To assess milk feeding on the maternity ward and during infancy, and their relationship to sociodemographic determinants. The validity of our 3-month questionnaire in measuring hospital feeding was assessed.

A prospective Finnish birth cohort with increased risk to type 1 diabetes recruited between 1996 and 2004. The families completed a follow-up form on the age at introduction of new foods and age-specific dietary questionnaires.

Type 1 Diabetes Prediction and Prevention (DIPP) project, Finland.

A cohort of 5993 children (77 % of those invited) participated in the main study, and 117 randomly selected infants in the validation study.

Breast milk was the predominant milk on the maternity ward given to 99 % of the infants. Altogether, 80 % of the women recalled their child being fed supplementary milk (donated breast milk or infant formula) on the maternity ward. The median duration of exclusive breast-feeding was 1·4 months (range 0–8) and that of total breast-feeding 7·0 months (0–25). Additional milk feeding on the maternity ward, short parental education, maternal smoking during pregnancy, small gestational age and having no siblings were associated with a risk of short duration of both exclusive and total breast-feeding. In the validation study, 78 % of the milk types given on the maternity ward fell into the same category, according to the questionnaire and hospital records.

The recommendations for infant feeding were not achieved. Infant feeding is strongly influenced by sociodemographic determinants and feeding practices on the maternity wards. Long-term breast-feeding may be supported by active promotion on the maternity ward.

To assess coffee consumption in the Sami and Norwegian populations and to investigate the impact of unfiltered boiled coffee consumption on serum cholesterol concentrations.

A cross-sectional study. Information was collected by self-administrated questionnaires and total serum cholesterol was analysed. Participants were divided into three ethnic groups: Sami I (Sami used as home language in the last three generations), Sami II (at least one Sami identity marker) and Norwegian.

In an area with Sami, Kven/Finnish and Norwegian populations, the SAMINOR study, 2003–2004.

A total of 5647 men and 6347 women aged 36–79 years.

More than 90 % of the study populations were coffee drinkers. Only 22 % were unfiltered coffee consumers. Sami I had the highest proportion of participants who consumed nine or more cups of unfiltered coffee per day, although the number of participants was limited. Total coffee consumption was associated with increased total cholesterol for men (P < 0·01) and women (P < 0·0001). For those who drank only unfiltered coffee, a significant association was found only in Norwegian men, adjusted for physical activity in leisure time, BMI and smoking habits (P < 0·001). From the lowest (less than five cups) to the highest (nine or more cups) unfiltered coffee consumption category, the mean total cholesterol levels increased by 0·29 mmol/l in Norwegian men.

Unfiltered coffee consumption was lower in the present study compared to previous reports. In general, total coffee consumption was positively associated with total cholesterol levels. However, for unfiltered coffee consumption, an association was found only in Norwegian men.

To validate a 204-item quantitative FFQ for measurement of nutrient intake in the Adventist Health Study-2 (AHS-2).

Calibration study participants were randomly selected from the AHS-2 cohort by church, and then subject-within-church. Each participant provided two sets of three weighted 24 h dietary recalls and a 204-item FFQ. Race-specific correlation coefficients (r), corrected for attenuation from within-person variation in the recalls, were calculated for selected energy-adjusted macro- and micronutrients.

Adult members of the AHS-2 cohort geographically spread throughout the USA and Canada.

Calibration study participants included 461 blacks of American and Caribbean origin and 550 whites.

Calibration study subjects represented the total cohort very well with respect to demographic variables. Approximately 33 % were males. Whites were older, had higher education and lower BMI compared with blacks. Across fifty-one variables, average deattenuated energy-adjusted validity correlations were 0·60 in whites and 0·52 in blacks. Individual components of protein had validity ranging from 0·40 to 0·68 in blacks and from 0·63 to 0·85 in whites; for total fat and fatty acids, validity ranged from 0·43 to 0·75 in blacks and from 0·46 to 0·77 in whites. Of the eighteen micronutrients assessed, sixteen in blacks and sixteen in whites had deattenuated energy-adjusted correlations ≥0·4, averaging 0·60 and 0·53 in whites and blacks, respectively.

With few exceptions validity coefficients were moderate to high for macronutrients, fatty acids, vitamins, minerals and fibre. We expect to successfully use these data for measurement error correction in analyses of diet and disease risk.

To describe the association between duration of exclusive breast-feeding (EBF), weight gain in infancy and childhood BMI in two populations with a long duration of EBF.

Cohort study with follow-up in childhood. Breast-feeding status was reported monthly during infancy. Weight and length were measured at birth, 2, 6 and 12 months of age, as well as in childhood at 6 or 10 years of age.

Iceland and Denmark.

Randomly selected healthy newborns from Denmark (n 85) and Iceland (n 100).

Infants exclusively breast-fed for ≤2 months gained 348 (95% CI 69, 626) g more weight from 2 to 6 months than infants exclusively breast-fed for 3–4 months (P = 0·009). Weight gain from 6 to 12 months was found to be greater among infants exclusively breast-fed for ≤2 months compared with those exclusively breast-fed for ≥5 months (P = 0·008). A greater weight change, in terms of Z-score, between the ages of 2 and 6 months was associated with higher Z-score of childhood BMI, adjusted for birth weight, country and duration of EBF (B = 0·49, se = 0·11, P < 0·001, adj. R2 = 0·15). However, the association was much stronger in the Icelandic cohort than the Danish one.

Although duration of EBF was not associated with childhood BMI in the present study it may modulate growth rate in infancy, which is related to childhood BMI. However, other factors determinative for infant growth also need to be considered when assessing the relationship of early growth and nutrition to childhood overweight, as traditions in complementary food might differ between populations.

To describe the relative validity and reliability of the FFQ used for assessing nutrient intakes of participants in the Tehran Lipid and Glucose Study (TLGS).

A total of 132 subjects (sixty-one males and seventy-one females) were included in the study. Dietary data were collected monthly by means of twelve 24 h dietary recalls (24hDR). Subjects completed two, 168-item semi-quantitative FFQ. Blood and urine samples were taken every season for measurement of plasma biomarkers and urinary N and K.

Mean age and BMI of the participants were 35·5 (sd 16·8) years and 25·5 (sd 5·2) kg/m2, respectively. The mean energy-adjusted and deattenuated correlation coefficients for overall nutrient intake between the 24hDR and FFQ2 were 0·44 and 0·37 in ≤35-year-olds and >35-year-olds, respectively, and for individual nutrients ranged from 0·24 to 0·71 in men (mean r = 0·53) and from 0·11 to 0·60 in women (mean r = 0·39). The mean energy-adjusted reliability coefficients varied from 0·48 in ≤35-year-olds to 0·65 in >35-year-olds, and ranged from 0·41 to 0·79 in men (mean r = 0·59) and from 0·39 to 0·74 in women (mean r = 0·60). The FFQ2 and 24hDR produced exact agreement rates ranging between 39·6 % and 68·3 % in men and between 39·6 % and 54·1 % in women. The ranges of questionnaire validity coefficients, with the sample correlation between the questionnaires and biochemical marker as the lower limit and the estimate obtained by the method of triads as the upper limit, were 0·21–0·56 (protein) and 0·37–0·61 (K).

The FFQ developed for the TLGS has reasonable relative validity and reliability for nutrient intakes in Tehranian adults.

To develop an index that assesses the degree of adherence to existing diet–lifestyle recommendations for preschoolers (Preschoolers Diet–Lifestyle Index (PDL-Index)) and to investigate its association with obesity.

The PDL-Index was constructed using eleven components (i.e. questions regarding the frequency of consumption of selected foods/food groups, time spent on television watching and on moderate-to-vigorous physical activities).

Scores from 0 to 4 were assigned to all components of the index. The PDL-Index total score ranged from 0 to 44. Higher values of the PDL-Index indicate greater adherence to dietary and lifestyle recommendations for preschoolers or otherwise greater adherence to healthier dietary–lifestyle patterns.

As a validation procedure, a sample of 2287 preschoolers from Greece (GENESIS study) was used.

The participants following healthier diet–lifestyle patterns (third tertile of PDL-Index) were less likely to be obese or overweight/obese compared to those following unhealthy diet–lifestyle patterns (first tertile of PDL-Index). It was observed that a 1/44 unit increase in the score of the PDL-Index was associated with approximately 5 % and 3 % lower odds of being obese and overweight/obese, respectively. Statistically significant results were observed after adjusting for potential confounders.

The suggested PDL-Index could help public health policy makers in identifying vulnerable population subgroups and developing cost-effective, targeted intervention actions both in family and preschool settings. In addition, health-care professionals can use the PDL-Index to evaluate diet quality, lifestyle and risk for overweight/obesity at an individual level and counsel parents accordingly.

Previous studies in Western populations have linked caffeine intake with health status. While detailed dietary assessment studies in these populations have shown that the main contributors to caffeine intake are coffee and tea, the wide consumption of Japanese and Chinese teas in Japan suggests that sources of intake in Japan may differ from those in Western populations. Among these teas, moreover, caffeine content varies widely among the different forms consumed (brewed, canned or bottled), suggesting the need for detailed dietary assessment in estimating intake in Japanese populations. Here, because a caffeine composition database or data obtained from detailed dietary assessment have not been available, we developed a database for caffeine content in Japanese foods and beverages, and then used it to estimate intake in a Japanese population.

The caffeine food composition database was developed using analytic values from the literature, 16 d weighed diet records were collected, and caffeine intake was estimated from the 16 d weighed diet records.

Four areas in Japan, Osaka (Osaka City), Okinawa (Ginowan City), Nagano (Matsumoto City) and Tottori (Kurayoshi City), between November 2002 and September 2003.

Two hundred and thirty Japanese adults aged 30–69 years.

Mean caffeine intake was 256·2 mg/d for women and 268·3 mg/d for men. The major contributors to intake were Japanese and Chinese teas and coffee (47 % each). Caffeine intake above 400 mg/d, suggested in reviews to possibly have negative health effects, was seen in 11 % of women and 15 % of men.

In this Japanese population, caffeine intake was comparable to the estimated values reported in Western populations.

To assess and compare the food consumption and nutrient intake between 3-year-old children cared for at home full-time and those attending day care outside the home. Nutrient intake on weekdays and weekends was also studied.

Cross-sectional sample of children invited to the nutrition study within the Type 1 Diabetes Prediction and Prevention (DIPP) birth cohort born in 2001. Families returned 3-d food record completed close to the child’s third birthday.

A total of 471 pre-school children aged 3 years of whom 285 had only been cared for at home during the recording time and 186 had attended day care outside the home.

Among the children cared for outside the home, there were more consumers of recommendable foods as fresh vegetables, fruits, berries, rye bread, fish, skimmed milk and vegetable margarines, than among those cared for at home. The day-care group had higher intake of protein, dietary fibre, thiamine, potassium and magnesium, and lower intake of sucrose compared with the group cared for at home. Adjustment for sociodemographic factors did not change the results. In all children, food consumption was more varied on weekdays compared with weekends. On weekdays, children had higher intake of dietary fibre and protein and lower intake of sucrose compared to weekends.

The type of day care was associated with food consumption and nutrient intake among pre-school children and hence might have an impact on their nutrition and health. The diet of the children attending day care outside the home was more balanced and closer to the national recommendations.

Obesity in children is a serious public health issue in Greece. The purpose of the current study was to identify risk factors such as birth weight, breast-feeding, dietary patterns, family history of obesity and sedentary behaviours that are possibly associated with paediatric obesity.

Two hundred and five overweight and obese children (OW/OB; group 1) aged 7–15 years from eight primary and secondary schools and a control group (group 2) of normal-weight children were matched for age and sex. Overweight and obesity were calculated based on the International Obesity Taskforce criteria. Lifestyle parameters as well as anthropometric data were collected in all children. Conditional logistic regression analysis was used to identify risk factors for obesity.

Breast-feeding (≥3 months) and leisure-time physical activity proved to be protector factors against obesity (OR = 0·21, 95 % CI 0·11, 0·79, P < 0·001 and OR = 0·87, 95 % CI 0·85, 0·89, P < 0·001 respectively). On the other hand, family history of obesity (OR = 3·79, 95 % CI 2·61, 4·18, P < 0·001), sugar-sweetened beverage consumption (OR = 1·77, 95 % CI 1·03, 2·76, P < 0·001) and watching television (OR = 1·99, 95 % CI 1·54, 2·76, P = 0·04) were found to be positively associated with a higher obesity risk.

The current findings support the literature according to which duration of breast-feeding (<3 months), a family history of obesity, watching television, sedentary lifestyle and consumption of sugar-sweetened beverages are important risk factors for childhood obesity. More studies are needed to elucidate the relationship of paediatric obesity and possible predictor factors in order to avoid health consequences in these children later on in life.

Only a few cross-sectional studies have assessed the association between coffee, tea and caffeine and the risk of depression. Our aim was to determine the association in a population-based cohort study.

The population-based Kuopio Ischaemic Heart Disease Risk Factor Study cohort was recruited between 1984 and 1989 and followed until the end of 2006. We investigated the association between the intake of coffee, tea and caffeine and depression.

Eastern Finland.

Middle-aged men (n 2232).

Altogether, forty-nine men received a discharge diagnosis of depression. We classified subjects into quartiles according to their mean daily coffee intake: non-drinkers (n 82), light drinkers (<375 ml/d, n 517), moderate drinkers (375–813 ml/d, n 1243) and heavy drinkers (>813 ml/d, n 390). Heavy drinkers had a decreased risk (RR = 0·28, 95 % CI 0·08, 0·98) for depression when compared with non-drinkers, after adjustment for age and examination years. Further adjustment for socio-economic status, alcohol consumption, smoking, maximal oxygen uptake, BMI and the energy-adjusted daily intakes of folate and PUFA did not attenuate this association (relative risk (RR) = 0·23, 95 % CI 0·06, 0·83). No associations were observed between depression and intake of tea (drinkers v. non-drinkers; RR = 1·19, 95 % CI 0·54, 2·23) or caffeine (highest quartile v. lowest quartile; RR = 0·99, 95 % CI 0·40, 2·45).

Coffee consumption may decrease the risk of depression, whereas no association was found for tea and caffeine intake.

The purpose was to update the Healthy Eating Index-C (HEI-C) with Canada’s new food guide recommendations (HEIC-2009) and compare scores and ratings among a small sample of grade 6 students.

Updates to the HEI-C were completed with Canada’s new food guide recommendations for daily number of servings. HEI-C and HEIC-2009 scores were computed for a small sample (n 405) of grade 6 students utilizing nutrition data that were collected using the Food Behaviour Questionnaire, a validated web-based dietary assessment tool (including a 24 h dietary recall, FFQ, and food and physical activity behavioural questions).

Data were collected in fifteen schools in the Region of Waterloo District School Board, Ontario, Canada.

A total of 405 students (48 % males and 52 % females) from grade 6 classrooms completed the web-based survey.

The index scores revealed that participants scored higher (74·5 v. 69·6, P < 0·001) using the HEIC-2009 compared with the HEI-C, even though both index scores are rated in the ‘needs improvement’ category (HEIC-2009, 75 %; HEI-C, 71 %). A small group of participants (n 14), who were previously rated (using the HEI-C) in the ‘poor’ category, were rated in the ‘needs improvement’ category using the HEIC-2009 (χ2 = 589·647, df = 4, P < 0·001).

The HEIC-2009 has the potential to be used as a population-level diet quality index in Canada.

Although diet is a modifiable lifestyle factor to reduce abdominal obesity risk, the relationship between the Health Eating Index (HEI) and waist circumference (WC) has not been studied. The present study aimed to describe relationships between the HEI and abdominal obesity among adults.

Secondary data analysis of a cross-sectional national survey, the Third National Health and Nutrition Examination Survey (NHANES III). The HEI data, including the total HEI score and HEI component scores, were collected with a 24 h recall. WC measures were taken during a physical examination. Abdominal obesity was defined as WC ≥ 102 cm for men and WC ≥ 88 cm for women. Other covariates were collected during an interview.

In total 15 658 US adults, men (n 7470) and non-pregnant women (n 8188).

The odds of abdominal obesity was 8·3 % (95 % CI 1·8, 14·9 %, P = 0·014) lower for women and 14·5 % (95 % CI 6·8, 21·9 %, P ≤ 0·001) lower for men with each 10-unit increase in total HEI score (HEI scale, 0–100). For each point increase for the fruit score, abdominal obesity risk decreased by 2·6 % (95 % CI 0·8, 4·4 %, P = 0·007) for women. Abdominal obesity risk decreased for men with each point increase in saturated fat and variety scores, by 3·1 % (95 % CI 0·1, 6·0 %, P = 0·042) and 4·0 % (95 % CI 0·1, 7·7 %, P = 0·043) respectively.

Dietary consumption that follows the HEI is associated with a lower risk for abdominal obesity.

To evaluate the reproducibility of a semi-quantitative FFQ used in the Seguimiento Universidad de Navarra (SUN) project.

The data that were analysed were collected from an FFQ answered twice by a 326-participant subsample of the SUN project (115 men, 35·3 %; 211 women, 64·7 %), with either less than 1 year or more than 1 year between responses. The questionnaire included 136 items. Pearson correlation coefficients (r) were calculated to evaluate the magnitude of the association between both measures after energy adjustment and correcting for within-person variability. We also evaluated misclassification by quintiles distribution.

The highest corrected correlations among participants who answered before 1 year were found for PUFA (r = 0·99). Among participants who answered after 1 year between both questionnaires, olive oil had the highest corrected correlation (r = 0·99). The highest percentage of gross misclassification, lowest quintile in FFQ1 and highest quintile in FFQ2 or highest quintile in FFQ1 and lowest quintile in FFQ2 was for cereals, fish or seafood, and n-3 fatty acids (7·6 %). Alcoholic drinks had the highest percentage of reasonable classification, same or adjacent quintile, in FFQ1 and FFQ2 (86·4 %).

Our study suggests that FFQ reproducibility is acceptable for participants who answered the same questionnaire twice less than 1 year apart. Participants who answered FFQ more than 1 year apart showed worse values on reproducibility. We consider this Spanish FFQ as an important, valid and reproducible tool in nutritional epidemiology.

To quantify marine food product consumption and EPA + DHA intake among Quebecers, and to compare the results with the most recent recommendations.

Data were obtained from a representative cross-sectional telephone survey (June 2006). Intakes of marine food product species and EPA + DHA were estimated from a validated FFQ on the consumption of marine food products during the previous month. Prevalence of fish oil consumption in the last 6 months was also assessed.

Province of Quebec (Canada).

A representative sample (n 1001) of adults in the province of Quebec. Of these, eight were excluded from the present analysis (n 993).

Mean and median EPA + DHA intakes for all participants were estimated to be 291 mg/d (sem 11) and 207 mg/d, respectively. 85·0 % (95 % CI 82·7, 87·3) of Quebecers had an EPA + DHA intake lower than 500 mg/d, which is the amount internationally recommended for the prevention of CVD. Mean and median DHA intakes among women of childbearing age (n 128, 18–34 years) were estimated to be 169 mg/d (sem 17) and 126 mg/d, respectively. Of these women, 27·7 % had a daily intake >200 mg DHA and 15·9 % had an intake >300 mg DHA. We noted that 13 % of Quebecers take ≥1 capsule of fish oil/d.

Consumption of marine food products and EPA + DHA among Quebecers clearly appears to be lower than international recommendations. Since EPA + DHA confer health benefits and may reduce health costs, strategies to increase their consumption should be implemented to improve public health in Quebec.

The present study evaluates the reliability and validity of an FFQ designed for use with adolescents in urban Vietnam.

A cohort study was conducted between December 2003 and June 2004. The FFQ was administered three times over a 6-month period (FFQ 1–3) and nutrient intakes were compared to those obtained from four 24 h recalls collected over the same period (24 h recalls 1–4) using crude, energy-adjusted and de-attenuated correlation coefficients. The level of agreement between the two measurements was also evaluated with Bland–Altman analysis. The percentage of nutrient intakes classified within one quintile, as well as quadratic-weighted kappa statistics, were calculated.

Ho Chi Minh City, Vietnam.

A total of 180 students were recruited in three junior high schools.

Coefficients ranged from 0·22 for retinol to 0·78 for fibre for short-term reliability, and from 0·30 for retinol to 0·81 for zinc for long-term reliability. Coefficients for nutrient intakes between the mean of the three FFQ and mean of four 24 h recalls were mostly around 0·40, but higher for energy-adjusted nutrients. After allowing for within-person variation, the mean coefficient was 0·52 for macronutrients and 0·46 for micronutrients. There were a relatively high proportion of nutrient intakes classified within one quintile and a small number grossly misclassified. Kappa values shows ‘fair’ to ‘good’ agreement for all food/nutrient categories, while the Bland–Altman plots indicated that the FFQ is accurate in assessing nutrient intake at a group level.

This newly developed FFQ is a valid tool for measuring nutrient intake in adolescents in urban Vietnam.

To identify the correlates of the home food environment (parents’ intake, availability and food-related parenting practices) at the age of 10 years with dietary patterns during childhood and in adolescence.

Primary-school children of fifty-nine Flemish elementary schools completed a questionnaire at school in 2002. Four years later they completed a questionnaire by e-mail or mail at home. Their parents completed a questionnaire on food-related parenting practices at baseline.

Longitudinal study.

The analyses included 609 matched questionnaires.

Multi-level regression analyses were used to identify baseline parenting practices (pressure, reward, negotiation, catering on demand, permissiveness, verbal praise, avoiding negative modelling, availability of healthy/unhealthy food items and mothers’ fruit and vegetable (F&V) and excess scores) associated with children’s dietary patterns (F&V and excess scores).

Mother’s F&V score was a significant positive independent predictor for children’s F&V score at baseline and follow-up, whereas availability of unhealthy foods was significantly negatively associated with both scores. Negotiation was positively associated with children’s follow-up score of F&V, while permissiveness was positively associated with children’s follow-up excess score. Availability of unhealthy foods and mother’s excess score were positively related to children’s excess score at baseline and follow-up.

Parental intake and restricting the availability of unhealthy foods not only appeared to have a consistent impact on children’s and adolescents’ diets, but also negotiating and less permissive food-related parenting practices may improve adolescents’ diets.

To provide an overview of the household dietary diversity score and the food consumption score, two indicators used for food security assessment and surveillance, and compare their performance in food security assessments in three countries.

Cross-sectional cluster sampling design using an interview-administered structured questionnaire on household food security, including household-level food group consumption measured over 1 d and 7 d.

Survey data are from Burkina Faso, Lao People’s Democratic Republic (Lao PDR) and northern Uganda.

Households in Burkina Faso (n 3640), Lao PDR (n 3913) and northern Uganda (n 1956).

Spearman’s correlation coefficients between the scores were 0·73 in Burkina Faso, 0·65 in Lao PDR and 0·53 in northern Uganda. Prevalence-adjusted kappa coefficients showed substantial strength of agreement in two countries. The proportion of agreement between the two scores ranged from 85 % in Lao PDR to 65 % in northern Uganda. Dietary profiles based on food group consumption using score tertiles were comparable. Rankings of the most food-insecure areas within a country corresponded well in northern Uganda and Burkina Faso but not in Lao PDR. Both indicators showed moderate correlations with other proxy measures of food security.

The comparative study highlights the similarities and differences between the food consumption and household dietary diversity scores. Similar classification of the most food-insecure areas within sub-national levels was obtained. The choice of indicator for food security assessment and surveillance will vary depending on user needs.

To investigate barriers to increasing fruit and vegetable (f + v) intakes in a large sample of the older population of Northern Ireland (NI), in relation to current intakes.

The study was conducted using a telephone survey assessing f + v intakes, barriers to increasing intakes and various demographic and lifestyle characteristics. Barriers to increasing intakes were investigated using twenty-two closed-response items and one open-response item.

NI.

Four hundred and twenty-six older people from NI, representative of the older population of NI.

Principal component analysis of the twenty-two closed-response items revealed five factors affecting f + v consumption. Significant associations with current intakes were found where greater f + v consumption was associated with greater ‘liking’ for f + v (B = 0·675, P < 0·01), greater ‘awareness of current recommendations’ for consumption (B = 0·197, P < 0·01) and greater ‘willingness to change’ (B = 0·281, P < 0·01). ‘Ease of consumption’ and ‘difficulties in achieving consumption’ were not associated with f + v intakes. Similar associations between f + v intakes and ‘liking’ and ‘awareness’ were also found in those consuming low intakes of f + v or those at risk of consuming low intakes. Low awareness and knowledge of recommendations were also found in response to the open-ended question in all groups, although some weight was also given here to environmental difficulties, such as cost and access.

These findings suggest that interventions aiming to increase f + v intakes in the older population of NI should focus predominantly on improving liking and improving knowledge and awareness of current recommendations.

To describe how the time spent in food-related activities by Americans has changed over the past 30 years.

Data from four national time diary surveys, spanning 1975–2006, are used to construct estimates of trends in American adults’ time spent in food-related activities. Multivariate Tobits assess how food-related activities have changed over time controlling for sociodemographic and economic covariates.

Both bivariate and multivariate estimates reveal that between 1975 and 2006, American women’s time spent in food preparation declined substantially, whereas the time spent in these activities by American men changed very little. On the contrary, grocery shopping time increased modestly for both men and women. The primary eating time (i.e. time when eating/drinking was the respondent’s main focus) declined for both men and women over this historical period, and the composition of this time changed with less primary eating time being done alone. Concurrently, secondary eating time (i.e. time when something else had the respondent’s primary attention, but eating/drinking simultaneously occurred) rose precipitously for both women and men between 1975 and 1998.

The total time spent in eating (i.e. primary plus secondary eating time) has increased over the past 30 years, and the composition of this time has shifted from situations in which energy intake can be easily monitored to those in which energy intake may be more difficult to gauge. Less time is also being spent in food preparation and clean-up activities. Future research should explore possible links between these trends and Americans’ growing obesity risk.

Some versions of restaurant menu labelling legislation do not require energy information to be posted on menus for drive-through lanes. The present study was designed to quantify the number of customers who purchase fast food through drive-in windows as a means of informing legislative labelling efforts.

This was an observational study.

The study took place at two McDonald’s and Burger King restaurants, and single Dairy Queen, Kentucky Fried Chicken, Taco Bell and Wendy’s restaurants.

The number of customers entering the chain restaurants and purchasing food via the drive-through lane were recorded. A total of 3549 patrons were observed.

The percentage of customers who made their purchases at drive-throughs was fifty-seven. The overall average (57 %) is likely a conservative estimate because some fast-food restaurants have late-night hours when only the drive-throughs are open.

Since nearly six in ten customers purchase food via the drive-through lanes, menu labelling legislation should mandate the inclusion of menu labels on drive-through menu boards to maximise the impact of this public health intervention.