Intake and status of carotenoids have been associated with chronic disease. The objectives of this study were to examine the association between carotenoid intakes as measured by two regional food-frequency questionnaires (FFQs) and their corresponding measures in serum, and to report on dietary food sources of carotenoids in Jackson Heart Study (JHS) participants.

Cross-sectional analysis of data for 402 African American men and women participating in the Diet and Physical Activity Sub-Study (DPASS) of the JHS.

Mean serum carotenoid concentrations and intakes in this population were comparable to those reported for the general US population. After adjustment for covariates, correlations between serum and dietary measures of each carotenoid, for the average of the recalls (deattenuated), the short FFQ and the long FFQ, respectively, were: 0·37, 0·35 and 0·21 for α-carotene; 0·35, 0·26 and 0·28 for total (diet plus supplements) β-carotene; 0·25, 0·17 and 0·20 for dietary β-carotene; 0·42, 0·34 and 0·26 for β-cryptoxanthin; 0·33, 0·15 and 0·17 for lutein plus zeaxanthin; and 0·37, 0·19 and 0·14 for lycopene. Major dietary sources of α-carotene were orange vegetables; of β-carotene and lutein plus zeaxanthin, mustard, turnip and collard greens; of β-cryptoxanthin, orange juice; and of lycopene, tomato juice.

On average, carotenoid intakes and serum concentrations are not lower in this southern African American population than the general US population. The two regional FFQs developed for a southern US population and used as dietary assessment tools in the JHS appear to provide reasonably valid information for most of these carotenoids.

Whereas there are numerous reports in the literature relating the impact of maternal nutritional status on subsequent birth outcome, much less is known about the long-term impact on infant growth after birth. Therefore, we conducted a prospective cohort study to investigate the association of maternal micronutrient status (vitamins A, C and E, folate) and oxidative stress status in pregnancy with infant growth during the first year of life.

Prospective cohort study.

Outpatient clinic of obstetrics, Ewha Womans University Hospital, Seoul, South Korea.

Two groups were constructed for this study – the Ewha pregnancy cohort (n = 677) and the infant growth cohort comprising follow-up live newborns of all the recruited pregnant women (n = 317). Maternal serum vitamin and urinary oxidative stress levels were collected and infant weights and heights were measured at birth and at 6 and 12 months after birth.

Division of the subjects into folate-deficient and normal groups revealed that infant weight and height at 0, 6 and 12 months were adversely affected by folate deficiency. High maternal vitamin C was associated with increased infant weight and height at birth and after birth.

Our findings indicate the importance of preventing folate deficiency and supplementing vitamin C during pregnancy.

Despite the increasing dependence on systematic reviews to summarise the literature and to issue public health recommendations, the formal assessment of the reliability of conclusions emerging from systematic reviews has received little attention. The main goal of the present study was to evaluate whether two independent centres, in two continents, draw similar conclusions regarding the association of food, nutrition and physical activity and endometrial cancer, when provided with the same general instructions and with similar resources.

The assessment of reproducibility concentrated on four main areas: (1) paper search and selection; (2) assignment of study design; (3) inclusion of ‘key’ papers; and (4) individual studies selected for meta-analysis and the summary risk estimate obtained.

In total 310 relevant papers were identified, 166 (54 %) were included by both centres. Of the remaining 144 papers, 72 (50 %) were retrieved in the searches of one centre and not the other (54 in centre A, 18 in centre B) and 72 were retrieved in both searches but regarded as relevant by only one of the centres (52 in centre A, 20 in centre B). Of papers included by both centres, 80 % were allocated the same study design. Agreement for inclusion of cohort-type and case–control studies was about 63 % compared with 50 % or less for ecological and case series studies. The agreement for inclusion of 138 ‘key’ papers was 87 %. Summary risk estimates from meta-analyses were similar.

Transparency of process and explicit detailed procedures are necessary parts of a systematic review and crucial for the reader to interpret its findings.

To evaluate whether consumption of breakfast cereals is associated with BMI in a sample of Greek adolescents.

A cross-sectional health and nutrition survey.

During 2004–5, 2008 schoolchildren aged 12–17 years were selected from twelve schools located in Vyronas region (Athens metropolitan area). Height and weight were measured and BMI was calculated. A semi-quantitative FFQ was applied and multiple logistic regression analysis was used.

Overall, 4·7 % of boys and 1·7 % of girls were obese, whereas 19·4 % of boys and 13·2 % of girls were overweight. Only 20·7 % of boys and 15·5 % of girls reported that they consume cereals as a first choice for breakfast. Consumption of breakfast cereals was associated with lower BMI in boys (P = 0·08) and girls (P = 0·019), irrespective of age and physical activity status. More prominent results were observed for daily cereal consumption or for more than two daily servings of cereals consumed for breakfast. Consumption of pre-sweetened breakfast cereals was associated with lower BMI compared with non-pre-sweetened or no intake of cereals, in both genders (P < 0·001). Consumption of breakfast cereals was associated with 33 % (95 % CI 14 %, 48 %) lower likelihood of overweight/obesity, irrespective of age, sex and physical activity status.

Consumption of breakfast cereals was associated with lower BMI levels and a lower likelihood of overweight/obesity in both genders; thus a solid basis for public health professionals could be built when issuing advice on weight management.

To assess the Ca, nutrient and food intake of Greek Orthodox Christian monks during a vegetarian-type fasting week, compared with their normal diet.

Dietary data collection (using 7 d weighed food records), anthropometric and blood pressure measurements, as well as serum glucose and lipid analyses, were performed during Palm Sunday week (fasting) and the week following Pentecost Sunday (non-fasting). Mean daily nutrient and food (g/d) intakes were calculated from the food records.

The study took place in two monasteries in the Municipality of Heraklion, Crete.

The study involved ten healthy monks aged 25–65 years, with BMI > 30 kg/m2, who had been performing fasts for the last 24·4 (sd 10·4) years and lived in monasteries in Crete during April–June 2005.

Nutrient and food intake profiles were more favourable during the fasting week, when participants had lower intakes of total and saturated fat and trans-fatty acids, and higher intakes of dietary fibre, Fe, folate, legumes and fish/seafood. Ca intake was lower when participants fasted, whereas consumption of dairy products, meat and eggs increased significantly in the non-fasting week. Systolic blood pressure was significantly higher, whereas blood lipid levels were more favourable during the fasting week.

The periodic vegetarianism recommended by the Greek Orthodox Church contributes to the favourable profiles of several biomarkers of health among this sample of monks. The fasting rituals described are an important component of the traditional diet of Crete and should be emphasised in nutrition education programmes promoting this Mediterranean eating pattern.

Parents’ child-feeding behaviours have been implicated in children’s food choices and weight, but little is known about the social class distribution of parent’s child-feeding behaviours in the UK. The present study compares parents’ self-reported child-feeding behaviours in two socio-economically contrasting areas.

A cross-sectional survey using the Parental Feeding Style Questionnaire. Mean scores were calculated for five child-feeding behaviours: control over eating, emotional feeding, encouragement/prompting, instrumental feeding and restriction. Parents’ self-reported child-feeding behaviours were compared with their sociodemographic characteristics.

Three primary schools in two contrasting electoral wards of Sheffield, UK.

Two hundred and ten parents of children aged 4 to 11 years, recruited from a convenience sample.

Parents in the least deprived ward reported using all five types of child-feeding behaviour more frequently than parents in the most deprived ward. After adjusting for parent sex, parent age, single parent status, employment status and level of education, emotional feeding was the only behaviour showing any evidence of a difference between wards. The most frequently used behaviours were control, encouragement and restriction – behaviours that might be used to directly influence children’s food intake and weight.

Child-feeding behaviours differ between areas within a single city and within a largely white population, and this distribution is related to socio-economic and educational factors. Experimental and longitudinal studies are needed to further investigate the potential role of child-feeding behaviours in childhood overweight and obesity.

BMI and waist circumference (WC) are used to screen for cardio-metabolic risk; however it is unclear how well these indices perform in populations subject to childhood stunting.

To evaluate BMI and WC as indicators of cardio-metabolic risk and to determine optimal cut-off points among 1325 Guatemalan adults (44 % stunted: ≤150 cm women; ≤162 cm men).

Cardio-metabolic risk factors were systolic/diastolic blood pressure ≥130/≥85 mmHg, glucose ≥5·5 mmol/l, TAG ≥1·7 mmol/l, ratio of total cholesterol to HDL-cholesterol ≥5·0, and the presence of two or more and three or more of the preceding risk factors. Receiver operating characteristic (ROC) curve analysis was used.

Areas under the ROC curve were in the range of 0·59–0·77 for BMI and 0·59–0·78 for WC among men and 0·66–0·72 and 0·64–0·72 among women, respectively. Optimal cut-off points for BMI were 24·7–26·1 kg/m2 among men (24·5–26·1 kg/m2 stunted; 24·8–26·3 kg/m2 non-stunted) and 26·5–27·6 kg/m2 among women (26·3–27·8 kg/m2 stunted; 26·6–27·9 kg/m2 non-stunted). Optimal cut-off points for WC were 87·3–91·1 cm among men (85·3–89·4 cm stunted; 88·5–93·3 cm non-stunted) and 91·3–95·3 cm among women (90·9–94·4 cm stunted; 91·8–95·6 cm non-stunted).

Optimal cut-off points for BMI were slightly higher among women than men with no meaningful differences by stature. Optimal cut-off points for WC were several centimetres lower for stunted compared with non-stunted men, and both were substantially lower than the current recommendations among Western populations. Cut-off points derived from Western populations may not be appropriate for developing countries with a high prevalence of stunting.

To estimate the proportion of ‘healthy’ snack food and beverage choices available to an Australian consumer.

A survey of product Nutrition Information Panels (NIP) and product labels on snack foods and beverages offered for sale. Data on nutrient content were compared with criteria from different nutrient profile systems to estimate the proportion of items conforming to a ‘healthy’ choice.

A large supermarket in metropolitan Melbourne, Australia.

A consumer could choose from 1070 different snack foods and 863 different drinks. Flavour variety was more common in snacks (maximum thirteen per product) while variation in container size was more common for drinks (up to ten per product). Recommended serving size for snacks varied greatly (18–100 g) while the serving size for drinks frequently did not correspond to the size of the container. Depending on the nutrient profile system selected, only 9–22 % of snack foods presented for sale could be deemed ‘nutritious’ by multiple criteria. Similarly, only 14–27 % of beverages met ‘healthy’ criteria.

As one factor to help reduce the obesogenic environment, the supply balance needs to be shifted in favour of ‘healthier’ snack foods and beverages, e.g. by reformulation of many products by the food industry and their presentation in smaller, standardised portion-size packaging.

To identify dietary and lifestyle variables that may affect cognitive function in the elderly.

Population-based prospective cohort study.

General community residing in Athens and the surrounding Attica region of Greece.

A total of 732 men and women, 60 years or older, participating in the EPIC–Greece cohort (European Prospective Investigation into Cancer and Nutrition) and residing in the Attica region had sociodemographic, anthropometric, medical, dietary and lifestyle variables ascertained at enrolment (1993–1999). Six to 13 years later, cognitive function was evaluated through the Mini-Mental State Examination (MMSE) score and affective state through the Geriatric Depression Scale (GDS).

MMSE score was positively associated with years of formal education, height and physical activity and inversely with age, diabetes mellitus and GDS score (P < 0·05 for all). Among dietary variables, intake of PUFA was inversely associated with cognitive function and this association was largely accounted for by a similar association with seed oils. Adherence to the Mediterranean diet, as well as intake of olive oil, MUFA and SFA exhibited weakly positive but not significant associations.

Physical activity and early life factors as reflected in height are significant predictors of cognitive function in the elderly. Seed oil consumption may adversely affect cognition, whereas other nutritional factors do not appear to have a quantitatively large effect.

To advance understanding of nutrition change dynamics and strategies needed to tackle complex global nutrition challenges.

Two frameworks, a descriptive framework of orders of change and a change model (Theory U), are introduced to advance understanding of how to promote effective action on a complex social problem like nutrition. The descriptive framework explores the types of change pursued by four current global nutrition initiatives and the strategies they use to achieve their goals. Theory U provides a conceptual model to help understand breakthrough or transformative change, i.e. change that shifts the entire system.

The focus is on global and regional nutrition initiatives.

Using the criteria of desired outcomes, purpose, participation and process, the orders of change framework categorizes programme strategies according to the levels of change likely to be achieved. Such a framework can help to structure conversations among actors about prerequisites for, and the likelihood of, transformative change. Theory U provides a conceptual framework to facilitate transformative change by providing insight into change processes and levers for action.

Nutrition is a complex social issue, and not only a biological or technical challenge. But nutritionists seldom inquire into the nature of changes required to achieve goals or the processes through which change occurs. Lack of understanding and failure to address such change processes directly mean that nutrition policies and programmes continue to fall short. There is a need to understand the dynamics of change in nutrition; to learn from current change experiences; and to create dynamic learning communities.

To investigate the relationship between BMI and blood pressure as this is of crucial interest in evaluating both public health and the clinical impact of the so-called obesity epidemic.

Data were gathered from 1899 children aged between 6 and 14 years, analysing and evaluating a possible relationship between BMI and systolic and diastolic blood pressure values for both girls and boys. Each child was classified on the basis of age- and sex-specific BMI percentile as normal weight (<85th percentile), overweight (≥85th and <95th percentile) or obese (≥95th percentile).

In comparisons among age–sex–BMI percentile groups, systolic and diastolic blood pressure values were higher in obese and overweight groups than in normal weight groups for both sexes. Although BMI among girls was higher than among boys in all three percentile groups, there were no significant differences between sexes with respect to blood pressure values.

The present findings emphasize the importance of the prevention of obesity in order to prevent future related problems such as hypertension in children and adolescents.