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.

Lower levels of B vitamins (particularly folate, vitamin B12 and vitamin B6) may be associated with psychological distress. Little is known about the impact of childhood nutrition on psychological distress in adult life.

We investigated whether prospectively measured childhood and adult dietary intakes of thiamin, riboflavin, niacin, folate, vitamin B6 and vitamin B12 were related to the psychological distress of women in mid-age, taking into account socio-economic, behavioural and lifestyle factors.

Prospective data were collected from a cohort of 636 British women followed up since their birth in 1946. Participants completed a 28-item, scaled version of the General Health Questionnaire (GHQ-28) to measure psychological distress at age 53 years. Dietary intakes in childhood (at age four) were determined by 24h recall and in adulthood (at age 36, 43 and 53 years) by a 5d food record.

Low dietary vitamin B12 intake at age 53 was associated with higher psychological distress at that age. Women in the lowest third of vitamin B12 intake in adulthood had a higher GHQ-28 score compared with those in the highest third (percentage change, adjusted regression coefficient, 21 (95% CI 3, 39)). There were no other significant associations between dietary B vitamin intake in childhood or adulthood and psychological distress in the cohort.

Overall, there is evidence that intake of vitamin B12 at age 53 is related to adult psychological distress but there is no evidence for the effects of other adult B vitamin intakes or childhood intakes on psychological distress.

This exploratory study assessed how 8–13-year-old children categorised and labelled fruit and vegetables (FaV), and how these were influenced by child characteristics, to specify second-level categories in a hierarchical food search system for a computerised 24 h dietary recall (hdr).

Two sets of food cards, sixty-seven for fruit (F) and sixty-four for vegetables (V), with pictures and names of FaV from ten professionally defined food categories were sorted, separately, by each child into piles of similar foods. Demographic data, BMI and 6-n-propylthiouracil (PROP) taster status were obtained.

Participants attended the Children’s Nutrition Research Center in the summer of 2006.

In all, 152 8–13-year-old children, predominantly English-speaking, of whom sixteen were predominantly Spanish-speaking.

Children created an average of 8·5 (5·3) piles with 7·9 (11·4) cards per pile for the F, and an average of 10·1 (4·8) piles with 6·2 (7·9) cards per pile for the V. No substantial differences in Robinson clustering were detected across subcategories for each of the demographic characteristics, BMI or PROP sensitivity. Children provided clusters names that were mostly ‘Taxonomic – Professional’ labels, such as salads, berries, peppers, for both F (51·8 %) and V (52·1 %).

These categories should be tested to assess their ability to facilitate search of FaV items in a computerised 24 hdr for children in this age group.

To describe the differences in socio-economic characteristics and body measurements between low, adequate and high energy reporting (LER, AER and HER) teenagers; furthermore, to investigate the relationship to misreporting mothers.

Cross-sectional study. Habitual dietary intake was reported in a questionnaire. Classification into LER, AER and HER using the Goldberg equation within three activity groups based on physical activity questionnaire and calculated BMR.

Stockholm, Sweden.

Four hundred and forty-one 16–17-year-old teenagers (57 % girls) and their mothers.

Of the teenagers, 17–19 % were classified as HER, while 13–16 % as LER. There was a highly significant trend from HER to LER in BMI (P < 0·001) and body fat % (P < 0·001). There was also a trend in number of working hours of mother (P = 0·01), family income (P = 0·008) and number of siblings (among boys only) (P = 0·02), but not in educational level of either father or mother. HER teenagers were lean, had mothers working fewer hours with lower income and had siblings. It was more likely that an LER girl had an LER mother than an AER mother (OR = 3·32; P = 0·002).

The reasons for the high number of over-reporters could be many: misclassification due to growth, lacking established eating pattern due to young age or method-specific. Nevertheless, the inverted characteristic of HER compared to LER indicates that this is a specific group, worth further investigation.

To determine whether an educational programme aimed at discouraging students from drinking sugar-sweetened beverages could prevent excessive weight gain.

Forty-seven classes in twenty-two schools were randomised as intervention or control.

Participants were 1140, 9–12-year-old fourth graders (435 in the intervention group and 608 in the control group). Sugar-sweetened beverages and juice intake were measured through one 24 h recall at baseline and another at the end of the trial. The main outcome was the change in BMI (BMI = weight (kg)/height (m2)), measured at the beginning and at the end of the school year. Intention-to-treat analysis was performed taking into account the cluster (classes) effect.

A statistically significant decrease in the daily consumption of carbonated drinks in the intervention compared to control (mean difference = −56 ml; 95 % CI −119, −7 ml) was followed by a non-significant overall reduction in BMI, P = 0·33. However, among those students overweight at baseline, the intervention group showed greater BMI reduction (−0·4 kg/m2 compared with −0·2 kg/m2 in the control group (P = 0·11)), and this difference was statistically significant among girls (P = 0·009). Fruit juice consumption was slightly increased in the intervention group (P = 0·08), but not among girls.

Decreasing sugar-sweetened beverages intake significantly reduced BMI among overweight children, and mainly among girls. Efforts to reduce energy intake through liquids need to emphasise overall sweetened beverages and addition of sugar on juices.

The present paper reports the prevalence of underweight, overweight and obesity by gender, ethnicity and grade, among participants in a 2002 national survey among South African school-going youth that included height and weight measurements.

A stratified two-stage sample was used. Nationally representative rates of underweight, overweight and obesity were calculated using weighted survey data and compared using χ2 analysis.

In all, 9224 grade 8 to grade 11 students, present at school in selected classes within selected South African government-funded schools in all nine provinces, participated in this study. Most of the students were between 13 and 19 years of age.

Higher rates of underweight were observed for males than females as well as for black and ‘coloured’ than white students. Within each gender group, black and ‘coloured’ students had significantly higher rates of underweight than their white counterparts. Higher percentages of females than males were overweight and obese, overall and among black students. Furthermore, white male students had significantly higher rates of overweight than their black and ‘coloured’ counterparts. Among females, black and white students had significantly higher rates than ‘coloured’ students. Students in higher grades showed significantly lower rates of underweight and higher rates of overweight.

These data confirm that South Africa, a developing nation in socio-economic transition, is experiencing both undernutrition and overnutrition. However, these problems are disproportionately distributed by gender, socio-economics and ethnicity. Continued surveillance of nutritional status may be one important component of a national strategy to prevent and control malnutrition.

To examine knowledge of and adherence to the Mediterranean dietary pattern (MDP) among Greek adolescents, assess associations between MDP knowledge and adherence with BMI, and determine socio-cultural factors predicting MDP compliance.

Cross-sectional.

Greek adolescents aged 15–17 years.

Two hundred adolescents (103 females, ninety-seven males) from six schools on the Greek island of Chios. The sampling procedure was similar for all schools; schools were randomly selected from different geographic areas and all municipalities. BMI was calculated from measured height and weight; participants completed four questionnaires assessing parents’ socio-economic status and education, adolescents’ perceived and actual MDP knowledge, past-week dietary habits, and MDP adherence.

Participants’ BMI indicated 64·5 % were normal weight and 35·5 % were overweight/obese (mean BMI 23·7 (sd 3·8) kg/m2). Over half had very poor MDP knowledge (58·5 %) and adherence (59·5 %); both perceived (F = 3·35, P = 0·037) and actual MDP knowledge (F = 3·45, P = 0·034) were significantly different across MDP adherence. Perceived MDP knowledge was positively correlated with vegetable consumption (r = 0·185, P = 0·009); actual knowledge was negatively correlated with meat consumption (r = −0·191, P = 0·007). BMI was negatively correlated with family income (r = −0·202, P = 0·004), indicating higher BMI in less affluent households. Actual MDP knowledge was the only significant predictor of MDP adherence (standardized β = 0·162, P = 0·030) in a model accounting for 7·3 % of overall variance.

Greek adolescents reported consuming a more Westernized diet detached from the traditional MDP. Actual MDP knowledge and family income were important factors affecting MDP adherence and BMI, respectively. Promoting the traditional MDP among Greek adolescents and their families appears warranted.

To determine changes in ability to identify specific vegetables and fruits, and attitudes towards vegetables and fruit, associated with the introduction of a school-based food garden.

A 12-month intervention trial using a historical control (control n 132, intervention n 120), class-based, self-administered questionnaires requiring one-word answers and 3-point Likert scale responses.

A state primary school (grades 4 to 7) in a low socio-economic area of Brisbane, Australia.

The introduction of a school-based food garden, including the funding of a teacher coordinator for 11 h/week to facilitate integration of garden activities into the curriculum.

Ability to identify a series of vegetables and fruits, attitudes towards vegetables and fruit.

Frequency distributions for each item were generated and χ2 analyses were used to determine statistical significance. Exploratory factor analysis was employed to detect major trends in data.

The intervention led to enhanced ability to identify individual vegetables and fruits, greater attention to origins of produce (garden-grown and fresh), changes to perceived consumption of vegetables and fruits, and enhanced confidence in preparing fruit and vegetable snacks, but decreased interest in trying new fruits.

The introduction of this school-based food garden was associated with skill and attitudinal changes conducive to enhancing vegetable and fruit consumption. The ways in which such changes might impact on dietary behaviours and intake require further analysis.

The purpose of the present paper was to assess dietary energy reporting as a function of sex and weight status among Ontario and Alberta adolescents, using the ratio of energy intake (EI) to estimated BMR (BMRest).

Data were collected using the FBQ, a validated web-based dietary assessment tool (including a 24 h dietary recall, FFQ, and food and physical activity behavioural questions). BMI was calculated from self-reported height and weight and participants were classified as normal weight, overweight or obese. BMR was calculated using the WHO equations (based on weight). Reporting status was identified using the ratio EI:BMRest.

Data were collected in public, Catholic and private schools in Ontario and Alberta, Canada.

A total of 1917 (n 876 male and n 1041 female) students (n 934 grade 9 and n 984 grade 10) participated.

The mean EI:BMRest ratio across all participants was 1·4 (sd 0·6), providing evidence of under-reporting for the total sample. Females under-reported more than males (t = 6·27, P < 0·001), and under-reporting increased with increasing weight status for both males (F = 33·21, P < 0·001) and females (F = 14·28, P < 0·001). After removing those who reported eating less to lose weight, the EI:BMRest was 1·56 (sd 0·6) for males and 1·4 (sd 0·6) for females.

The present study highlights methodological challenges associated with self-reported dietary data. Systematic differences in under-reporting of dietary intake by gender and weight status were observed using a web-based survey, similar to observations made using paper-based 24 h recalls and dietitian interviews.

Rapidly transitioning societies are experiencing dramatic increases in obesity and cardio-metabolic risk; however, few prospective studies from developing countries have quantified these increases or described their joint relationships.

We collected dietary, physical activity, demographic, anthropometric and cardio-metabolic risk factor data from 376 Guatemalan young adults in 1997–98 (aged 20–29 years) and in 2002–04 (aged 25–34 years).

In total, 42 % of men and 56 % of women experienced weight gain >5 kg in 5 years. Percent body fat (%BF) and waist circumference (WC) increased by 4·2 % points and 5·5 cm among men, and 3·2 % points and 3·4 cm among women, respectively. Five-year increases in both %BF and WC were associated with lower physical activity, urban residence and shorter height among men but not among women (test for heterogeneity P < 0·05 for residence and physical activity). Changes in %BF and WC and concomitant changes in cardio-metabolic risk factors were similar for men and women. In standardised regression, change in %BF was associated with changes in TAG (β=0·19; 95 % CI 0·08, 0·30), total:HDL cholesterol (β=0·22; 95 % CI 0·12, 0·33) and systolic (β=0·22; 95 % CI 0·12, 0·33) and diastolic (β=0·18; 95 % CI 0·08, 0·28) blood pressure, but not with glucose; associations were similar for WC.

Over 5 years this relatively young population of Guatemalan adults experienced rapid increases in multiple measures of adiposity, which were associated with adverse changes in lipid and blood pressure levels.

We hypothesized that young adults would commonly have vitamin D deficiency and that a questionnaire could help identify subjects with the condition.

Between January and May 2004, we administered a questionnaire to a convenience sample of young adults. We measured each participant’s serum level of 25-hydroxyvitamin D (25(OH)D) using a chemiluminescent assay and defined deficiency as serum 25(OH)D < 16 ng/ml.

We recruited young adults living in Madison, Wisconsin without pre-existing conditions affecting vitamin D and/or Ca metabolism.

One hundred and eighty-four adults (mean age 24 years, 53 % women, 90 % Caucasian) participated in the study. Nearly three in four adults (71 %) had 25(OH)D level <30 ng/ml and 26 % were vitamin D-deficient. In multivariate analysis, persons reporting a suntan (OR = 0·24, 95 % CI 0·09, 0·63, P = 0·004), tanning booth use (OR = 0·09, 95 % CI 0·02, 0·43, P = 0·002) and daily ingestion of two or more servings of milk (OR = 0·21, 95 % CI 0·09, 0·48, P < 0·001) were less likely to be deficient. These three questions provided a sensitivity and specificity of 79 % and 78 %, respectively, for the presence of deficiency.

The questionnaire is moderately useful to identify young adults likely to be vitamin D-deficient. Additional revisions of the questionnaire may improve its ability to predict vitamin D deficiency.

To find the ideal combination of Fe fortifier and its food vehicle is an essential measure in developing countries. However, its cost also plays an important role. In the present study, the effect on blood parameter values of corn flour-derived products fortified with powdered elemental Fe in the form of H2-reduced Fe was investigated in children and adolescents.

One hundred and sixty-two individuals (eighty-six boys and seventy-six girls) from public educational centres in Londrina, Paraná (southern Brazil) participated in the study. Fe-deficiency anaemia (IDA) was defined when Hb and serum ferritin values fell below 12 g/dl and 20 μg/l, respectively; Fe deficiency (ID) was considered when serum ferritin was below 20 μg/l.

The prevalence of ID and IDA decreased from 18·0 % and 14·9 %, values found at the beginning of the study, to respectively 5·6 % and 1·2 % after 6 months. Changes from altered to normal values occurred more often than normal to altered values with transferrin saturation (14·2 % v. 6·8 %; P < 0·04) and ferritin (12·4 % v. 0 %; P < 0·001). Hb, transferrin saturation and ferritin showed differences between normal and altered parameters after 6 months (P < 0·001).

A pronounced reduction in the prevalence of ID and IDA was observed in children and adolescents following 6 months’ ingestion of corn flour-derived products enriched with elemental Fe.

Breakfast consumption has been associated with better mental health in adulthood, but the relationship between breakfast and mental health in adolescence is less well known. The aims of the present study were to evaluate breakfast quality in a cohort of adolescents and to investigate associations with mental health.

Cross-sectional population-based study. Breakfast quality was assessed by intake of core food groups at breakfast, as determined from 3 d food diaries. Mental health was assessed using the Child Behaviour Checklist (CBCL), with higher scores representing poorer behaviour.

The Western Australian Pregnancy Cohort (Raine) Study, Perth, Western Australia.

Eight hundred and thirty-six males and females aged between 13 and 15 years.

Mean mental health score as assessed by the CBCL was 45·24 (sd 11·29). A high-quality breakfast consisting of at least three food groups was consumed by 11 % of adolescents, while 7 % of adolescents did not consume any items from core food groups on average over the 3 d period. The two most common core food groups consumed at breakfast in this population were dairy products followed by breads and cereals. For every additional food group eaten at breakfast, the associated total mental health score decreased by 1·66 (95 % CI −2·74, −0·59) after adjustment for potential confounding factors, representing an improvement in mental health score.

These findings support the concept that breakfast quality is an important component in the complex interaction between lifestyle factors and mental health in early adolescence.

To investigate whether fruit and vegetable (F&V) intake in 11-year-olds, and social–environmental correlates of F&V intake such as parental modelling and encouragement, family food rules and home availability, differ according to general parenting styles in Belgium, The Netherlands, Portugal and Spain.

Cross-sectional study.

Primary schools in four countries.

Pupils and one of their parents completed questionnaires to measure F&V intake, related social–environmental correlates and general parenting styles. The sample size was 4555 (49·3 % boys); 1180 for Belgium, 883 for The Netherlands, 1515 for Portugal and 977 for Spain. Parenting styles were divided into authoritative, authoritarian, indulgent and neglectful.

No differences were found in F&V intake across parenting styles and only very few significant differences in social–environmental correlates. The authoritarian (more parental encouragement and more demands to eat fruit) and the authoritative (more availability of fruit and vegetables) parenting styles resulted in more favourable correlates.

Despite earlier studies suggesting that general parenting styles are associated with health behaviours in children, the present study suggests that this association is weak to non-existent for F&V intakes in four different European countries.

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.