To evaluate the prevalence of undernutrition among community-dwelling elderly people in Spain using the Mini Nutritional Assessment (MNA) and to analyse its distribution according to age, gender and residence region.

Cross-sectional study assessing the nutritional status of elderly persons through both the short form and the full version of the MNA test.

Pharmacy offices across the whole country (Spain) were enrolled to recruit participants.

A total of 22 007 participants (8014 men and 13 993 women), aged ≥65 years, assessed during the last two months of 2005.

According to MNA screening, 4·3 % subjects were classified as undernourished (MNA score <17) and 25·4 % were at risk of undernutrition (MNA score ≥17 to ≤23·5). The MNA short form correlated strongly with the full MNA version (r = 0·85). MNA total score was significantly higher in men than in women (25·4 (sd 3·7) v. 24·6 (sd 3·9); P < 0·001) and lower in the oldest than in the youngest subjects (P < 0·001) in both genders. According to regional distribution, the best nutritional status was found in elderly from the north of Spain excluding the north-west area.

Female gender, older age and living in the south half or north-west of the country were associated with higher rates of undernutrition among community-dwelling elderly persons in Spain.

It has been substantiated that the onset of most major diseases (CVD, diabetes, obesity, cancers, etc.) is modulated by the interaction between genetic traits (susceptibility) and environmental factors, especially diet. We aim to report more specific observations relating the effects of Mediterranean-type diets on cardiovascular risk factors and the genetic background of subjects.

In the first part, general concepts about nutrigenetics are briefly presented. Human genome has, overall, only marginally changed since its origin but it is thought that minor changes (polymorphisms) of common genes that occurred during evolution are now widespread in human populations, and can alter metabolic pathways and response to diets.

In the second part, we report the data obtained during the Medi-RIVAGE intervention study performed in the South-East of France. Data obtained in 169 subjects at moderate cardiovascular risk after a 3-month dietary intervention indicate that some of the twenty-three single nucleotide polymorphisms (SNP) studied exhibit interactions with diets regarding changes of particular parameters after 3-month regimens. Detailed examples are presented, such as interactions between SNP in genes coding for microsomial transfer protein (MTTP) or intestinal fatty acid binding protein (FABP2) and triglyceride, LDL-cholesterol or Framigham score lowering in responses to Mediterranean-type diets.

The data provided add further evidence of the interaction between particular SNP and metabolic responses to diets. Finally, improvement in dietary recommendations by taking into account known genetic variability has been discussed.

To explore the everyday consumption of meals and snacks from the child’s perspective, among those with healthier v. less healthy dietary habits.

The sample in this qualitative study comprised two groups of Danish schoolchildren aged 10 to 11 years, one with a healthier diet (n 9) and the other with a less healthy diet (n 8). Both groups were recruited from respondents to a dietary survey. Semi-structured interviews took their starting point in photographs of their meals and snacks taken by the children themselves.

Both subgroups of children had a meal pattern with three main meals and two to four snacks. We found a connection between the nutritional quality of the diet and the social contexts of consumption, especially with regard to snacks. Among children with healthier eating habits, both snacks and meals tended to be shared social events and items of poor nutritional quality functioned as markers of a special social occasion. This was not the case among children with less healthy eating habits. All children described particular rules governing food consumption within their families. Although only some of them had participated in the development of these rules, and despite the fact that rules were different and were perceived as having been developed for different reasons, children from both subgroups tended to accept them.

The results of the study suggest that dietary interventions designed to promote children’s health should focus more on the different social contexts of consumption and more on the role of parents.

To describe a conceptual framework to assist in the application of capacity-building principles to public health nutrition practice.

A review of the literature and consideration of the determinants of effective public health nutrition practice has been used to inform the development of a conceptual framework for capacity building in the context of public health nutrition practice.

The limited literature supports a greater integration and application of capacity-building strategies and principles in public health nutrition practice, and that this application should be overt and strategic. A framework is proposed that identifies a number of determinants of capacity for effective public health nutrition action. The framework represents the key foundations for building capacity including leadership, resourcing and intelligence. Five key strategic domains supported by these foundation elements, including partnerships, organisational development, project management quality, workforce development and community development, are proposed. This framework can be used to assist the systematic assessment, development and evaluation of capacity-building activity within public health nutrition practice.

Capacity building is a strategy within public health nutrition practice that needs to be central to public health nutrition intervention management. The present paper defines, contextualises and outlines a framework for integrating and making explicit the importance of capacity building within public health nutrition practice at many levels.

The present study aimed to compare two situations of endemic malnutrition among <5-year-old African children and to estimate the incidence, the duration and the case fatality of severe wasting episodes.

Secondary analysis of longitudinal studies, conducted several years ago, which allowed incidence and duration to be calculated from transition rates. The first site was Niakhar in Senegal, an area under demographic surveillance, where we followed a cohort of children in 1983–5. The second site was Bwamanda in the Democratic Republic of Congo, where we followed a cohort of children in 1989–92. Both studies enrolled about 5000 children, who were followed by routine visits and systematic anthropometric assessment, every 6 months in the first case and every 3 months in the second case.

Niakhar had less stunting, more wasting and higher death rates than Bwamanda. Differences in cause-specific mortality included more diarrhoeal diseases, more marasmus, but less malaria and severe anaemia in Niakhar. Severe wasting had a higher incidence, a higher prevalence and a more marked age profile in Niakhar. However, despite the differences, the estimated mean durations of episodes of severe wasting, calculated by multi-state life table, were similar in the two studies (7·5 months). Noteworthy were the differences in the prevalence and incidence of severe wasting depending on the anthropometric indicator (weight-for-height Z-score ≤–3.0 or mid upper-arm circumference <110 mm) and the reference system (National Center for Health Statistics 1977, Centers for Disease Control and Prevention 2000 or Multicentre Growth Reference Study 2006).

Severe wasting appeared as one of the leading cause of death among under-fives: it had a high incidence (about 2 % per child-semester), long duration of episodes and high case fatality rates (6 to 12 %).

In view of the fact that height differences between socio-economic groups are apparent early in childhood, it is of interest to examine whether skeletal growth is reflective of the social class gradient in CVD risk. The present study examined blood pressure levels, adiposity and growth of adolescent boys from high and low social classes.

In a cross-sectional study, skeletal growth (height and sitting height), adiposity (weight, BMI and body fat) and blood pressure levels of the adolescents were measured.

Pune, India.

Adolescent schoolboys (9–16 years) from high socio-economic (HSE; n 1146) and low socio-economic (LSE; n 932) class.

LSE boys were thin, short and undernourished (mean BMI: 15·5 kg/m2v. 19·3 kg/m2 in HSE boys, P = 0·00). Social gradient was revealed in differing health risks. The prevalence of high systolic blood pressure (HSBP) was high in HSE class (10·5 % v. 2·7 % in LSE class, P = 0·00) and was associated with adiposity, while the prevalence of high diastolic blood pressure (HDBP) was high in LSE class (9·8 % v. 7·0 % in HSE class, P = 0·00) and had only a weak association with adiposity. Despite this, lower ratio of leg length to height was associated with significantly higher respective health risks, i.e. for HDBP in LSE class (OR = 1·99, 95 % CI 1·14, 3·47) and for HSBP in HSE class (OR = 1·69, 95 % CI 1·02, 2·77).

As stunting in childhood is a major problem in India and Asia, the leg length to height indicator needs to be validated in different populations to understand CVD risks.

The focus in understanding the causes of and preventing obesity has broadened from the individual level to include the obesogenic environment. Proving a causal relationship between environmental factors and eating patterns poses a great challenge because randomised controlled trials are seldom possible or feasible to conduct. Interactions between the environment and individuals are beginning to be explored in multilevel studies and qualitative and sociological research.

The aim is to give an overview of the wider environmental determinants of diet such as the national food supply, food availability and accessibility in different settings as well as the economic food environment and in relation to socio-economic status.

The indicators suggested are based on the amount of data available in the scientific literature and the potential for intervention. They can be used to monitor societal interventions or evaluate ‘natural’ changes in the food environment. The indicators are of relevance to the Second WHO European Action Plan for Food and Nutrition Policy 2007–2012.

The relatively weak empirical evidence does not imply the absence of causal relationships between environmental factors and diet. Potentially relevant factors have not been evaluated due to the complexity of the task and to lack of political will to change the food environment in a more healthy direction by use of legislation or economic instruments. Future intervention research, targeting the wider environmental determinants of diet, will give us better evidence to propose societal actions to counteract obesity and to strike the right balance between individual and societal action.

To provide current global and regional estimates of anaemia prevalence and number of persons affected in the total population and by population subgroup.

We used anaemia prevalence data from the WHO Vitamin and Mineral Nutrition Information System for 1993–2005 to generate anaemia prevalence estimates for countries with data representative at the national level or at the first administrative level that is below the national level. For countries without eligible data, we employed regression-based estimates, which used the UN Human Development Index (HDI) and other health indicators. We combined country estimates, weighted by their population, to estimate anaemia prevalence at the global level, by UN Regions and by category of human development.

Survey data covered 48·8 % of the global population, 76·1 % of preschool-aged children, 69·0 % of pregnant women and 73·5 % of non-pregnant women. The estimated global anaemia prevalence is 24·8 % (95 % CI 22·9, 26·7 %), affecting 1·62 billion people (95 % CI 1·50, 1·74 billion). Estimated anaemia prevalence is 47·4 % (95 % CI 45·7, 49·1 %) in preschool-aged children, 41·8 % (95 % CI 39·9, 43·8 %) in pregnant women and 30·2 % (95 % CI 28·7, 31·6 %) in non-pregnant women. In numbers, 293 million (95 % CI 282, 303 million) preschool-aged children, 56 million (95 % CI 54, 59 million) pregnant women and 468 million (95 % CI 446, 491 million) non-pregnant women are affected.

Anaemia affects one-quarter of the world’s population and is concentrated in preschool-aged children and women, making it a global public health problem. Data on relative contributions of causal factors are lacking, however, which makes it difficult to effectively address the problem.

To evaluate the correspondence of diet and lifestyle to the Mediterranean model in two groups of Italian and Spanish university students.

A cross-sectional nutritional survey to determine BMI, dietary habits (FFQ), energy daily expenditure and lifestyle (SenseWear® Armband; BodyMedia Inc.), and to define the Mediterranean diet quality index (MDQI) in the different student groups.

Bologna (Italy) and León (Spain).

The survey was carried out on 210 (105 Italian; 105 Spanish) university students (mean age 27·0 (sd 3·8) years) of two different Mediterranean areas, Bologna (Italy) and León (Spain).

The frequency of consumption of some food groups showed differences related to nationality and gender. Some classic Mediterranean foods such as cereals and vegetables were generally consumed more frequently by Italian students; others such as fish and pulses by Spanish students. Percentage of overweight was higher among Spanish students in spite of their higher physical activity level.

Young generations seem to give up the traditional Mediterranean dietary pattern, adopting new dietary trends. Overweight appears to be related not only to physical activity level, but also to the poor MDQI.

To describe the proportion of women reporting time is a barrier to healthy eating and physical activity, the characteristics of these women and the perceived causes of time pressure, and to examine associations between perceptions of time as a barrier and consumption of fruit, vegetables and fast food, and physical activity.

A cross-sectional survey of food intake, physical activity and perceived causes of time pressure.

A randomly selected community sample.

A sample of 1580 women self-reported their food intake and their perceptions of the causes of time pressure in relation to healthy eating. An additional 1521 women self-reported their leisure-time physical activity and their perceptions of the causes of time pressure in relation to physical activity.

Time pressure was reported as a barrier to healthy eating by 41 % of the women and as a barrier to physical activity by 73 %. Those who reported time pressure as a barrier to healthy eating were significantly less likely to meet fruit, vegetable and physical activity recommendations, and more likely to eat fast food more frequently.

Women reporting time pressure as a barrier to healthy eating and physical activity are less likely to meet recommendations than are women who do not see time pressure as a barrier. Further research is required to understand the perception of time pressure issues among women and devise strategies to improve women’s food and physical activity behaviours.

Fish is considered an important part of a healthy diet and is frequently recommended as a main course at least twice a week.

To study the frequency of fish consumption among young overweight European adults and their compliance to varying seafood consumption in weight loss intervention diets.

After meeting the inclusion criteria, the subject’s seafood intake was evaluated. Subjects were randomly assigned into four groups and were advised energy-restricted diets for 8 weeks, including no seafood (control), cod, salmon or fish oil. A validated FFQ was used to evaluate the consumption of seafood at baseline, midpoint and endpoint, and long-chain n-3 fatty acids in blood erythrocytes were measured.

Iceland, Ireland and Spain.

The sample (n 324); 20–40-year-olds with BMI = 27·5–32·5 kg/m2; 85 % participated.

At baseline, 34 % of the participants reported eating fish at least twice a week as the main course. During the intervention, six participants reported that they did not finish their fish portions, 15 % of the participants consumed small amount of fish additional to the study protocol in weeks 1–4 and 23 % in weeks 5–8 (P = 0·010). Changes in erythrocyte long-chain n-3 fatty acids confirmed good compliance, with increases in the salmon (P < 0·001) and fish oil (P < 0·001) groups, smaller increase in the cod group (P = 0·037) and decrease in the control group (P = 0·030).

Frequency of fish consumption among 66 % of young European overweight adults is lower than frequently recommended. Compliance to varying seafood consumption was good. Therefore, including more fish in the diet of this group should be encouraged.

To examine changes in the age-specific prevalence of overweight and obesity in Japanese children between 2000 and 2005 and compare Japanese centile curves with international ones.

A large, Japanese, representative cross-sectional growth study.

Japan.

Japanese children aged 5–17 years, including 669 986 subjects in 2000, 670 143 in 2001, 668 760 in 2002, 670 785 in 2003, 669 120 in 2004 and 668 234 in 2005.

BMI (weight/height2).

The prevalence of overweight and obesity in children aged 5–17 years decreased from 2000 to 2005 in both males and females, according to the definitions of the Centers for Disease Control and Prevention and the International Obesity Taskforce. For each year, the centile curves were drawn so that at age 17 years they passed through respectively 24·46 kg/m2 and 24·70 kg/m2 for males, and 29·41 kg/m2 and 29·69 kg/m2 for females, which are the BMI values at age 17 years from the international reference curves.

The study results indicate that centile curves can change according to the time of observation, thus suggesting that international reference curves therefore need to be regularly revised while including more data from a larger range of countries.

To review how countries of the WHO European Region address issues related to the catering sector in their nutrition policy plans.

Documentary analysis of national nutrition policy documents from the policy database of the WHO Regional Office for Europe by a multidisciplinary research team. Recurring themes were identified and related information extracted in an analysis matrix. Case studies were performed for realistic evaluation.

Fifty-three member states of the WHO European Region in September 2007.

The catering sector is a formally acknowledged stakeholder in national nutrition policies in about two-thirds of countries of the European region. Strategies developed for the catering sector are directed mainly towards labelling of foods and prepared meals, training of health and catering staff, and advertising. Half of the countries reviewed propose dialogue structures with the catering sector for the implementation of the policy. However, important policy fields remain poorly developed, such as strategies for stimulating and monitoring actual implementation of policies. Others are simply lacking, such as strategies to ensure affordability of healthy out-of-home eating or to enhance accountability of stakeholders. It is also striking that strategies for the private sector are rarely developed.

Important policy issues are still embryonic. As evidence is accumulating on the impact of out-of-home eating on the increase of overweight, member states are advised to urgently develop operational frameworks and instruments for participatory planning and evaluation of stakeholders in public health nutrition policy.