To receive stakeholders’ feedback on the new structure of the Nutritional Disorders section of the International Classification of Diseases, 11th Revision (ICD-11).

A twenty-five-item survey questionnaire on the ICD-11 Nutritional Disorders section was developed and sent out via email. The international online survey investigated participants’ current use of the ICD and their opinion of the new structure being proposed for ICD-11. The LimeSurvey® software was used to conduct the survey. Summary statistical analyses were performed using the survey tool.

Worldwide.

Individuals subscribed to the mailing list of the WHO Department of Nutrition for Health and Development.

Seventy-two participants currently using the ICD, mainly nutritionists, public health professionals and medical doctors, completed the questionnaire (response rate 16 %). Most participants (n 69) reported the proposed new structure will be a useful improvement over ICD-10 and 78 % (n 56) considered that all nutritional disorders encountered in their work were represented. Overall, participants expressed satisfaction with the comprehensiveness, clarity and life cycle approach. Areas identified for improvement before ICD-11 is finalized included adding some missing disorders, more clarity on the transition to new terminology, links to other classifications and actions to address the disorders.

The Nutritional Disorders section being proposed for ICD-11 offers significant improvements compared with ICD-10. The new taxonomy and inclusion of currently missing entities is expected to enhance the classification and health-care professionals’ accurate coding of the full range of nutritional disorders throughout the life cycle.

Despite the importance of cooking in modern life, public perceptions about what it means to cook are unknown. We aimed to examine perceptions of cooking and their association with cooking confidence, attitudes and behaviours in the USA.

We designed and fielded a nationally representative survey among US adults (n 1112) in April 2015. We used factor analysis to identify perceptions about cooking and multivariate ordered logit and Poisson models to explore associations between those perceptions and cooking confidence, attitudes and behaviours.

Nationally representative web-based survey of US adults.

US adults aged ≥18 years.

Americans conceptualized cooking in three ways: the use of scratch ingredients, convenience foods and not using heat. Respondents who perceived cooking as including convenience foods were less confident in their ability to cook from scratch (OR=0·52, P<0·001) and less likely to enjoy cooking (OR=0·68, P=0·01) than those who did not. Although individuals who perceived cooking as including only scratch ingredients reported cooking dinner (4·31 times/week) and using packaged/boxed products (0·95 times/week) the least frequently, few notable differences in the frequency of cooking meals were observed.

Cooking frequency is similar among US adults regardless of how they perceive cooking, but cooking confidence and enjoyment are lowest among Americans who perceive cooking as including the use of convenience foods. These insights should inform the development of more specific measures of cooking behaviour as well as meaningful and targeted public health messages to encourage healthier cooking.

To identify major dietary patterns and their association with socio-economic status (SES) and food insecurity in two major ethnic groups living in Urmia, north-west Iran.

A cross-sectional study.

All four geographical zones of Urmia city.

Participants (n 723; 427 women and 296 men), aged 20–64 years, from two ethnic groups (445 Azeri Turks and 278 Kurds).

Three major dietary patterns were extracted: ‘Traditional High SES’ (THS), ‘Traditional Low SES’ (TLS) and ‘Transitional’. After adjusting for confounders, the THS pattern was positively associated with education level and negatively associated with moderate or severe food insecurity in Azeri Turks; whereas, among Kurds, it was more common in women and positively associated with age. The TLS pattern was more common among men and negatively associated with educational level and all levels of food insecurity in Azeris; while, among Kurds, it was more common among men, positively associated with being married and negatively associated with household income/capita. The ‘Transitional’ pattern was positively associated with being employed and negatively associated with age and all levels of food insecurity in Azeris; while, among Kurds, it was more common among men and negatively associated with age, being married and physical activity level.

Findings suggest that household SES and food insecurity are associated with detrimental dietary patterns and that this effect may be stronger than cultural and ethnic background. These patterns differ by age and gender. Therefore, such characteristics should be considered in planning and formulating diet-related policies and programmes.

Parental body image dissatisfaction (BID) is associated with children’s weight in cross-sectional studies; however, it is unknown whether BID predicts development of adiposity. The objective of the present study was to investigate the associations between maternal dissatisfaction with her or her child’s body and children’s BMI trajectories.

Longitudinal study. Maternal dissatisfaction (BID) with her and her child’s body was calculated based on ratings of Stunkard scales obtained at recruitment, as current minus desired body image. Children’s height and weight were measured at baseline and annually for a median of 2·5 years. Mixed-effects models with restricted cubic splines were used to construct sex- and weight-specific BMI-for-age curves according to maternal BID levels.

Public primary schools in Bogotá, Colombia.

Children (n 1523) aged 5–12 years and their mothers.

After multivariable adjustment, heavy boys and thin girls whose mothers desired a thinner child gained an estimated 1·7 kg/m2 more BMI (P=0·04) and 2·4 kg/m2 less BMI (P=0·004), respectively, between the age 6 and 14 years, than children of mothers without BID. Normal-weight boys whose mothers desired a thinner child’s body gained an estimated 1·8 kg/m2 less BMI than normal-weight boys of mothers without BID (P=0·02). Maternal BID with herself was positively related to children’s BMI gain during follow-up.

Maternal BID is associated with child’s BMI trajectories in a sex- and weight-specific manner.

We aimed to investigate the prevalence of grade 1, 2 and 3 thinness among Chinese children and to explore their associations with socio-economic status (SES).

A population, school-based cross-sectional study using multistage, stratified cluster random sampling. Grade 1, 2 and 3 thinness, overweight, obesity and severe obesity were defined by the International Obesity Task Force BMI cut-offs.

Seven districts of Shanghai, China.

Chinese children aged 3–12 years (n 84 075).

In boys and girls, respectively, the prevalence of grade 1 thinness was 8·89 % and 11·78 %, of grade 2 thinness was 2·80 % and 3·74 %, and of grade 3 thinness was 2·23 % and 2·93 %. Compared with urban children, suburban children had higher prevalence of thinness. Children whose parent had low education had higher prevalence of grade 1, 2 and 3 thinness than those whose parent had high education. The prevalence of grade 2 and 3 thinness, obesity and severe obesity in low-SES children was higher than that in high-SES children, and the prevalence of grade 1 thinness was lower than that in high-SES children. Particular patterns of prevalence of grade 1, 2 and 3 thinness appeared in low-, middle- and high-SES children.

The study describes associations of SES with grade 1, 2 and 3 thinness, overweight, obesity and severe obesity in Shanghai children. The patterns of thinness and obesity in Shanghai provide further insights into BMI patterns in mega-cities in developing countries.

The present study aimed to evaluate the precision, ease of use and likelihood of future use of portion size estimation aids (PSEA).

A range of PSEA were used to estimate the serving sizes of a range of commonly eaten foods and rated for ease of use and likelihood of future usage.

For each food, participants selected their preferred PSEA from a range of options including: quantities and measures; reference objects; measuring; and indicators on food packets. These PSEA were used to serve out various foods (e.g. liquid, amorphous, and composite dishes). Ease of use and likelihood of future use were noted. The foods were weighed to determine the precision of each PSEA.

Males and females aged 18–64 years (n 120).

The quantities and measures were the most precise PSEA (lowest range of weights for estimated portion sizes). However, participants preferred household measures (e.g. 200 ml disposable cup) – deemed easy to use (median rating of 5), likely to use again in future (all scored either 4 or 5 on a scale from 1=‘not very likely’ to 5=‘very likely to use again’) and precise (narrow range of weights for estimated portion sizes). The majority indicated they would most likely use the PSEA preparing a meal (94 %), particularly dinner (86 %) in the home (89 %; all P<0·001) for amorphous grain foods.

Household measures may be precise, easy to use and acceptable aids for estimating the appropriate portion size of amorphous grain foods.

To test modifications to nutrition label serving size information on understanding of energy (calorie) content among youth and young adults.

Participants completed two online experiments. First, participants were randomly assigned to view a beverage nutrition label with a reference amount of per serving (250 ml), per container (473 ml) or a dual-column format with both reference amounts. Participants were then randomized to view a cracker nutrition label which specified a single serving in small font, a single serving in large font, or the number of servings per bag with single serving information below. In both experiments, participants estimated energy content. Logistic regression analysis modelled correct energy estimation. Finally, participants reported their preference for serving size display format.

Canada.

Canadian youth and young adults (n 2008; aged 16–24 years).

In experiment 1, participants randomized to view the nutrition label with per container or dual column were more likely to correctly identify energy content than those using per serving information (P<0·01). For experiment 2, the serving size display format had no association with correct energy estimation. The majority of participants (61·9 %) preferred the serving size format that included servings per package.

Labelling foods with nutrition information using a serving size reference amount for the entire container increased understanding of energy content. Consumers prefer nutrition labels that include more prominently featured serving size information. Additional modifications that further improve consumers’ accuracy should be examined. These results have direct implications for nutrition labelling policy.

The rate of type 2 diabetes mellitus among Inuit is 12·2 % in individuals over 50 years of age, similar to the Canadian prevalence. Given marked dietary transitions in the Arctic, we evaluated the dietary and other correlates of not previously diagnosed glucose intolerance, defined as type 2 diabetes mellitus, impaired fasting glucose or impaired glucose tolerance.

Cross-sectional analyses were limited to adults with a completed 2 h oral glucose tolerance test and without pre-existing diabetes. Anthropometric assessments, health and medication usage questionnaires and a 24 h dietary recall were administered.

Canadian International Polar Year Inuit Health Survey (2007–2008).

Inuit adults (n 777).

Glucose intolerance was associated with older age and adiposity. Percentage of energy from protein above the Acceptable Macronutrient Distribution Range of 35 %, compared with intake within the range, was associated with increased odds of glucose intolerance (OR=1·98; 95 % CI 1·09, 3·61) in multivariable analyses. Further, cholesterol intake in the highest three quartiles combined (median exposures of 207, 416 and 778 mg/d, respectively) compared with the lowest quartile (median intake of 81 mg/d) was associated with glucose intolerance (OR=2·15; 95 % CI 1·23, 3·78) in multivariable analyses. Past-day traditional food consumption was borderline protective of glucose intolerance (P=0·054) and high fibre intake was not significantly protective (P=0·08).

The results contribute to the existing literature on high protein and cholesterol intakes as they may relate to diabetes risk.

To assess the prevalence of and explanations for the avoidance of dairy foods, including symptoms attributed to their consumption, diagnoses and psychological predictors of avoidance. Also considered were comparisons with symptom-related avoidance of wheat in the same sample.

Cross-sectional population survey.

The study was conducted in Australia using a national postal omnibus survey.

Adults aged 18 years and over (n 1184; 52·9 % female) selected at random from the Australian Electoral Roll.

Despite few claims of formally diagnosed allergy or intolerance, 11·8 % of the sample reported avoiding dairy products because of adverse physiological effects, which commonly included gastrointestinal symptoms. Unlike wheat (3·5 %) or wheat-and-dairy (3·6 %) avoidance, dairy avoidance (8·2 %) was predicted by age (negatively) and worry about illness (positively).

The findings are further evidence of a widespread tendency for consumers to exercise control over their health by eliminating dietary factors considered suspect without medical evidence or oversight. Unanswered questions include the decision processes underlying dairy avoidance, whether symptoms are attributed correctly, the agents and physiological mechanism(s) involved, the relative contributions of symptom severity and vigilance to the association with illness worry, and the nutritional adequacy of dairy avoiders’ diets. Irrespective of the accuracy of self-diagnoses, if the elimination of suspect foods is an end in itself the paradoxical possibility for nutritional imbalances may have significant public health implications.

To evaluate the association of snacking between main meals with the risk of developing metabolic syndrome.

A dynamic prospective cohort study (the SUN Project; Seguimiento Universidad de Navarra). Snack consumption was evaluated using the question: ‘Do you have the habit of snacking between main meals?’ Metabolic syndrome was defined according to the updated harmonizing criteria. We estimated multivariable-adjusted relative risks (RR) of metabolic syndrome and their 95 % confidence intervals using Poisson regression models. An exploratory factor analysis was also used to identify patterns of snacking.

University of Navarra, Spain.

The study included 6851 university graduates, initially free of metabolic syndrome, and followed-up them for a median of 8·3 years.

Among our participants, 34·6 % reported usual snacking between main meals. The cumulative incidence of metabolic syndrome was 5·1 % (9·5 % among men and 2·8 % among women). Snacking between main meals was significantly associated with higher risk for developing metabolic syndrome after multivariable adjustment (RR=1·44; 95 %CI 1·18, 1·77). Higher adherence to an ‘unhealthy snacking pattern’ was also independently associated with increased incidence of metabolic syndrome (fourth quartile of adherence compared with non-snacking: RR=1·68; 95 % CI 1·23, 2·29; P for trend <0·001).

Our findings suggest that avoidance of snacking between main meals can be included among the preventive approaches to reduce the risk of metabolic syndrome development, especially when snacks contain foods of poor nutritional quality.

The nutrition transition has exacerbated the gender gap in health in the Middle East and North Africa region as the increase in excess adiposity has been much higher among women than men. This is not exclusive of the persistence of anaemia, generally also more prevalent among women. We assessed the magnitude and sociodemographic factors associated with gender inequality vis-à-vis the double burden of excess adiposity and anaemia.

Cross-sectional study, stratified two-stage cluster sample. BMI (=weight/height2) ≥25·0 kg/m2 defined overweight and BMI≥30·0 kg/m2 obesity. Anaemia was defined as Hb <120 g/l for women, <130 g/l for men. Gender inequalities vis-à-vis the within-subject coexistence of excess adiposity and anaemia were assessed by women v. men relative prevalence ratios (RPR). Their variation with sociodemographic characteristics used models including gender × covariate interactions.

Greater Tunis area in 2009–2010.

Adults aged 20–49 years (women, n 1689; men, n 930).

Gender inequalities in excess adiposity were high (e.g. overweight: women 64·9 % v. men 48·4 %; RPR=2·1; 95 % CI 1·6, 2·7) and much higher for anaemia (women 38·0 % v. men 7·2 %; RPR=8·2; 95 % CI 5·5, 12·4). They were striking for overweight and anaemia (women 24·1 % v. men 3·4 %; RPR=16·2; 95 % CI 10·3, 25·4). Gender inequalities in overweight adjusted for covariates increased with age but decreased with professional activity and household wealth score; gender inequality in anaemia or overweight and anaemia was more uniformly distributed.

Women were much more at risk than men, from both over- and undernutrition perspectives. Both the underlying gender-related and sex-linked biological determinants of this remarkable double burden of malnutrition inequality must be addressed to promote gender equity in health.

To assess the association between maternal caffeine intake and risk of pregnancy loss using a systematic review and meta-analysis.

Categorical and dose–response meta-analysis of prospective studies.

Relevant articles were identified by searching MEDLINE and SCOPUS databases through 30 January 2015. Two authors independently extracted information from eligible studies. Random-effects models were used to derive the summary relative risks (RR) and corresponding 95 % CI for specific categories of caffeine consumption and for a continuous association using generalized least-squares trend estimation.

A total of 130 456 participants and 3429 cases in fourteen included studies.

Compared with the reference category with no or very low caffeine intake, the RR (95 % CI) of pregnancy loss was 1·02 (0·85, 1·24; I2=28·3 %) for low intake (50–149 mg/d), 1·16 (0·94, 1·41; I2=49·6 %) for moderate intake (150–349 mg/d), 1·40 (1·16, 1·68; I2=18·6 %) for high intake (350–699 mg/d) and 1·72 (1·40, 2·13; I2=0·0 %) for very high intake (≥700 mg/d). In the dose–response analysis, each 100 mg/d increment in maternal caffeine intake (~1 cup of coffee) was associated with 7 % (95 % CI 3 %, 12 %) higher risk of pregnancy loss. Our results may have been affected by publication bias, but the association remained significant for the subset of larger studies. Furthermore, adjustment for smoking and pregnancy symptoms may have been incomplete, potentially resulting in residual confounding.

Albeit inconclusive, higher maternal caffeine intake was associated with a higher risk of pregnancy loss and adherence to guidelines to avoid high caffeine intake during pregnancy appears prudent.

To assess the relative validity of a semi-quantitative, web-based FFQ completed by female pregnancy planners in the Danish ‘Snart Forældre’ study.

We validated a web-based FFQ based on the FFQ used in the Danish National Birth Cohort against a 4 d food diary (FD) and assessed the relative validity of intakes of foods and nutrients. We compared means and medians of intakes, and calculated Pearson correlation coefficients and de-attenuated coefficients to assess agreement between the two methods. We also calculated the proportion correctly classified based on the same or adjacent quintile of intake and the proportion of grossly misclassified (extreme quintiles).

Participants (n 128) in the ‘Snart Forældre’ study who had completed the web-based FFQ were invited to participate in the validation study.

Participants in the ‘Snart Forældre’ study, in total ninety-seven women aged 20–42 years.

Reported intakes of dairy products, vegetables and potatoes were higher in the FFQ compared with the FD, whereas reported intakes of fruit, meat, sugar and beverages were lower in the FFQ than in the FD. Overall the de-attenuated correlation coefficients were acceptable, ranging from 0·33 for energy to 0·93 for vitamin D. The majority of the women were classified in the same or adjacent quintile and few women were misclassified (extreme quintiles).

The web-based FFQ performs well for ranking women of reproductive age according to high or low intake of foods and nutrients and, thus, provides a solid basis for investigating associations between diet and fertility.

To describe the energy-dense snack food (EDSF) and energy-dense drink (EDD) consumption of children in the Netherlands and investigate subgroup differences. The amounts consumed, eating occasions, places of consumption and consumed types are reported.

Twenty-four hour dietary recall data were used to describe the EDSF and EDD consumption. Subgroup differences concerning these intakes were identified with ANCOVA.

Dutch National Food Consumption Survey 2007–2010.

Children (n 860) aged 7–12 years.

The mean number of EDSF events was 3·3 (sd 1·6) per day, yielding 1569·7 (sd 928·7) kJ. Average EDD consumption was 594·2 (sd 342·3) ml/d, yielding 737·2 (sd 495·9) kJ. Over 90 % of the children consumed more energy from non-core foods per day than recommended. Differences in EDSF and EDD consumption were found between several subgroups. Most importantly, we found higher intakes among older children and children with low educated mothers. Almost half of the EDSF events took place in the afternoon and at home. Cookies and sweets were consumed during half of the EDSF events. Almost one-third of the EDD were consumed in the afternoon. The majority of these drinks were consumed at home and most were soft drinks.

The results demonstrate that snack food and drink consumption is highly prevalent among Dutch children. Health promotion efforts addressing these behaviours are warranted and the present study could accelerate these initiatives. Focusing on children with low educated parents and on snacking at home after school offers the greatest potential to reduce snack food and drink intakes.

To evaluate consistency levels of nutrition labelling on supermarket websites.

This is a comparative, quantitative study examining page position, content and design of nutrition labels on own-brand and branded products. Online and in-store nutrition labels were examined, categorised and analysed to discern variety of label designs used and consistency between online and in-store labelling.

Five large online food retailers in the UK.

Nutrition labels displayed on 100 webpages were examined for twenty branded and own-brand products. Equivalent labels on in-store packaged products were also examined.

Eight different combinations of nutrition label designs were found. The online supermarket sites were found to use from three to six of these label combinations across the sample. The consistency level between online and in-store package labels ranged from 25 % to 90 %. In many cases the nutrition label required scrolling to view and in all cases items could be purchased without the label being visible from the search result listings.

The main recommendation of the paper is that online nutrition labelling needs to be much more consistently presented than is currently practised, both within each website and between online and in-store experiences. Particular attention should be made to polychrome colour and the inclusion of summary graphics. Designers should also ensure visibility of the label and raise its vertical page position. The paper also proposes additional expansion of the use of nutrition information online, using nutrition values as database fields in search criteria and checkout aggregation reporting.

The present study assessed the impact of the retailer-led removal of unhealthy beverages from display at a self-service café within a major health service. While unhealthy beverages remained available from behind the counter upon request, this was not communicated directly to customers.

Drinks were categorised based on the state government nutrient profiling system, classifying drinks as ‘green’ (best choices), ‘amber’ (choose carefully) and ‘red’ (limit). Total drink sales (as number of items sold per week) in the café were measured for five weeks. All unhealthy ‘red’ beverages were removed from display (but were still available for purchase) and the sales of all beverages were measured for another six weeks.

We found that, in response to this strategy, the proportion of ‘red’ drinks sold decreased from 33 % to 10 % of total drink sales. As ‘amber’ and ‘green’ drink sales increased in response to this strategy, total retailer sales remained steady. Most consumers appeared to switch to purchasing ‘amber’ drinks rather than the healthiest option, ‘green’ drinks.

The removal of unhealthy beverages from display can result in consumers making healthier purchases, while not significantly affecting retailers’ sales.

To describe the prevalence and determinants of gestational night blindness in pregnant women receiving care in a hospital in Rio de Janeiro, Brazil.

Cross-sectional study of pregnant and postpartum women receiving care in a public hospital in Rio de Janeiro from 1999 to 2001 (group I; n 225) or from 2005 to 2008 (group II; n 381). Night blindness was identified through a standardized and validated interview (WHO, 1996). The determinants of gestational night blindness were identified through a hierarchical logistic regression model.

Public maternity hospital in Rio de Janeiro, RJ, Brazil.

Adult pregnant and postpartum women (n 606), aged ≥20 years.

The prevalence of gestational night blindness was 9·9 %. The final model revealed that not living in the South Zone of Rio de Janeiro (distal level: adjusted OR=1·846; 95 % CI 1·002, 3·401), belonging to group I (intermediate level: adjusted OR=2·183; 95 % CI 1·066, 4·471) and for the proximal level, having a history of abortion (adjusted OR=2·840; 95 % CI 1·134, 7·115) and having anaemia during the first and second trimesters of pregnancy (adjusted OR=3·776; 95 % CI 1·579, 9·029) were determinants of gestational night blindness.

Gestational night blindness should be assessed for during the prenatal care of all pregnant women, especially those living in deprived areas of the city and/or who have a history of abortion or anaemia. Nutritional monitoring is recommended during pregnancy to control gestational night blindness.

Polycyclic aromatic hydrocarbons (PAH) are common dietary exposures that cross the human placenta and are classified as a probable human carcinogen. The aim of the present study was to investigate the potential impact of exposure to PAH-containing meat consumed during pregnancy on birth outcomes.

Prospective birth cohort study. Only non-smoking women with singleton pregnancies, who were free from chronic disease such as diabetes and hypertension, were included in the study. Maternal consumption of PAH-rich meat was estimated through FFQ. Multiple linear regression was used to assess factors related to higher intake and the association between dietary PAH and birth outcomes.

Republic of Korea, 2006–2011.

Pregnant women (n 778) at 12–28 weeks of gestation enrolled in the Mothers and Children’s Environmental Health (MOCEH) study.

The multivariable regression model showed a significant reduction in birth weight associated with higher consumption level of foods rich in PAH, such as grilled or roasted meat, during pregnancy (β=−17·48 g, P<0·05 for every 1 point higher in meat score). Further adjusting for biomarkers of airborne PAH did not alter this association. There was no evidence that higher consumption level of PAH-rich meat shortens the duration of gestation (P=0·561). Regression models performed for birth length and head circumference produced negative effects that were not statistically significant.

Consumption of higher levels of barbecued, fried, roasted and smoked meats during pregnancy was associated with reduced birth weight. Dietary risk of PAH exposure in Korean women is of concern.

The aims of the present study were to assess the reliability and validity of the Food Choice Questionnaire (FCQ) and to determine the factors associated with food-choice motives in public junior-high-school students in Jakarta, Indonesia.

Cross-sectional study with self-administered questionnaires. Trained research assistants measured height and weight of the participants on the day of the data collection.

Fourteen randomly selected public junior-high schools in East Jakarta, Indonesia.

Public junior-high-school students (n 681) in grades 7 and 8, aged 13–14 years (377 girls and 304 boys).

Three food-choice motives (subscales) were obtained from factor analysis and reliability testing: (i) comfort; (ii) convenience and price; and (iii) health. The subscale with the greatest mean value was health. Family affluence was inversely associated with the convenience and price subscale (β=−0·05, P=0·01) and with the health subscale (β=−0·04; P=0·02). Females were less likely than males to consider health when choosing foods (β=−0·16; P=0·03).

While its factor structure differed from those found in previous studies of adults, the FCQ can provide reliable measures of food-choice motives among these adolescents. Students from less affluent families placed more importance on food’s convenience and price, but more affluent students did not necessarily make healthier choices. Compared with females, males were more likely to choose healthy foods. Future interventions should be tailored based on the socio-economic status of the target group.

The objective of the present study was to examine the external validity of an FFQ designed to estimate dietary vitamin D intake compared with a plasma biomarker and three repeated 24 h dietary recalls in women of reproductive age in Serbia, where there is no exposure to food fortified with vitamin D. The method of triads was applied.

In a cross-sectional study, 422 women completed the Women and Reproductive Health FFQ (WRH-FFQ) during the winter months. From a representative subgroup (n 44), three 24 h dietary recalls and anthropometric parameters were collected as well as a fasting blood sample for vitamin D biomarker analyses. Correlation coefficients were calculated between each of the dietary methods. Validity coefficients, as a correlation between the measured and estimated ‘true’ exposure, were calculated using the method of triads. Bland–Altman plots were also constructed.

Three major universities in Serbia.

Healthy young women (n 422) aged 18–35 years.

The WRH-FFQ estimate of vitamin D intake for all participants was 4·0 (sd 3·3) µg/d and 3·1 (sd 2·3) µg/d for the subgroup. Bland–Altman plots for these intakes showed high agreement. Validity coefficients for the FFQ, 24 h recall and biomarker were ρQI=0·847 (95 % CI 0·564, 0·928), ρRI=0·810 (95 % CI 0·537, 0·997) and ρBI=0·499 (95 % CI 0·190, 0·840), while the correlation coefficients were 0·686, 0·422 and 0·404.

The FFQ applied in the present study is a valid tool for assessing dietary vitamin D intake in women living in Serbia, a region without mandatory vitamin D food fortification.