a sample (5–12%) of all cohorts (n = 36 900) in the European Prospective Investigation into Cancer and Nutrition (EPIC). Study participants totalled 35 955 after exclusion of subjects younger than 35 or older than 74 years of age. Soy products were subdivided into seven sub-groups by similarity. Distribution of consumption and crude and adjusted means of intake were computed per soy product group across countries. Intake of soy products was also investigated among participants with an HHL.

In total, 195 men and 486 women reported consuming soy products in the 24-HDR interview. Although soy product intake was generally low across all countries, the highest intake level was observed in the UK, due to over-sampling of a large number of participants with an HHL. The most frequently consumed soy foods were dairy substitutes in the UK and France and beans and sprouts among mid-European countries. For both genders, the sub-group of soy dairy substitutes was consumed in the highest quantities (1.2 g day−1 for men; 1.9 g day−1 for women). Participants with an HHL differed substantially from others with regard to demographic, anthropometric and nutritional factors. They consumed higher quantities of almost all soy product groups.

Consumption of soy products is low in centres in Western Europe. Soy dairy substitutes are most frequently consumed. Participants with an HHL form a distinct sub-group with higher consumptions of fruit, vegetables, legumes, cereals and soy products compared with the other participants.

In the 1980s evidence of rising levels of hunger was a concern for many, but disputed by some, Americans. Acknowledgement and quantification of hunger was hindered by the lack of an accepted definition and measure of hunger. Qualitative research at Cornell provided a conceptual framework, description, definition and survey items for hunger. The Community Childhood Hunger Identification Project developed an instrument used in numerous communities. Based upon these initiatives, widely accepted definitions of hunger and food insecurity, and the US Household Food Security Module for its measurement, now exist. The module classifies households as food-secure, or food-insecure without hunger or with moderate or severe hunger, and contains household-, adult- and child-referent items. Its inclusion in the Current Population Survey (CPS) since 1995 has yielded annual estimates of food insecurity. A six-item short form of the module, for surveys with severe time constraints, classifies households only as food-secure or food-insecure without or with hunger and contains no child-specific items. Surveys using the 18-item or short-form module can compare results with published national data from the CPS. Information about the module is available at http://www.ers.usda.gov/briefing/foodsecurity and http://www.fns.usda/fsec. Current research on food security measurement includes measurement of individual food insecurity and hunger, module performance regarding hunger duration and frequency, performance of the module in population subgroups, and the effect of translations on module meaning and performance. National surveys in Canada, New Zealand and Australia also have measured food security.

To investigate food and nutrient intakes in 3-year-old children.

Eight hundred and sixty-three children resident in South West England (69% of those invited at this age), a randomly selected sub-sample of the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC).

Diet was assessed using a 3-day descriptive food record. Food and nutrient intakes were compared with intakes at 18 months in the same children, with intakes in the British National Diet and Nutrition Survey (NDNS) of pre-school children, and with dietary reference values (DRVs).

Intakes of energy and most nutrients had increased between 18 and 43 months. The macronutrient content of the diet had also changed, the percentage of energy from starch rose from 21 to 23% and from non-milk extrinsic (NME) sugar from 12 to 16%, while the polyunsaturated to saturated fat ratio increased from 0.26 to 0.33. When compared with the NDNS, intakes of energy and all nutrients were higher with the exception of NME sugar. Energy intakes were below the estimated average requirements. Mean intakes of iron and vitamin D were below the Reference Nutrient Intake. Fewer children were eating beef at 43 months than at 18 months. Total daily meat consumption was lower than in the NDNS. The proportion of children consuming any vegetables dropped between 18 and 43 months, although fruit eating remained constant.

The diets of 3-year-olds in this study were adequate in most nutrients. Our results suggest that energy requirements of pre-school children in the 1990s are less than the DRV. Nutrient and food intakes changed between 18 and 43 months. Children were eating less meat than their counterparts in the NDNS.

To identify the food that has the greatest effect on the variation in the percentage of energy intake derived from fat and saturated fatty acids for the consumption of a Spanish population.

A cross-sectional study of food consumption, using the 24-hour recall method for three non-consecutive days, one of which was a non-working day. Subjects were interviewed by trained interviewers in the subjects' homes. We used multiple linear regression for statistical analysis.

The citizens of Reus.

One thousand and sixty subjects over five years old, randomly selected from the population census of Reus.

In both sexes, the foods that mainly determine a high consumption of fat are oil and red meat while those that determine a lower consumption of fat are bread, savoury cereals and fruit. The foods that mainly determine a high consumption of saturated fatty acids are red meat and whole-fat dairy products while those that determine a low consumption are bread, savoury cereals and fruit.

In our population, feasible variations in the intake of some foods – less than one portion – would reduce the estimated percentage of energy intake derived from fat and saturated fatty acids by a quantity considered important for cardiovascular disease prevention. The periodic identification and quantification of the food that most affects the dietary fat profile will help in drawing up dietary guidelines with more reasonable strategies for consuming a healthier diet and decreasing the risk of developing nutritional disorders.

To assess the effect on the haemoglobin concentrations of schoolchildren of weekly iron tablets administered by teachers.

Sixty schools were randomly assigned to two groups: in 30 schools children were given weekly for 10 weeks a tablet providing 65 mg of iron and 0.25 mg of folic acid; in the other 30 schools no iron tablets were given. All children were dewormed and given vitamin A before the study began. The haemoglobin concentration of up to 20 randomly selected children in each school was estimated before and 2 weeks after the end of treatment.

Rural community schools in Kolondieba district of Mali.

Some 1113 schoolchildren aged 6–19 years with a mean of 11.4 years.

The haemoglobin concentration of treated children rose on average by 1.8 g l-1 (P < 0.001) and the prevalence of anaemia fell by 8.2% (P < 0.001); in untreated children the haemoglobin concentration fell by an average of -2.7 g l-1 (P < 0.001) and the prevalence of anaemia rose by 9.4% (P < 0.001). The fall in haemoglobin concentration among untreated girls of -4.0 g l-1 was greater than in untreated boys (-0.3 g l-1, P < 0.001).

Weekly iron tablets given by teachers prevented a general fall in the haemoglobin concentrations of untreated children, and led to a small but statistically significant rise among treated children (P < 0.001). Young children benefited more than children aged ≥12 years, and girls benefited more than boys.

Our objective was to identify food intake patterns that might be associated with the risk of renal cell carcinoma.

A total of 461 cases (210 females, 251 males) were age frequency matched to population controls. Diet factors were created using factor analysis of 69 food items from a food-frequency questionnaire. These factors were modelled using logistic regression to identify those associated with renal cell carcinoma.

We investigated the role of diet in the aetiology of renal cell carcinoma using a population-based case–control study conducted in Ontario between 1995 and 1996.

Cases were Ontario residents 20 to 74 years of age identified through review of pathology reports in the Ontario Cancer Registry.

A ‘dessert’ diet factor was positively associated with disease for both sexes (odds ratio estimate (OR) for males = 3.7, 95% confidence interval (CI) 2.0–6.9; OR for females = 1.4, 95% CI 0.8–2.2, for the highest vs. lowest quartile). In males, a ‘beef’ diet factor was identified and was associated with an increased risk of renal cell carcinoma. Furthermore, a ‘juices’ diet factor also showed an association with increased risk in males ( OR = 1.8, 95% CI 1.0–3.1). For females, a positive association was observed between renal cell carcinoma and an ‘unhealthy’ diet factor ( OR = 1.4, 95% CI 0.8–2.4).

Our findings confirmed that high-fat and high-protein diets might be risk factors for renal cell carcinoma. The data also suggest an increased risk associated with juice intake, a finding not previously reported.

This study examines the relationship between tea consumption and colon cancer risk in the US population.

Data from the NHANES I Epidemiologic Follow-up study (NHEFS) were used to examine the hypothesis. Cox proportional hazard models were used to examine the hypothesis of a protective effect of frequent tea consumption on colon cancer occurrence.

Due to differences in the precision of the exposure data, we analysed two cohort periods based on the NHEFS. Cohort I was based on the survey conducted at the NHEFS baseline and Cohort II began at the first follow-up.

After excluding non-incidence cases and cases lost to follow-ups, there were 2359 tea users and 6498 non-tea users at baseline and 7656 tea users and 4514 non-tea users at the first follow-up.

After adjusting for confounders, the relative risks of colon cancer are 0.57 (95% confidence interval (CI) 0.42, 0.78) and 0.59 (95% CI = 0.35, 1.00) for subjects who consumed ≤1.5 cups and ≥1.5 cups per day, respectively, compared with non-tea users in Cohort II. Although more women consumed tea and the mean intake was higher, the preventive effect of tea consumption on colon cancer was found predominantly in men. The relative risks of colon cancer are 0.41 (95% CI = 0.25, 0.66) for men who consumed ≤1.5 cups day-1 and 0.30 (95% CI = 0.09, 0.98) for >1.5 cups day-1 of tea consumption (P-value for trend <0.01). No significant results were found in Cohort I.

This study suggests an inverse association between colon cancer risk and habitual tea consumption.

The purpose of this review is to provide guidance on the development, validation and use of food-frequency questionnaires (FFQs) for different study designs. It does not include any recommendations about the most appropriate method for dietary assessment (e.g. food-frequency questionnaire versus weighed record).

A comprehensive search of electronic databases was carried out for publications from 1980 to 1999. Findings from the review were then commented upon and added to by a group of international experts.

Recommendations have been developed to aid in the design, validation and use of FFQs. Specific details of each of these areas are discussed in the text.

FFQs are being used in a variety of ways and different study designs. There is no gold standard for directly assessing the validity of FFQs. Nevertheless, the outcome of this review should help those wishing to develop or adapt an FFQ to validate it for its intended use.

To review data on selected risk factors related to the emergence of non communicable diseases (NCDs) in the black population of South Africa.

Data from existing literature on South African blacks were reviewed with an emphasis placed on changes in diet and the emergence of obesity and related NCDs.

Review and analysis of secondary data over time relating to diet, physical activity and obesity and relevant to nutrition-related NCDs.

Urban, peri-urban and rural areas of South Africa. National prevalence data are also included.

Black adults over the age of 15 years were examined.

Shifts in dietary intake, to a less prudent pattern, are occurring with apparent increasing momentum, particularly among blacks, who constitute three-quarters of the population. Data have shown that among urban blacks, fat intakes have increased from 16.4% to 26.2% of total energy (a relative increase of 59.7%), while carbohydrate intakes have decreased from 69.3% to 61.7% of total energy (a relative decrease of 10.9%) in the past 50 years. Shifts towards the Western diet are apparent among rural African dwellers as well. The South African Demographic and Health Survey conducted in 1998 revealed that 31.8% of African women (over the age of 15 years) were obese (body mass index (BMI) ≥ 30 kgm−2) and that a further 26.7% were overweight (BMI ≥ 25 to <30 kgm−2). The obesity prevalence among men of the same age was 6.0%, with 19.4% being overweight. The national prevalence of hypertension in blacks was 24.4%, using the cut-off point of 140/90 mmHg. There are limited data on the population's physical activity patterns. However, the effects of the HIV/AIDS epidemic will become increasingly important.

The increasing emergence of NCDs in black South Africans, compounded by the HIV/AIDS pandemic, presents a complex picture for health workers and policy makers. Increasing emphasis needs to be placed on healthy lifestyles.

Guided by theory, this study explored cross-sectional differences in factors influencing adolescent eating behaviour including gender and socio-economic status (SES), and subsequently tested the longitudinal predictive power of the models.

Design/setting/subjects: Data were collected by questionnaires in a longitudinal study of adolescents (age 13 years at baseline) and their parents from Hordaland County, Norway. Association of personal and environmental variables (family, friends, school/society) with the consumption of fruit and vegetables (FV) and selected sources of fat and of sugar were assessed at age 15 (n = 613). The final cross-sectional models were subsequently employed in groups stratified by gender/SES and to predict consumption at age 21 (n = 380).

The model explained more of the variation in the sugar score (21%) and the FV score (13.5%) than in the fat score (5%). SES was associated with both the sugar and FV scores. The strongest associations with the sugar score and FV were for antisocial behaviour and evaluation of own diet, respectively. The former association was significant in all gender/SES groups, whereas the latter association was only significant in the low SES groups. For all three types of food, the strongest significant predictors in the longitudinal models were frequency of consumption at age 15.

The model's ability to explain variation in eating behaviours differed by food type, and possibly by gender/SES, but previous eating behaviour was an important predictor for all three foods. Prospective studies should carefully operationalise theoretical constructs when further investigating the influences of and interrelationships between these factors and gender/SES on the development of eating behaviours.

To describe the distribution of carotenoid intakes and important food sources of carotenoids in the diet of a representative population of older Australians.

Population-based cohort study.

Two post-code areas in the Blue Mountains, west of Sydney, Australia.

We studied 2012 (86%) of the 2334 participants aged 55 + years attending the 5-year follow-up of the cross-sectional Blue Mountains Eye Study (BMES), who completed a detailed semi-quantitative food-frequency questionnaire. The intakes for five carotenoids were studied: α-carotene, β-carotene, β-cryptoxanthin, lutein and zeaxanthin combined, and lycopene.

The mean intake per day for each carotenoid was: α-carotene, 2675 μg; β-carotene equivalents, 7301 μg; β-cryptoxanthin, 299 μg; lutein and zeaxanthin, 914 μg; lycopene, 3741 μg; retinol, 653 μg; total vitamin A, 1872 μg retinol equivalents. β-Carotene equivalents contribute a substantial proportion of total vitamin A intake (65%) in this population. Women had slightly higher intakes than men for α-carotene, β-carotene equivalents, and lutein and zeaxanthin (P<0.05) . Carrots and pumpkin were the main contributors to α-carotene and β-carotene equivalent intakes. Orange juice, oranges and papaw were the main contributors to β-cryptoxanthin intake. Broccoli, green beans and oranges contributed substantially to lutein and zeaxanthin intake. The main contributors to lycopene intake were tomatoes and bolognaise sauce.

Vitamin A intake in this population is high relative to the Australian Recommended Dietary Intake. Carotenoid intakes, particularly β-carotene, make a substantial contribution, particularly from fruit and vegetables. This study provides important information as a basis for examining associations between dietary carotenoid intake and eye disease in the BMES.

To examine associations between nutrition screening checklists and the health of older women.

Cross-sectional postal survey including measures of health and health service utilisation, as well as the Australian Nutrition Screening Initiative (ANSI), adapted from the Nutrition Screening Initiative (NSI).

Australia, 1996.

In total, 12 939 women aged 70–75 years randomly selected as part of the Australian Longitudinal Study on Women's Health.

Responses to individual items in the ANSI checklist, and ANSI and NSI scores, were associated with measures of health and health service utilisation. Women with high ANSI and NSI scores had poorer physical and mental health, higher health care utilisation and were less likely to be in the acceptable weight range. The performance of an unweighted score (TSI) was also examined and showed similar results. Whereas ANSI classified 30% of the women as ‘high-risk’, only 13% and 12% were classified as ‘high-risk’ by the NSI and TSI, respectively. However, for identifying women with body mass index outside the acceptable range, sensitivity, specificity and positive predictive values for all of these checklists were less than 60%.

Higher scores on both the ANSI and NSI are associated with poorer health. The simpler unweighted method of scoring the ANSI (TSI) showed better discrimination for the identification of ‘at risk’ women than the weighted ANSI method. The predictive value of individual items and the checklist scores need to be examined longitudinally.

To review the various biomarkers of dietary intakes of fatty acids in human populations, their measurement, limitations and analytical considerations.

Review of the literature.

Although there is no good biomarker of intake of total fat, a number of alternatives exist for assessing the intakes of exogenously produced fatty acids that are consumed. Adipose tissue, erythrocyte membrane concentrations and serum or plasma levels can reflect prior intakes over the past few hours to the past few years. The concentrations of individual fatty acids in these media generally reflect relative levels, and are influenced by a number of factors. Although relatively expensive to analyse, a single analysis by gas chromatography or high-performance liquid chromatography provides information on multiple fatty acids, and is superior to attempting to measure specific fatty acids using traditional dietary assessment methods.

Biomarkers of fatty acids that reflect long-term intake are available for nutritional epidemiology purposes. Analytical methods have become very accurate and able to detect and quantify smaller families, such as trans-fatty acids.