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.

Se is an essential trace element in human nutrition associated with antioxidant activity. Previous studies on predictors of toenail Se or serum Se have mostly concentrated on demographic factors such as age and gender. The present paper examines the association between apoE genotype and Se levels in nail samples in a rural elderly Chinese cohort.

Two thousand Chinese aged 65 years and over from four counties in China were enrolled in a cohort to study the association of Se with cognitive decline. Nail samples were collected from each participant and analysed for Se levels. Dietary Se intake was estimated from an FFQ using Se contents measured in food items collected from each village. Blood samples on filter cards were collected and analysed for apoE genotype. Mixed-effect models were constructed with nail Se level as the dependent variable and each village as the random effect, which controlled for the potential confounding effect from correlation in Se measures obtained from participants residing in the same village.

In this elderly Chinese cohort, carriers of the apoE ε4 allele had significantly lower Se levels measured in nail samples than non-carriers after adjusting for other significant covariates and controlling for estimated dietary Se intake. There was no significant difference between the two genotypes on estimated Se dietary intake (P = 0·6451).

Future studies are needed to examine the mechanism underlying the association between the apoE ε4 allele and Se levels, including the role of oxidative stress and that of reduced lipid metabolism in the apoE ε4 carriers.

Many Iranian adolescent girls are Fe-deficient, but it is unclear whether Fe deficiency is associated with other nutritional risk indicators. The present study aimed to investigate the association between Fe deficiency and weight status (measured as BMI) among a representative sample of adolescent girls.

A cross-sectional study. Fe-deficient high-school girls (with or without anaemia) were selected by systematic random sampling among all students in grades 1 to 4 from high schools for girls. Blood samples were collected and analysed for Hb, haematocrit, serum ferritin, Fe and total Fe binding capacity. Weight and height were measured. BMI was calculated and compared with age- and gender-specific BMI reference values.

South Iran.

A total of 431 adolescent girls aged 13–20 years.

Some 15·3 % of the participants were at risk for overweight and 9·5 % of them were overweight. An inverse association was found between serum ferritin and BMI (r = −0·38, β = −0·21, P < 0·001). Anaemia was more prevalent among overweight Fe-deficient adolescents than among those Fe-deficient and at risk for overweight or normal weight (34·1 % v. 28·8 % v. 27·8 %, respectively; P < 0·001).

An inverse association was found between BMI and serum ferritin. Overweight adolescents demonstrated an increased prevalence of Fe-deficiency anaemia. It seems that both abnormalities of weight and Fe status should simultaneously be targeted in overweight female adolescents.

To examine the relationship between food insecurity and child well-being indicators.

Cross-sectional survey conducted in 2344 households with children. The main exposure measure was food insecurity status, which was categorized as food secure or food insecure based on two or more food insecurity questions answered in the affirmative. Multiple logistic regression analysis was used to model the association between food insecurity status and selected child well-being indicators.

Barbados, St. Lucia and St. Vincent and the Grenadines (hereafter St. Vincent), three Eastern Caribbean countries, 2005.

A random sample of households with children was identified by the governments of Barbados, St. Lucia and St. Vincent. In-home interviews were conducted by social workers.

One-third (33 %) of households were categorized as food insecure. Food-insecure households were more likely to include a chronically ill parent (OR = 2·48; 95 % CI 1·76, 3·49), a recently divorced parent (OR = 1·92; 95 % CI 1·21, 3·05), a child requiring multiple visits to a health-care provider for a disability (OR = 3·98; 95 % CI 1·20, 13·19) or injury (OR = 1·78; 95 % CI 1·12, 2·83), a child with a learning disability (OR = 2·08; 95 % CI 1·16, 3·74) or a child with a physical disability (OR = 2·54; 95 % CI 1·22, 5·32) after adjustment for poverty and other demographic variables.

The results indicate that food-insecure households were more likely to be burdened by child disability (learning and physical), family system disruption (recent divorce and chronic illness) and child health-care needs (for disability and injury) than food-secure households. The implementation of programmes and policies to minimize food insecurity in the Eastern Caribbean may be warranted.

To study the association between diet quality and the new health messages in the Danish Dietary Guidelines 2005, i.e. ‘Eat a varied diet’, ‘Engage in regular physical activity’ and ‘Maintain a healthy body weight’.

The study was cross-sectional, comprising a random sample of 3151 Danish adults aged 18–75 years. Dietary intake was estimated using a 7 d pre-coded food diary. Information on social background, leisure-time physical activity, height, body weight and intention to eat healthily was obtained by in-person interviews. Logistic regression models were used to explore the independent effects of energy intake, leisure-time physical activity, food variety, BMI, age, gender, education, household income, location of residence and intention to eat healthily on the likelihood to have high diet quality measured by an index based on the intake of dietary fibre and saturated fat.

Greater food variety (OR = 1·32 for women, 1·13 for men), high leisure-time physical activity (OR = 2·20 for women, 1·91 for men), frequent intentions to eat healthily (OR = 8·19 for women, 5·40 for men) and low energy intake (OR=0·78 for women, 0·85 for men) were significantly associated with high diet quality. For women education was positively associated with diet quality. The study did not demonstrate any association between BMI and diet quality.

The health behaviours ‘Eat a varied diet’ and ‘Engage in regular physical activity’ were positively associated with healthy eating. The dietary habits reported were strongly influenced by personal intentions. Thus, the biggest challenge for public health nutritionists will be to reach non-compliers who seldom have intentions to eat healthily.

In developed countries, there is abundant information on the epidemic of childhood obesity, but only a few studies on trends in the dual burden of body weight (overweight and thinness).

To examine trends in overweight and thinness among 9–10-year-old Spanish children in the last decade.

Data were taken from cross-sectional studies on schoolchildren in Cuenca (Spain), conducted in 1992, 1996, 1998 and 2004 with similar methods. Weight and height were measured by trained personnel with standardized procedures. Overweight (including obesity) and thinness were defined according with the International Obesity Taskforce BMI cut-offs.

The overall prevalence of overweight increased from 24·4 % in 1992 to 30·9 % in 2004 (P = 0·07), rising from 21·2 % in 1992 to 32·0 % in 2004 (P = 0·03) among boys and from 27·7 % to 29·8 % (P = 0·67) among girls. The overall prevalence of thinness was 2·7 % in 1992 and 9·2 % in 2004 (P < 0·001); in the same period, thinness prevalence rose from 1·9 % to 9·0 % (P = 0·10) among boys and from 3·7 % to 9·5 % (P < 0·01) among girls.

The dual burden of body weight has increased among children in Cuenca in the last decade. Population-based policies addressing childhood obesity, which is the most frequent problem, should not increase the risk of thinness.

The present study aimed to understand the relationship between need and help-seeking behaviour in older adults by examining the patterns of food insecurity and participation in food assistance programmes (FAP), i.e. the Food Stamp Program and home-delivered meals.

Data from two longitudinal studies were used. The studies were designed to obtain nationally representative information on health, insurance coverage, financial status, family support systems, labour market status and retirement planning, every two years: the Health and Retirement Study (HRS, 1996–2002) and Asset and Health Dynamics Among the Oldest Old (AHEAD, 1995–2002).

USA.

There were 7623 participants for HRS and 3378 for AHEAD.

The older adults appeared to have persistent patterns between food insecurity and participation in FAP, especially in the Food Stamp Program. More persistently food-insecure older adults had higher participation in FAP (P < 0·001). Food-insecure older adults at one time were more likely to shift from non-participation to participation in FAP the next time than food-secure older adults (P < 0·001). Regardless of previous food insecurity status, previous participants in FAP were more likely to participate subsequently.

The relationship between need and help-seeking behaviour in older adults was found to follow a persistent positive pattern, determined by looking at the patterns of food insecurity and participation in FAP. Although food insecurity as a need is a good predictor of participation in FAP, it is not enough to fully predict participation in FAP. Help-seeking behaviour (i.e. previous programme participation) is also important in predicting participation in FAP.

To compare estimates of under-nutrition among pre-school Pakistani children using the WHO growth standard and the National Center for Health Statistics (NCHS) reference.

Prevalence of stunting, wasting and underweight as defined by WHO and NCHS standards are calculated and compared.

The data are from two cross-sectional surveys conducted in the early 1990s, the time frame for setting the baseline for the Millennium Development Goals: (i) National Health Survey of Pakistan (NHSP) assessed the health status of a nationally representative sample and (ii) Thatta Health System Research Project (THSRP) was a survey in Thatta, a rural district of Sindh Province.

In all, 1533 and 1051 children aged 0–35 months from national and Thatta surveys, respectively.

WHO standard gave a significantly higher prevalence of stunting for both national [36·7 (95 % CI 33·2, 40·2)] and Thatta surveys [52·9 (95 % CI 48·9, 56·9)] compared to the NCHS reference [national: 29·1 (95 % CI 25·9, 32·2) and Thatta: 44·8 (95 % CI 41·1, 48·5), respectively]. It also gave significantly higher prevalence of wasting for the Thatta survey [22·9 (95 % CI 20·3, 25·5)] compared to the NCHS reference [15·7 (95 % CI 13·5, 17·8)]. Differences due to choice of standard were pronounced during infancy and for severely wasted and severely stunted children.

Pakistan should switch to the robustly constructed and up-to-date WHO growth standard for assessing under-nutrition. New growth charts should be introduced along with training of health workers. This has implications for nutritional intervention programmes, for resetting the country’s targets for Millennium Development Goal 1 and for monitoring nutritional trends.

To describe the development of a short questionnaire including a wide range of personal, social and environmental constructs in relation to a healthy diet in an adolescent population.

The questionnaire was developed based on the literature, past experiences and feedback from a small pilot study (n 10). Test and retest (2 weeks later) of the questionnaire was done to investigate test–retest reliability. Data of four non-consecutive 24 h recalls were collected to investigate the predictive validity with food (fruit, vegetables, milk, snacks, soft drinks), nutrient (fibre, ascorbic acid, Ca, percentage energy from fat) and energy intakes.

At home, in the presence of a student.

Convenience sample of fifty-five Belgian-Flemish adolescents approached by university students for course credits.

Test–retest correlations of the constructs ranged between 0·51 and 0·78. Eleven of the eighteen final constructs were significantly associated with one or more of the five selected food items, all in the expected direction. Most significant associations with the food items were found for taste, perceived peers’ behaviour and availability of soft drinks at home. Fresh fruit and soft drinks were correlated with most constructs (seven) followed by snacks (five). Concerning energy and the selected nutrient variables, the findings were less clear.

The results are promising: the test–retest stability was moderate to good; most of the psychosocial constructs were significantly associated with one or more of the selected dietary variables. Future work in a larger sample of European adolescents is warranted.

To study patterns of phytosterol intakes in the Irish population from enriched sources.

An interview-assisted questionnaire, which recorded information on sociodemographics, product types, intake amounts and patterns of intake. Independent samples t tests, one-way ANOVA and cross-tabulations were used to establish significant relationships between groups of variables. The top tertile of phytosterol intakes was also calculated.

Point-of-purchase of phytosterol-enriched products in Irish supermarkets.

Four hundred and sixty-eight consumers (186 men and 282 women) of phytosterol-enriched foods.

The mean phytosterol intake from enriched sources for the sample population was 2·45 g/d. Men had greater intakes than women (2·71 g/d v. 2·29 g/d, respectively). A total of 62 % of consumers were unaware of the importance of consuming fruit and vegetables while taking these products. The majority of respondents reported that they had high cholesterol (61 %) and 22 % of consumers also took cholesterol-lowering medication (statins). In total, 23 % had phytosterol intakes >3·0 g/d and the majority of consumers (58 %) had been consuming these products for >1 year. The mean intake for respondents with phytosterol intakes >3·0 g/d was 4·1 g/d and 74 % of this subgroup had been consuming these products for >1 year.

In general, phytosterol intakes are within efficacious levels in the Irish population. However, there appears to be a subgroup that has been consuming these products at intakes greater than current recommendations for >1 year.

To assess current Mediterranean dietary patterns (MDP) in the western and eastern Mediterranean, i.e. in Balearic islanders (BI) and Greek islanders (GI).

Dietary patterns were assessed using FFQ on a representative sample (n 1200) of the BI and GI (n 1324) adult population. A Mediterranean Diet Score (MDS) was calculated according to the consumption of nine MDP components: (i) with a beneficial effect on health, i.e. vegetables, fruits and nuts, cereals, legumes, fish and shellfish, MUFA:SFA ratio, and moderate alcohol consumption; and (ii) with a detrimental effect on health, i.e. meat and meat products, and milk and dairy products. Persons with consumption of beneficial components below the median (GI plus BI) received a value of 0 and those with consumption above the median a value of 1. Persons with below-median consumption of detrimental components received a value of 1 and above-median consumption a value of 0. For alcohol, a value of 1 was given to consumptions of 10–50 g/d (men) and 5–25 g/d (women). The range of the MDS was 0–9, with higher scores indicating greater adherence to the MDP.

GI showed higher adherence (mean MDS 5·12 (sd 1·42)) to the MDP than BI (mean MDS 3·32 (sd 1·23)). BI diet was characterized by a high intake of legumes, nuts, seed oils, sugar and confectionery, and non-alcoholic beverages compared with GI, whereas GI diet was richer in fruit, vegetables, potatoes, olive oil, animal products and alcoholic beverages.

The GI diet seems closer to the traditional MDP than the BI diet.