To compare nutrient profile models with a standard ranking of 120 foods.

Over 700 nutrition professionals were asked to categorise 120 foods into one of six positions on the basis of their healthiness. These categorisations were used to produce a standard ranking of the 120 foods. The standard ranking was compared with the results of applying eight different nutrient profile models to the 120 foods: Models SSCg3d and WXYfm developed for the UK Food Standards Agency, the Nutritious Food Index, the Ratio of Recommended to Restricted nutrients, the Naturally Nutrient Rich score, the Australian Heart Foundation's Tick scheme, the American Heart Association's heart-check mark and the Netherlands tripartite classification model for foods. Rank correlation was assessed for continuous models, and dependence was assessed for categorical models.

The continuous models each showed good correlation with the standard ranking (Spearman's ρ = 0.6–0.8). The categorical models achieved high χ2 results, indicating a high level of dependence between the nutrition professionals' and the models' categorisations (P < 0.001). Models SSCg3d and WXYfm achieved higher scores than the other models, implying a greater agreement with the standard ranking of foods.

The results suggest that Models SSCg3d and WXYfm rank and categorise foods in accordance with the views of nutrition professionals.

To characterise misreporters of energy intake (EI) and energy expenditure (EE).

Cross-sectional study, using a validated position and motion instrument, ActiReg®, as the reference method to study misreporters of EI and of EE. EI was measured using a dietary record and EE using a physical activity questionnaire (PAQ). Misreporters were defined as subjects outside the 95% confidence limits of agreement between EI or EE reported/EE measured.

Free-living Danish volunteers.

One hundred and thirty-eight volunteers aged between 20 and 59 years.

Body mass index, smoking, ‘try to eat healthily’ and worries about weight were related to degree of under-reported EI. The percentage energy from added sugar was lowest (P < 0.001) and the percentage energy from protein (P < 0.001) highest in under-reporters compared with acceptable reporters. Subjects who reported being very physically active at work or in leisure time reported a higher EE than measured EE compared with less physically active subjects (P < 0.05). Likewise, subjects who regard themselves as fit or very fit reported a higher EE than subjects who regard themselves as moderately fit (P < 0.05). Possible over-reporters reported less time as very light activity (P = 0.007), more time as moderate activity (P = 0.01) and more time as vigorous activity (P = 0.02) than acceptable reporters.

Under-reporting of EI should always be taken into consideration; however, only a few characteristics of under-reporters are consistent among studies. Misreporting of EI was more prevalent than misreporting of EE. The level of physical activity more than the time spent involved in various activities was misreported.

Little is known about the relationship of monetary diet costs to dietary intake and obesity, particularly in non-Western populations. This study examined monetary cost of dietary energy in relation to diet quality and body mass index (BMI) among young Japanese women.

Dietary intake was assessed by a validated, self-administered, diet history questionnaire. Diet costs were estimated using retail food prices. Monetary cost of dietary energy (Japanese yen 1000 kcal−1) was then calculated. BMI was computed from self-reported body weight and height.

A total of 3931 female Japanese dietetic students aged 18–20 years.

Monetary cost of dietary energy was positively associated with intakes of fruits, vegetables, fish and shellfish, and pulses; however, higher monetary cost of dietary energy was also associated with higher consumption of fat and oil, meat and energy-containing beverages, and lower consumption of cereals (rice, bread and noodles) (all P for trend <0.01). At the nutrient level, monetary cost of dietary energy was positively associated with intakes of dietary fibre and key vitamins and minerals, but also associated positively with intakes of fat, saturated fatty acids, cholesterol and sodium, and negatively with carbohydrate intake (all P for trend <0.0001). After adjustment for possible confounders, monetary cost of dietary energy was quite weakly but significantly negatively associated with BMI (P for trend = 0.0197).

Increasing monetary cost of dietary energy was associated with both favourable and unfavourable dietary intake patterns and a quite small decrease in BMI in young Japanese women.

To conduct a needs assessment of all aspects of food provision in a residential home and to evaluate a subsequent nutrition intervention.

An intervention study using a before and after design. A participatory approach was adopted and quantitative and qualitative methods used throughout. The intervention involved a revised menu, kitchen equipment, and establishing wholesale shopping and food donations.

A residential home for senior citizens in Guyana.

Meals at the home were nutritionally inadequate and deeply unpopular with the residents. Intakes of fruits and vegetables were low and the home was heavily reliant on donated soya mince and rice. Meals were served within an eight-hour period to accommodate the staff's hours of work. Cutbacks in the food budget indicated that the financial state of the home explained some of the problems. The intervention was unable to address all problems identified, but led to substantial improvements in the nutritional adequacy of the food provided following the inclusion in the menu of a number of nutrient-dense foods such as chicken liver. The new menu was acceptable to the cooks and largely popular with the residents, although some problems persisted.

The results show that improvements in the nutrient profile of the diet could be achieved with a flexible, community-based, participatory approach that addressed all elements of a home's food provision system. The changes also proved largely popular with the residents, thus potentially contributing to their quality of life.

Valid dietary data are essential when trying to identify whether or not one or more dietary exposures are responsible for disease. We examined diet composition in women who reported dietary change in the past compared with non-changers, and how the associations between dietary factors and postmenopausal breast cancer are influenced by dietary change, obesity status and misreporting of energy.

A population-based prospective cohort study. Data were obtained by a diet history method, anthropometrical measurements and an extensive lifestyle questionnaire including items on past food habit change.

The Malmö Diet and Cancer (MDC) study, conducted in Malmö, Sweden.

A subsample of 12 781 women from the MDC cohort recruited from 1991 to 1996. A total of 428 postmenopausal women were diagnosed with incident breast cancer, during 9.2 years of follow-up.

Past food habit changers reported healthier food habits and lower energy intake compared with non-changers, a finding that raises issues regarding possible reporting biases. When excluding diet changers, the trend of increased breast cancer risk across omega-6 fatty acid quintiles was stronger, and a tendency of decreased risk emerged for ‘fruit, berries and vegetables’. When excluding individuals with non-adequate reports of energy intake, risk estimates were similar to that of the whole sample. In women with body mass index < 27 kg m− 2, significant trends of increased breast cancer risk were seen for total fat and omega-6 fatty acids, and of decreased risk for ‘fruit, berries and vegetables’.

This study indicates that both obesity and self-reported past food habit change may be important confounders of diet–breast cancer relationships. The study demonstrates that sensitivity analysis, through stratification, may facilitate interpretation of risk relationships and study results.

A comparison of a parent-completed Willett food-frequency questionnaire (FFQ) and a self-completed Youth/Adolescent Questionnaire (YAQ) has not yet been conducted.

In the Diabetes Autoimmunity Study in the Young (DAISY), parents report their child's diet on the FFQ annually from birth until age 10 years, when the child begins to report their own diet using the YAQ.

To determine the comparability of these collection methods, 89 children aged 10–17 years and their parents completed the YAQ and FFQ, respectively, for the child's previous year's diet.

We compared reported intakes for energy, the macronutrients and a variety of micronutrients of interest to the DAISY study.

Bland–Altman plots of energy-adjusted differences between questionnaire responses against their means suggested that the two collection methods gave similar results. The average Spearman correlation coefficient of all energy-adjusted nutrient intakes was 0.50, and did not differ significantly by gender (males, r = 0.48; females, r = 0.46) or age (10–11 years, r = 0.49; 12–17 years, r = 0.51). While correlated, the nutrient values from the FFQ were higher than the nutrient values from the YAQ.

While reported nutrient intakes are correlated, an indicator variable defining which survey method a nutrient was collected with should be included in any longitudinal data analyses examining nutrient intakes collected with the YAQ and the FFQ as independent predictors of a disease outcome.

To determine the relationship of diet to overweight and obesity among populations of African origin.

Cross-sectional data were obtained from adults aged 25–74 years in rural Cameroon (n = 686), urban Cameroon (n = 975), Jamaica (n = 924) and Afro-Caribbeans in the UK (n = 257). Dietary data were collected using food-frequency questionnaires specifically designed for each site. Body mass index (BMI) was used as a measure of overweight.

The expected gradient in the distribution of overweight across sites was seen in females (rural Cameroon, 9.5%; urban Cameroon, 47.1%; Jamaica, 63.8%; UK, 71.6%); however, among males overweight was less prevalent in Jamaica (22.0%) than urban Cameroon (36.3%). In developing countries increased risks of overweight (BMI ≥ 25 kg m− 2) were influenced by higher energy (urban Cameroonian men) and protein (Jamaican women) intakes. No dietary variables were associated with obesity (BMI ≥ 30 kg m− 2) in Cameroon or Jamaica. In the UK, energy intakes were inversely related with overweight whereas increased risks of being overweight were associated with higher protein (men) and fat (women) intakes. Similarly, whereas higher protein and fat intakes in UK men and women were associated with obesity, carbohydrate intakes were associated with decreased risks of obesity in men.

Diet and overweight were associated in the UK but few dietary variables were related to overweight in Jamaica and the Cameroon. These findings suggest that associations between diet and overweight/obesity are not generalisable among populations.

The purpose of the present study was to examine the prevalence of fast-food purchases for family meals and the associations with sociodemographic variables, dietary intake, home food environment, and weight status in adolescents and their parents.

This study is a cross-sectional evaluation of parent interviews and adolescent surveys from Project EAT (Eating Among Teens).

Subjects included 902 middle-school and high-school adolescents (53% female, 47% male) and their parents (89% female, 11% male). The adolescent population was ethnically diverse: 29% white, 24% black, 21% Asian American, 14% Hispanic and 12% other.

Results showed that parents who reported purchasing fast food for family meals at least 3 times per week were significantly more likely than parents who reported purchasing fewer fast-food family meals to report the availability of soda pop and chips in the home. Adolescents in homes with fewer than 3 fast-food family meals per week were significantly more likely than adolescents in homes with more fast-food family meals to report having vegetables and milk served with meals at home. Fast-food purchases for family meals were positively associated with the intake of fast foods and salty snack foods for both parents and adolescents; and weight status among parents. Fast-food purchases for family meals were negatively associated with parental vegetable intake.

Fast-food purchases may be helpful for busy families, but families need to be educated on the effects of fast food for family meals and how to choose healthier, convenient family meals.

The purpose of this study was to assess the 10-year trend in lipid and antioxidant vitamin levels in the Catalan population from 1992 to 2003.

Two cross-sectional surveys were carried out in Catalonia, Spain, during 1992–93 and 2002–03. A subsample of the individuals participating in the surveys agreed to undergo a biochemical evaluation.

Eight hundred and eighty individuals (393 males and 487 females) in the 1992–93 nutritional survey and 429 individuals (205 males and 224 females) in the 2002–03 nutritional and health survey. The subjects’ ages ranged from 18 to 74 years.

Mean total cholesterol decreased from 5.3 to 5.1 mmol l−1 (P < 0.005), and the prevalence of hypercholesterolaemia decreased, especially in males (from 23% to 10% in males from 50 to 64 years old, P < 0.05). Mean cholesterol high-density lipoprotein (HDL) values decreased in the entire sample (from 1.4 to 1.3 mmol l−1, P < 0.001) and there was an increase in the percentage of population with low values of HDL (from 10% to 19%, P < 0.001). An increase in the percentage of the population with values of α-tocopherol at marginal risk levels (from 6% to 9%) and with low values of β-carotene (from 59% to 66%) was observed. The mean values for retinol increased in both males (from 1.99 to 2.44 μmmol l−1, P < 0.001) and females (from 1.69 to 2.29, P < 0.001).

Although there was a decrease in the percentage of population with hypercholesterolaemia, the decrease in HDL cholesterol worsened the lipid profile of the Catalan population. The increase in the values of some antioxidant vitamins did not affect the entire population since an increase in the number of individuals with marginal values was observed.

To examine how Australian children's reported everyday food preferences reflect dietary recommendations, and the impact of sociodemographic factors on these associations.

Cross-sectional survey.

Three hundred and seventy-one parents of children aged 2–5 years, recruited from three socio-economic groups in two Australian cities, completed a survey on their child's liking for 176 foods and drinks on a 5-point Likert scale in addition to demographic descriptors. Preferences were compared with the recommendations of the Dietary Guidelines for Children and Adolescents in Australia and the Australian Guide to Healthy Eating.

Foods in the Extra Foods (non-nutritious foods) and Cereals groups of the Australian Guide to Healthy Eating were highly liked (mean: 4.02 and 4.01, respectively), whilst foods in the Vegetables group were liked least (mean: 3.01). A large percentage of foods in the Cereals and Extra Foods groups were liked (64% and 56%, respectively) in contrast to the other food groups, especially Vegetables (7%). Children liked foods that were higher in sugar (r = 0.29, P < 0.0001) and more energy-dense (r = 0.34, P < 0.0001) but not those higher in saturated fat (r = 0.16, P = 0.03), total fat (r = 0.12, P = 0.12) or sodium (r = 0.10, P = 0.18). Sociodemographic variables (e.g. socio-economic status, parental education, children's age and sex) explained little of the variation in children's food preferences.

Australian pre-school children's food preferences align with dietary guidelines in some respects, but not others. Interventions are needed to shift children's preferences away from non-nutritious foods that are high in energy density and sugar, and towards vegetables and fruits.

To summarise the discussions of a seminar on peer-led approaches to dietary change held at the Food Standards Agency (FSA) on 19 July 2006.

Following presentations on three FSA-commissioned research projects involving peer-led dietary interventions, discussions in small workshop groups identified learning points for researchers, policy-makers and practitioners and considered how the findings of such studies can be effectively communicated to each of these groups. The target groups in the three separate projects were: older people living in sheltered accommodation; mothers and babies during the weaning period; and people with diabetes.

The projects discussed here were quite different from one another, involving three separate populations, having different aims and approaches and different styles of peer leading. Their effectiveness in achieving quantitative dietary change was disappointing. However, results for some of the qualitative outcomes (social, psychological, behavioural) were more positive. Process evaluation, whether built in or post hoc, provided useful learning to inform future projects and potentially improve their effectiveness and usefulness for researchers, policy-makers and health promotion practitioners.

The projects discussed here showed that peer-led interventions can achieve positive changes in outcomes such as knowledge, confidence and attitudes, as well as small improvements in diet. They also demonstrated that there is a need for a more sophisticated analysis of peer-led interventions that recognises the diversity of approaches and their suitability in different situations.

To evaluate the association between overweight and wheezing in pre-school children in 14 small Brazilian communities.

Cross-sectional epidemiological study, conducted between 2001 and 2002. A sample of 3453 children under 5 years of age was taken from nine communities in the state of Bahia and five in the state of São Paulo. Data on housing, family and children were obtained by applying structured questionnaires in loco. Weight and height for each child were also measured. The association between wheezing and overweight was assessed by unconditional logistic multivariate regression models.

Overweight children had a greater frequency of wheezing and an odds ratio of 2.57 (95% confidence interval 1.51–4.37) was estimated after controlling for several potential confounding variables. The magnitude of the risk was not affected by several different model specifications.

Excess weight is associated with increased risk for wheezing in this population of children below 5 years of age.

To evaluate the effects of a middle-school healthy eating promotion intervention combining environmental changes and computer-tailored feedback, with and without an explicit parent involvement component.

Clustered randomised controlled trial.

Fifteen West-Flemish (Belgian) middle schools.

A random sample of 15 schools with 2991 pupils in 7th and 8th grades was randomly assigned to an intervention group with parental support (n = 5), an intervention group without parental support (n = 5) and a control group (n = 5). In these 15 schools an intervention combining environmental changes with computer-tailored feedback was implemented. Fat and fruit intake, water and soft drinks consumption were measured with food-frequency questionnaires in the total sample of children.

In girls, fat intake and percentage of energy from fat decreased significantly more in the intervention group with parental support, compared with the intervention alone group (all F>3.9, P < 0.05) and the control group (all F>16.7, P < 0.001). In boys, there were no significant decreases in fat intake (F = 1.4, not significant (NS)) or percentage of energy from fat (F = 0.7, NS) as a result of the intervention. No intervention effects were found in boys or in girls for fruit (F = 0.5, NS), soft drinks (F = 2.6, NS) and water consumption (F = 0.3, NS).

Combining physical and social environmental changes with computer-tailored feedback in girls and their parents can induce lower fat intake in middle-school girls. However, to have an impact on the consumption of soft drinks and water, governmental laws that restrict the at-school availability of low-nutritive products may be necessary.

This study aimed to investigate the frequency of overweight and obesity among Iranian adolescent girls aged 14–17 years and its possible association with maternal education in Rasht city in 2005.

A cross-sectional survey on 1054 schoolgirls.

High schools in Rasht city, Iran.

A multistage sampling method was used and 1054 randomly selected schoolgirls were studied. Data on age and mother's years of schooling were collected by questionnaire and body weight and height were measured. Overweight and obesity were defined using age- and sex-specific body mass index (BMI) cut-off points proposed by the International Obesity Task Force (IOTF), and compared with 85th and 95th BMI percentile curves of the IOTF reference population, respectively. Data analyses included two groups based on mother's years of schooling: less educated ( < 12 years) and more educated ( ≥ 12 years).

The overall prevalence of overweight and obesity in this population was 21.9 and 5.3%, respectively. Results of logistic regression analysis showed that the risk of overweight was higher for lower age group (odds ratio = 2.0, 95% confidence interval 0.18–3.09). Overweight was more common in girls with less educated mothers than in girls with more educated mothers (26.0 vs. 19.8%, P = 0.03).

These data indicate that overweight is highly prevalent among adolescent girls, especially in lower social groups in Rasht, and the rate is exceeding those reported in other parts of the country. Preventive strategies need to be adopted to combat the epidemic of overweight and obesity in this population.

The promotion of a healthy and active lifestyle among the population is essential for the prevention of numerous chronic diseases. Physical activity measurement and surveillance is crucial for understanding and evaluating campaigns to promote its practice.

To evaluate the 10-year trends in physical activity habits in the Catalan population.

Two cross-sectional nutritional surveys were carried out within a 10-year interval in the population of Catalonia. Data on physical activity include leisure-time physical activity, occupational physical activity and walking activity and regular stair climbing.

In all, 2344 individuals participated in the ENCAT 1992–93 study and 2055 individuals in the ENCAT 2002–03 survey, aged 10 to 75 years.

Inactivity related to occupation increased (from 53% in 1992–93 to 56% in 2002–03 of the Catalan population having sedentary work-related activities). In both genders, the percentage of people who walked to work at least 30 min decreased (from 19% to 16% in men and from 25% to 19% in women). There was a decrease in the percentage of people who were completely sedentary during leisure time (from 59% to 56%), and an increase in the percentage of people who did at least 2 days of vigorous activity (from 39% to 46% in men and from 26% to 32% in women).

The physical activity related to work and transportation has decreased during the period observed. Although a slight improvement has been noted, the percentage of people who are sedentary during leisure time is still high among both men and women.

To examine the effectiveness of two methods of increasing fruit and fruit juice intake in pregnancy: midwives' advice and vouchers exchangeable for juice.

Pregnant women were randomly allocated to three groups: a control group, who received usual care; an advice group, given advice and leaflets promoting fruit and fruit juice consumption; and a voucher group, given vouchers exchangeable for fruit juice from a milk delivery firm. Dietary questionnaires were administered at ~16, 20 and 32 weeks of pregnancy. Serum β-carotene was measured at 16 and 32 weeks.

An antenatal clinic in a deprived area.

Pregnant women aged 17 years and over.

The study comprised 190 women. Frequency of fruit consumption declined during pregnancy in all groups, but that of fruit juice increased substantially in the voucher group. Serum β-carotene concentration increased in the voucher group, from 106.2 to 141.8 μmol l− 1 in women with measurements on both occasions (P = 0.003), decreased from 120.0 to 99.8 μmol l− 1 in the control group (P = 0.005), and was unchanged in the advice group.

Pregnant women drink more fruit juice if they receive vouchers exchangeable for juice supplied by the milk delivery service. Midwives' advice to eat more fruit has no great effect. Providing vouchers for fruit juice is a simple method of increasing its intake in a deprived population and may be useful for other sections of the community.

In 2001 the UK Department of Health funded pilot community-based interventions to improve fruit and vegetable intakes in five economically deprived areas of England. The effectiveness of the programme and the use of a brief tool for evaluating community interventions are reported here.

Data on intakes of and beliefs about fruit and vegetables were collected by a short postal questionnaire (FACET – Five-a-day Community Evaluation Tool) simultaneously from 810 individuals living in the pilot communities and 270 individuals who were participating in an unrelated observational study (controls). Data were collected before and after a 12-month intervention period. Quantitative dietary data derived from 7-day food diaries available for control subjects were used to assess the ability of the FACET questionnaire to estimate fruit and vegetable intakes.

Compared with controls, the intervention group significantly increased their knowledge of the 5-a-day optimum (P < 0.01) and reported increased access to fruits and vegetables (P < 0.001). Overall, the intervention had no demonstrable effect on total fruit and vegetable intakes as measured by FACET. However, smoking habit strongly predicted change in fruit and vegetable intakes (P < 0.01) in the intervention group. Opposite trends were observed in the two groups, with ‘smokers’ and ‘non-smokers’ in the intervention and control groups respectively reducing their fruit and vegetable intakes. The FACET questionnaire agreed with food diary estimates of fruit and vegetable intakes in 56% of cases.

Community-based interventions can produce important changes in knowledge of and access to fruit and vegetables. However, in this study change in fruit and vegetable intakes was strongly influenced by smoking habit. This bias needs to be considered in planning future intervention and evaluation programmes. The FACET questionnaire provides acceptable estimates of fruit and vegetable intakes which may be used for grading intake in large community-based projects.

Previous research on nutrition labelling has mainly used subjective measures. This study examines the effectiveness of two types of nutrition label using two objective measures: eye movements and healthiness ratings.

Eye movements were recorded while participants made healthiness ratings for two types of nutrition label: standard and standard plus the Food Standards Agency's ‘traffic light’ concept.

University of Derby, UK.

A total of 92 participants (mean age 31.5 years) were paid for their participation. None of the participants worked in the areas of food or nutrition.

For the standard nutrition label, participant eye movements lacked focus and their healthiness ratings lacked accuracy. The traffic light system helped to guide the attention of the consumer to the important nutrients and improved the accuracy of the healthiness ratings of nutrition labels.

Consumers have a lack of knowledge regarding how to interpret nutrition information for standard labels. The traffic light concept helps to ameliorate this problem by indicating important nutrients to which to pay attention.