To assess the iodine status of Sherpa residents living in Kunde village, Khumbu region, Nepal.

Prevalence of goitre was determined by palpation. Urinary iodine concentrations (UIC) were determined in casual morning samples, and thyroid-stimulating hormone (TSH) in finger-prick blood samples on filter paper. Dietary and demographic data were obtained via questionnaire, and selected foods analysed for iodine.

Khumbu region is an area of low soil iodine in Nepal, where the prevalence of goitre was greater than 90 % in the 1960s prior to iodine intervention.

Two hundred and fifteen of 219 permanent residents of Kunde were studied.

Overall prevalence of goitre was 31 % (Grade 1 goitre, 27·0 %; Grade 2, 4·2 %). When adjusted to a world population, goitre prevalence was 27 % (95 % CI 23, 32 %); Grade 2 goitre prevalence was 2·8 % (95 % CI 1·0, 4·6 %). Median UIC was 97 μg/l, but only 75 μg/l in women of childbearing age. Thirty per cent had UIC < 50 μg/l and 52 % had UIC < 100 μg/l, while 31 % of children aged <14 years had UIC > 300 μg/l. Ten per cent of participants had TSH concentrations >5 μU/ml.

The prevalence of severe iodine deficiency has decreased since the 1960s, but mild iodine deficiency persists, particularly in women of childbearing age. The consumption of high-iodine uncooked instant noodles and flavour sachets by school-aged children contributed to their low prevalence of goitre and excessive UIC values. This finding may obscure a more severe iodine deficiency in the population, while increasing the risk of iodine-induced hyperthyroidism in children. Ongoing monitoring is essential.

Canada’s Aboriginal population is vulnerable to food insecurity and increasingly lives off-reserve. The Canadian Community Health Survey, Cycle 2.2 Nutrition, was used to compare the prevalence and sociodemographic correlates of food insecurity between non-Aboriginal and off-reserve Aboriginal households.

Food insecurity status was based on Health Canada’s revised interpretation of responses to the US Household Food Security Survey Module. Logistic regression was used to assess if Aboriginal households were at higher risk for food insecurity than non-Aboriginal households, adjusting for household sociodemographic factors.

Canada.

Households (n 35,107), 1528 Aboriginal and 33 579 non-Aboriginal.

Thirty-three per cent of Aboriginal households were food insecure as compared with 9 % of non-Aboriginal households (univariate OR 5·2, 95 % CI 4·2, 6·3). Whereas 14 % of Aboriginal households had severe food insecurity, 3 % of non-Aboriginal households did. The prevalence of sociodemographic risk factors for household food insecurity was higher for Aboriginal households. Aboriginal households were more likely to have three or more children (14 % v. 5 %), be lone-parent households (2 1 % v. 5 %), not have home ownership (52 % v. 31 %), have educational attainment of secondary school or less (43 % v. 26 %), have income from sources other than wages or salaries (38 % v. 29 %), and be in the lowest income adequacy category (33 % v. 12 %). Adjusted for these sociodemographic factors, Aboriginal households retained a higher risk for food insecurity than non-Aboriginal households (OR 2·6, 95 % CI 2·1, 3·2).

Off-reserve Aboriginal households in Canada merit special attention for income security and poverty alleviation initiatives.

To evaluate the effect on decrease in blood pressure of modifying risk factors for stroke, such as blood lipid profiles, diet habits and indices of body weight, through a family-based nutrition health education programme among hypertensive patients and pre-hypertensive subjects without taking any antihypertensive drugs.

This was a community-based prospective study. The study population was randomly selected from communities in Taipei; potential subjects were invited by telephone to participate.

After excluding subjects whose blood pressure was normal and those using antihypertensive drugs, there were 390 participants included in the study. Subjects in the intervention group (n 293) received nutrition health education on blood pressure control and stroke-related risk factor modification at each visit. Non-intervention subjects (n 97) only acquired a general education sheet available in clinics. The blood pressure of study subjects was measured at baseline and 6-month follow-up to evaluate the intervention’s effect on decrease in blood pressure.

Significant decreases of 2·0 mmHg and 5·9 mmHg in systolic blood pressure were observed both in pre-hypertensive and hypertensive subjects in the intervention group. Additionally, intervention subjects with improvement of total cholesterol and LDL cholesterol, decrease in indices of body weight and increase in consumption of fruit and vegetables also had significant lowering of blood pressure.

The present study provided evidence that the blood pressure of pre-hypertensive and hypertensive subjects could decrease significantly, without taking antihypertensive drugs, after modifying blood lipid profiles and waist by dietary habits changed through a family-based nutrition heath education programme, resulting in a significant effect on stroke risk reduction.

To review associations between the family environment and young people’s fruit and vegetable consumption.

A systematic review. Published English-language (n 60) papers were identified using electronic databases and manual searches of personal files and reference lists. Observational research reporting a measure of fruit/vegetable intake for children (aged 6–11 years) and/or adolescents (aged 12–18 years) and at least one potential family correlate of dietary intake was included.

Parental modelling and parental intake were consistently and positively associated with children’s fruit and fruit, juice and vegetable (FJV) consumption. There were also positive associations between home availability, family rules and parental encouragement and children’s fruit and vegetable consumption. Parental intake was positively associated with adolescents’ fruit and vegetable consumption. There were also positive associations between parental occupational status and adolescent fruit consumption and between parental education and adolescents’ FJV consumption.

Our findings highlight the importance of targeting the family environment for the promotion of healthy eating behaviours among children and adolescents. Future interventions should encourage parents to be positive role models by targeting parental intake and to create a supportive home environment through increased encouragement and availability of fruits and vegetables and employing rules to govern eating behaviours. For adolescents, indicators of family circumstances (e.g. parental education) should be used to identify target groups for interventions aimed at promoting healthy eating.

To assess the trends in overweight and obesity in pre-school children in urban areas of Ho Chi Minh City (HCMC), Vietnam, over the period 2002 to 2005.

Two cross-sectional studies were conducted in 2002 and 2005. Multistage cluster sampling was used in both surveys to select the subjects. Sociodemographic information was collected using a self-administered questionnaire given to parents in 2002 and using an interview-administered questionnaire to parents in 2005. Weight and height were measured using the same standard methods in both surveys. BMI (kg/m2) was calculated and overweight/obesity was defined using the age- and sex-specific BMI cut-off points proposed by the International Obesity Taskforce.

Children aged 4 to 5 years, attending pre-schools in urban areas of HCMC, Vietnam, in 2002 (n 492) and 2005 (n 670).

The prevalence of overweight and obesity almost doubled from 2002 to 2005 (21·4 % and 36·8 %, respectively). The increase was more evident in less wealthy districts than in wealthy districts. The proportion of boys classified as obese in 2005 (22·5 %) was three times that in 2002 (6·9 %).

The prevalence of overweight and obesity has increased rapidly in children aged 4 to 5 years in urban areas, and especially in less wealthy districts, over a 3-year period. These results signal an urgent need for prevention programmes to control and reverse this rapid upward trend in overweight and obesity in young children in HCMC.

To explore knowledge, attitudes and behaviours regarding caloric soft drinks in a group of young adults attending university and to identify opportunities for a health promotion intervention aimed at reducing consumption.

In-depth, semi-structured focus groups segmented by gender.

Sydney, Australia.

Undergraduate University of Sydney students aged 18–30 years (n 35).

Social and environmental cues, intrinsic qualities of beverages and personal health beliefs were identified as important influences on consumption. Social cues included settings in which alcohol is usually consumed, socialising with friends, and family influences. Environmental cues included purchasing of fast foods, and ready availability, preferential pricing and promotion of caloric beverages. Reinforcing intrinsic qualities of caloric soft drinks included taste, sugar and caffeine content, and their association with treats and rewards. Major gender differences as well as variations in individual readiness for behaviour change were observed. Raising awareness of the sugar content of various beverages and the potential health impacts associated with their consumption was considered important.

The findings provide new insights with important implications for policy and practice, and suggest that there is considerable scope for promoting awareness in this group. Carefully designed social marketing campaigns highlighting the health issues and addressing social and environmental cues relating to caloric soft drink consumption are required. There is a need for gender-differentiated intervention programmes which are both informational and appealing to young adults. Further research is warranted, particularly to investigate beverage consumption relating to fast-food meal deals and young adults’ consumption patterns in more depth.

To examine the potential public health impact on CHD and stroke mortality of replacing one ‘unhealthy’ snack with one ‘healthy’ snack per person, per day, across the UK population.

Nutritional information was obtained for different ‘unhealthy’ (such as crisps, chocolate bars, cakes and pastries) and ‘healthy’ snack products (such as fresh fruit, dried fruit, unsalted nuts or seeds). Expected changes in dietary intake were calculated. The mean change in total blood cholesterol levels was estimated using the Keys equation. The effect of changing cholesterol and salt levels on CHD deaths and on stroke deaths was calculated using the appropriate equations from the Law and He meta-analyses. The estimated reductions in cardiovascular deaths were then tested in a sensitivity analysis.

Substituting one ‘healthy’ snack would reduce saturated fat intake by approximately 4·4 g per person per day, resulting in approximately 2400 fewer CHD deaths and 425 fewer stroke deaths per year. The associated 500 mg decrease in salt intake would result in approximately 1790 fewer CHD deaths and 1330 fewer stroke deaths.

Simply replacing one unhealthy snack with one healthy snack per day might prevent approximately 6000 cardiovascular deaths every year in the UK.

Poor nutrition and limited sunlight exposure (season) can be related to reduced serum 25-hydroxyvitamin D (25(OH)D) concentrations. Thus, elderly people in the Nordic countries might be at high risk for vitamin D deficiency. The aims of the study were to describe the prevalence of vitamin D deficiency in elderly hospitalized patients in Reykjavik, Iceland, and to investigate the effects of nutritional status and season on serum 25(OH)D.

Cross-sectional study. Nutritional status was assessed and fasting blood was drawn and analysed for serum 25(OH)D and other clinical routine measurements.

Departments of Geriatrics, Landspitali-University Hospital, Reykjavik, Iceland.

Sixty hospitalized patients (mean age 83·0 (sd 7·9) years) were randomly assigned.

Of the patients, 12·3 % suffered from vitamin D deficiency (serum 25(OH)D < 25 nmol/l) and 71·9 % suffered from hypovitaminosis D (serum 25(OH)D = 25–75 nmol/l). There were no significant effects of gender or nutritional status on serum 25(OH)D. Anthropometric variables correlated significantly with serum 25(OH)D, but on stepwise linear regression modelling for the prediction of serum 25(OH)D, BMI remained the only predictor variable (B = −1·454, 95 % CI −2·535, −0·373, P = 0·009).

BMI was significantly negatively associated with serum 25(OH)D in hospitalized elderly patients. Neither nutritional status nor season significantly affected serum 25(OH)D in our patient group. Higher levels of serum 25(OH)D in elderly subjects with lower BMI are most likely explained by volume of distribution rather than by mobilization of vitamin D from its storage in adipose tissue due to age and disease-related catabolism.

Low Ca intake is common among Japanese women, but its effect on bone metabolism has not been fully elucidated. The aim of the present study was to determine the relationship between Ca intake and serum markers of bone turnover in postmenopausal Japanese women.

A cross-sectional study.

A community setting.

Subjects were 595 home-dwelling postmenopausal Japanese women. Ca intake was assessed by a validated FFQ. Serum type I collagen cross-linked N-telopeptides (NTX) and osteocalcin were measured as markers of bone turnover. The relationships between demographic characteristics, lifestyles, serum Ca, vitamin D and intact serum parathyroid hormone and bone turnover were also assessed.

The average age of the subjects was 64·5 (sd 5·8) years and the mean Ca intake was 527 (sd 160) mg/d. Ca intake was significantly associated with serum NTX (P = 0·0104), but not with serum osteocalcin. Mean serum NTX concentration in the lowest quartile of Ca intake (<417 mg/d) was significantly higher than in the fourth, referent quartile. Among these Japanese postmenopausal women, very low Ca intake (less than ∼400 mg/d) was associated with increased bone resorption but not bone formation.

Increased bone resorption may be one mechanism by which this Ca-depleted population normalizes bone metabolism and prevents osteoporosis.

The WHO recommends a daily Ca intake for postmenopausal women of 1300 mg. The objective of the present study was to assess the dietary Ca intake in European postmenopausal osteoporotic women.

Assessment of dietary Ca intake (food and supplements) was performed with a validated self-questionnaire in 8524 osteoporotic women from nine European countries (Belgium, Denmark, France, Germany, Hungary, Italy, Poland, Spain and the UK).

Mean age of the patients was 74·2 (sd 7·1) years, mean BMI was 25·7 (sd 4·2) kg/m2. Of the study population, 37·2 % of the women took Ca supplements. The mean dietary intake of Ca was 930·7 (sd 422·9) mg/d. The lowest Ca intake was found in Hungary (586·7 (sd 319·1) mg/d) and the highest in Denmark (1145·6 (sd 463·0) mg/d). In the whole study population, only 19·1 % of the women had a dietary Ca intake >1300 mg/d. Only 17·1 % of women aged over 75 years achieved 1300 mg/d compared with 20·5 % of women aged less than 75 years (P = 0·0001 for the difference between the two groups).

Dietary intake of Ca is very low in European postmenopausal women. A greater awareness is needed to resolve this public health problem.

To assess the prevalence and identify possible predictors of food insecurity among college students at the University of Hawai’i at Mānoa.

Cross-sectional survey, including the US Department of Agriculture’s Household Food Security Survey Module, demographic and spending variables.

University of Hawai’i at Mānoa, Honolulu, Hawai’i (USA).

Four hundred and forty-one non-freshmen students from thirty-one randomly selected classes.

Twenty-one per cent of students surveyed were food-insecure, while 24 % were at risk of food insecurity. Students at higher risk of food insecurity included those who reported living on campus and those living off-campus with room mates. Those identifying themselves as Hawaiians and Pacific Islanders, Filipinos and mixed were also at increased risk of food insecurity.

Food insecurity is a significant problem among college students at the University of Hawai’i at Mānoa. Food availability and accessibility should be increased for these students through the establishment of on-campus food banks and student gardens. Future studies should assess the prevalence of food insecurity in other college campuses nationwide.

Millions of US households experienced food insecurity in 2005. Research indicates that low wages and little social support contribute to food insecurity. The present study aimed to examine whether social support moderates the relationship between income and food insecurity.

Using a mail survey, we collected data on social support sources (social network, intimate partner and community) and social support functions from a social network (instrumental, informational and emotional). We used hierarchical logistic regression to examine the potential moderation of various measures of social support on the relationship between income and food insecurity, adjusting for potential confounding variables.

Oregon, USA.

A stratified random sample of Oregonians aged 18–64 years (n 343).

We found no evidence of an association between social support and food insecurity, nor any evidence that social support acts as a moderator between income and food insecurity, regardless of the measure of social support used.

Although previous research suggested that social support could offset the negative impact of low income on food security, our study did not find support for such an effect.

Vitamin D is essential for Ca absorption, prevention of falls and fracture, and maintenance of muscle strength and balance. Lack of awareness of the importance of vitamin D in bone health is common in Asia.

To define key statements, objectives and actions for improving osteoporosis management and vitamin D inadequacy in Asia.

This declaration was jointly produced by specialists at the Asia Metaforum on the Role of Vitamin D and the Management of Osteoporosis, held in September 2006 in Hong Kong, to define actions to prevent vitamin D insufficiency in Asia. Although developed specifically for Asia, some or all of these statements may be applicable to other regions of the world.

To examine the association between television advertising exposure and adults’ consumption of fast foods.

Cross-sectional telephone survey. Questions included measures of frequency of fast-food consumption at different meal times and average daily hours spent watching commercial television.

Subjects comprised 1495 adults (41 % response rate) aged ≥18 years from Victoria, Australia.

Twenty-three per cent of respondents usually ate fast food for dinner at least once weekly, while 17 % consumed fast food for lunch on a weekly basis. The majority of respondents reported never eating fast food for breakfast (73 %) or snacks (65 %). Forty-one per cent of respondents estimated watching commercial television for ≤1 h/d (low viewers); 29 % watched for 2 h/d (moderate viewers); 30 % watched for ≥3 h/d (high viewers). After adjusting for demographic variables, high viewers were more likely to eat fast food for dinner at least once weekly compared with low viewers (OR = 1·45; 95 % CI 1·04, 2·03). Both moderate viewers (OR = 1·53; 95 % CI 1·01, 2·31) and high viewers (OR = 1·81; 95 % CI 1·20, 2·72) were more likely to eat fast food for snacks at least once weekly compared with low viewers. Commercial television viewing was not significantly related (P > 0·05) to fast-food consumption at breakfast or lunch.

The results of the present study provide evidence to suggest that cumulative exposure to television food advertising is linked to adults’ fast-food consumption. Additional research that systematically assesses adults’ behavioural responses to fast-food advertisements is needed to gain a greater understanding of the mechanisms driving this association.

To estimate the prevalence of overweight, obesity and nutritional habits in schoolchildren aged 10–18 years.

Contemporary, cross-sectional, population-based study, with a stratified probabilistic sample of secondary schools in Porto Alegre comprising a total of 511 schoolchildren. Data on family risk factors, anthropometrics and eating habits were collected.

The prevalence of excess weight was 27·6 % among the schoolchildren, with 17·8 % being overweight (BMI ≥ 85th and <95th percentile) and 9·8 % obese (BMI ≥ 95th percentile). Overweight was more prevalent in females (19·9 %) and obesity in males (11·8 %). Children who ate fewer meals per day tend to be more obese (mean: 3·51 (sd 1·14) v. 4·22 (sd 1·01) meals/d for students with normal weight). The mean weekly intake of unhealthy foods was 3·25 times for soft drinks, 2·91 for fried foods and 4·01 for sweets. The intake of skimmed milk (38·9 %) and diet soft drinks (20·9 %) was greater among obese children.

Overweight and obesity are increasing even in developing countries such as Brazil. Although many families are already taking measures towards healthier health habits, preventive actions must be considered a priority, with an emphasis on education, in order to avoid the need to treat obesity and its significant burden in the near future.

There is strong evidence that what we eat and how it is produced affects climate change.

The present paper examines coverage of food system contributions to climate change in top US newspapers.

Using a sample of sixteen leading US newspapers from September 2005 to January 2008, two coders identified ‘food and climate change’ and ‘climate change’ articles based on specified criteria. Analyses examined variation across time and newspaper, the level of content relevant to food systems’ contributions to climate change, and how such content was framed.

There were 4582 ‘climate change’ articles in these newspapers during this period. Of these, 2·4 % mentioned food or agriculture contributions, with 0·4 % coded as substantially focused on the issue and 0·5 % mentioning food animal contributions. The level of content on food contributions to climate change increased across time. Articles initially addressed the issue primarily in individual terms, expanding to address business and government responsibility more in later articles.

US newspaper coverage of food systems’ effects on climate change during the study period increased, but still did not reflect the increasingly solid evidence of the importance of these effects. Increased coverage may lead to responses by individuals, industry and government. Based on co-benefits with nutritional public health messages and climate change’s food security threats, the public health nutrition community has an important role to play in elaborating and disseminating information about food and climate change for the US media.

To quantify the role of dietary Fe in total body Fe (TBI) accumulation among homozygotes for the HFE gene associated with haemochromatosis.

A Monte Carlo model was built to simulate Fe accumulation based on findings from human feeding experiments and national dietary surveys. A hypothetical cohort of 1000 homozygotes with starting age 25 years was used in 39-year simulations. The impact of reducing dietary Fe intake on Fe accumulation was tested.

In the baseline model without any dietary intervention, by age 64, the percentage of males with TBI > 10 g, >15 g and >20 g was 93·2 %, 49·6 % and 14·7 %, respectively. When the Fe intake of individuals in the cohort was reduced to ≤200 % of the recommended dietary allowance (RDA), the corresponding percentages were 92·0 %, 40·5 % and 10·2 %, respectively. The corresponding figures were 91·0 %, 40·0 % and 9·3 % for Fe defortification and 70·3 %, 21·3 % and 4·1 % when Fe intake was capped at 100 % RDA. Similar trends were seen with sexes combined, although the impact of interventions was less. Sensitivity analysis revealed that the rate of Fe accumulation and the impact of dietary interventions are highly dependent on assumptions concerning Fe absorption rates.

Variation in Fe intake as currently observed in the USA contributes to variation in Fe accumulation among homozygotes, when continued over an extended period. Lifelong dietary habits and national fortification policy can affect the rate of Fe accumulation, although the magnitude of the effect varies by gender, the TBI level of interest and factors affecting the Fe absorption rate.