This study examined dietary intakes and nutritional status of marijuana users and non-current marijuana users in US adults aged 20 to 59 years.

We used data from the Third National Health and Nutrition Examination Survey (NHANES III), 1988–1994. Information on self-reported drug use, including marijuana, was obtained as part of the NHANES III physical examination component. Nutritional status was assessed using height and weight, and blood biochemistries. Dietary intake was assessed using a 24-hour recall and a food-frequency questionnaire.

Among adults 20–59 years of age, 45% reported ever having used marijuana in their lifetime. A total of 8.7% reported using marijuana in the past month. Current marijuana users had higher intakes of energy and nutrients than non-current marijuana users; however, body mass index (BMI) was slightly lower. We found higher cigarette-smoking rates and higher consumption of sodas and alcohol, specifically beer, among marijuana users than among non-current marijuana users. Marijuana users also consumed more sodium, fewer fruits, and more pork, cheese, and salty snacks. Nutritional status, using indicators of serum nutrients, serum albumin, haematocrit and haemoglobin, was similar between marijuana users and non-current marijuana users. Serum carotenoid levels were lower among marijuana users, independent of cigarette smoking.

Dietary intake was different among marijuana users than among non-current marijuana users. Although overall nutritional status was similar, serum carotenoid levels were lower in marijuana users. The long-term health effects of these differences in marijuana users deserve careful consideration in future research.

To study the knowledge, attitude and practice of pregnant women regarding periconceptional folic acid (FA) intake.

Questionnaire-based prospective study.

Antenatal clinic of a District General Hospital.

Three-hundred pregnant women in an antenatal clinic.

Nearly all (298/300) had heard of FA. A majority (275/300, 91%) knew that FA could prevent neural tube defects, and married women (P <0.001), those with higher education (P <0.001), those of Social Classes 1–3 (P <0.01) and women over 30 years of age (P <0.05) were more likely to be thus aware. Knowledge about the correct timing of FA intake was seen in 76% and was more likely in those with higher education (P <0.001), married women (P <0.001) and women age over 30 years (P <0.05). Intake of FA in the periconceptional period was seen in 134/300 (44.6%) women and was most likely in the married, Social Classes 1–3, women with higher education (all P <0.001), non-smokers (P <0.01), women with a planned pregnancy and women aged 30 years and over (P <0.05).

The knowledge of the correct timing of FA intake was present in only 76%. Less than half (44.6%) had taken FA in the periconceptional period, and this was far more common in the more ‘privileged’ classes. Low socio-economic status, age less than 30 years, lower educational status and unplanned pregnancy were high risk factors for not taking FA. The challenge to the medical profession for targeting this group cannot be over-emphasised.

To assess the effect of different methods of classifying food use on principal components analysis (PCA)-derived dietary patterns, and the subsequent impact on estimation of cancer risk associated with the different patterns.

Dietary data were obtained from 232 endometrial cancer cases and 639 controls (Western New York Diet Study) using a 190-item semi-quantitative food-frequency questionnaire. Dietary patterns were generated using PCA and three methods of classifying food use: 168 single foods and beverages; 56 detailed food groups, foods and beverages; and 36 less-detailed groups and single food items.

Classification method affected neither the number nor character of the patterns identified. However, total variance explained in food use increased as the detail included in the PCA decreased (~8%, 168 items to ~17%, 36 items). Conversely, reduced detail in PCA tended to attenuate the odds ratio (OR) associated with the healthy patterns (OR 0.55, 95% confidence interval (CI) 0.35–0.84 and OR 0.77, 95% CI 0.49–1.20, 168 and 36 items, respectively) but not the high-fat patterns (OR 0.95, 95% CI 0.57–1.58 and OR 0.85, 0.51–1.40, 168 and 36 items, respectively).

Greater detail in food-use information may be desirable in determination of dietary patterns for more precise estimates of disease risk.

To assess and contrast awareness of the link between dietary fibre and folate and their major food sources (fruit, vegetables, bread and cereals).

Mailed questionnaire investigating changes made to dietary intake of fibre, folate, fruit, vegetables, bread and cereals in the previous six months.

The survey was conducted between June and November 1998 in the Australian Capital Territory.

One thousand one hundred and twenty-six adults randomly selected from the electoral roll.

More women than men in both older (50 + years) and younger (18–49 years) age groups reported increasing their consumption of folate, fibre, fruit and vegetables in the prior six months. In contrast, more men than women reported increased consumption of bread, cereals, rice and pasta in the previous six months. For food categories and fibre, less than 4% of respondents were unsure about changes in these food habits. However, 26% of men and women were ‘not sure’ about changes to folate intake. Similar proportions of men and women (about 33%) reported consuming more fruit, vegetables or cereal-based foods over the prior six months, yet only 6% of these men and 14% of these women reported consuming more folate. In contrast, 44% of men and 51% of women who reported consuming more plant foods also reported consuming more dietary fibre.

The results suggested that subjects, particularly the younger age group, had a poor understanding of the relationship between folate intake and its major food sources. The understanding of the relationship between fibre intake and its food sources appeared substantial, but confusion about specific food sources was still evident. These outcomes question the effectiveness of nutrition education used to date, particularly for the current priority of increasing folate intake in younger women in the new, ‘health claims’ environment.

Using a national representative sample to identify groups within the UK male and female population over 65 years who report similar patterns of diet.

National representative dietary survey, using 4-day weighed dietary records of men and women aged over 65 years old and living in private households in Great Britain in 1994–1995. Cluster analysis was used to aggregate individuals into diet groups.

United Kingdom.

558 women and 539 men.

Consumption of predefined food groups, nutrient intakes, socio-economic, demographic and behavioural characteristics.

Three large clusters comprising 86% of the male population and three large clusters comprising 83% of the female population were identified. Among men, the most prevalent cluster was a ‘mixed diet’ with elements from a traditional diet and some elements from a healthy diet (48% of the male population); the second was a ‘healthy diet’ (21% of the male population); and the third was a ‘traditional diet high in alcohol’ (17% of the male population). Among women, the most prevalent diet was a ‘sweet traditional diet’ (33% of the female population); the second was a ‘healthy diet’ (32% of the female population); and the last was a ‘mixed diet’ with elements of the traditional diet and the healthy diet (18% of the female population). There were important differences in average nutrient intakes, socio-demographic and behavioural characteristics across these diet clusters.

Cluster analysis identified three diet groups among men and three among women. These differed not only in terms of reported dietary intake, but also with respect to their nutrient content, social and behavioural profile. The groups identified could provide a useful basis for health promotion based upon the diet clusters.

A new data-entry system (DINER – Data Into Nutrients for Epidemiological Research) for food record methods has been devised for the European Prospective Investigation into Cancer (EPIC) cohort study of 25 000 men and women in Norfolk. DINER has been developed to address the problems of efficiency and consistency of data entry, comparability of data, maximising information and future flexibility in large long-term population studies of diet and disease that use record methods to assess dietary intakes. DINER captures more detail than traditional systems and enables provision of new variables for specific food types or groups. The system has been designed to be fully flexible and easy to update. Analysis of consistency of data entry was tested in a group of 3525 participants entered by 25 coders.

A food list of 9000 food items and values for 24 000 portion sizes have been incorporated into the database, using information from the 5979 diaries coded since 1995. Analysis of consistency of entry indicated that this has largely been achieved. The effect of coders in a multivariate regression model was significant only if the three coders involved in early use of the program were included (P<0.013).

The development of DINER has facilitated the use of more accurate record methods in large-scale epidemiological studies of diet and disease. Furthermore, the retention of original information as an extensive food list allows greater flexibility in later analyses of data of multiple dietary hypotheses.

To estimate vitamin intakes and assess the contribution of different food groups to vitamin intakes in adults aged 18–64 years in Ireland as estimated in the North/South Ireland Food Consumption Survey. Intakes are reported for retinol, carotene, total vitamin A, vitamin D, vitamin E, thiamin, riboflavin, pre-formed niacin, total niacin equivalents, vitamin B6, vitamin B12, folate, biotin, pantothenate and vitamin C. The adequacy of vitamin intakes in the population and the risk of occurrence of excessive vitamin intakes are also assessed.

Food consumption was estimated using a 7-day food diary for a representative sample (n = 1379; 662 men and 717 women) of 18–64-year-old adults in the Republic of Ireland and Northern Ireland selected randomly from the electoral register. Vitamin intakes were estimated using tables of food composition.

In general, the percentage of the population with vitamin intakes below the average requirement (AR) was low. Mean daily intake of total vitamin A was below the AR in 20.2% and 16.6% of men and women, respectively, and mean daily intake of riboflavin was below the AR in 12.5% and 20.6% of men and women, respectively. Mean daily folate intakes were below the AR for folate in 11.2% and 6.6% of women aged 18–35 years and 36–50 years, respectively. Only 2.2% of women aged 18–35 years and 52% of women aged 36–50 years achieved the recommended folate intake of 600 (μg day−1 for women of reproductive age for the prevention of neural tube defects. A high proportion of the population has a low dietary vitamin D intake and is largely dependent on sunlight exposure to maintain adequate vitamin D status. Except for pre-formed niacin, the 95th percentile intake of vitamins did not exceed the tolerable upper intake level (UL) for any group and was much less than the UL for most vitamins. Although 20.8% of men and 6.3% of women exceeded the UL for pre-formed niacin (which is 35 mg, based on nicotinic-acid-induced flushing), the large contribution of meat and fish to the intake of niacin (as nicotinamide) suggests that the risk of overexposure to nicotinic acid is much lower than this and is probably solely related to supplement use. A small proportion of men (4.0%) and women (1.2%) aged 51-64 years had retinol intakes that exceeded the UL (3000 μg) and while the 95th percentile intake of women in the 18–50 year age group was well below the UL, 1.5% of 18–35-year-old and 2.4% of 36–50-year-old women had mean daily retinol intakes above the UL. About 2.0% of women had intakes of vitamin B6 that exceeded the UL (25 mg). There were significant differences by age and sex in nutrient densities of vitamin intakes between men and women and between age groups, which may be explained by differences in consumption of particular food groups as well as different patterns of supplement use.

Nutritional adequacy of the population for most vitamins was good. Folate intake in women of childbearing age is not meeting current recommendations for the prevention of neural tube defects. The public health significance of the relatively high proportion of men and women with inadequate intakes of vitamin A and riboflavin and with low dietary intakes of vitamin D is unclear and should be investigated further. With the possible exception of niacin (flushing) and vitamin B6 (neuropathy), there appears to be little risk of the occurrence of adverse effects due to excessive consumption of vitamins in this population, based on current dietary practices.

To describe the methodology applied in order to render comparable, at the level of the dietary information collected, the household budget survey (HBS) and individual nutrition survey (INS) data from four European countries (Belgium, Greece, Norway and the United Kingdom).

In Belgium, data from the HBS of 1987–88 were compared with data from the Belgian Interuniversity Research on Nutrition and Health collected from 1980 to 1985. In Greece, data from the HBS undertaken in 1993–94 in the greater Athens area were compared with data collected around 1994 in the same region, in the context of the Greek segment of the European Prospective Investigation on Cancer and Nutrition study. In Norway, data from the HBS carried out in 1992, 1993 and 1994 were compared with the NORKOST study conducted in 1993–94. In the United Kingdom, data from four HBSs carried out in 1985, 1986, 1987 and 1988 were compared with the National Dietary and Nutritional Survey of British adults conducted in 1987–88.

INS-generated data were converted into ‘HBS-like’ estimates with the application of yield factors for weight changes during cooking, recipe-based calculations and edible proportion coefficients taking into account weight changes during the food preparation. The ‘HBS-like’ estimates thus obtained were compared with the original HBS values, after applying an adjustment factor for food spoiled or given to pets.

The methodological considerations overviewed in the present paper indicate that a number of issues need to be taken into account before a proper comparison of the dietary data collected through surveys implemented with varied methodologies is carried out.

To identify the major perceived influences on food choice, to examine the use of and trust in information sources concerning healthy eating, and to assess attitudes towards and barriers to adopting healthy eating practices in a post-USSR country (Ukraine).

A survey of an urban adult population. The questions were adopted from the Pan-European Union (EU) Survey of Consumer Attitudes to Food, Nutrition and Health (1995–1996).

Lviv city, Ukraine.

The survey included 296 adults (84 males, 212 females) aged 18–55 years; they were primarily college students and subjects with tertiary education – the groups most likely to be both interested in healthy eating and affected by current socioeconomic downturns.

The major factors in food choice were: ‘quality/freshness’ (cited by 80%), ‘price’ (58%) and ‘taste’ (47%); only 34% cited ‘trying to eat healthily’. More older people cited ‘price’ than ‘quality/freshness’, and men were more likely than women to cite ‘taste’. Sources of healthy eating information included: ‘relatives/friends’ (cited by 65%, trusted by 85%) and health professionals (trusted by 92%, but used by only 35%); while advertising was the least trusted source (cited by 28%). Fifty-three per cent of respondents considered their diet to be healthy enough without further changes; 50% thought of the nutritional aspects of the food they ate; fewer women than men considered their diet healthy, and more women than men thought about nutrition. Barriers to healthy eating included: ‘cost’ (cited by 65%), ‘lack of time’ (55%), ‘self-control’ (54%), ‘selection influences’ (41%), ‘lack of knowledge’ (32%), ‘unpleasant foods’ and ‘resistance to change’ (both 30%).

Strategies to encourage healthy eating in this population should involve word-of-mouth nutrition education concerning low-cost healthy alternatives.

To develop and assess the reproducibility of a quantitative food frequency questionnaire (QFFQ) sensitive to the culture of the African population of the North West Province, South Africa.

A cross-sectional study.

A community-based field study in a population stratified according to level of urbanization from deep rural to urban upper class.

A total of 144 (99 women and 45 men) residents of the North West Province, aged between 15 and 65 years, participated in the study.

A culture-sensitive, 145-item interviewer-administered QFFQ was designed to cover the whole diet. Portion sizes were estimated from a food portion photograph book (FPPB) showing foods in three portion sizes. The QFFQ was administered twice, 6–12 weeks apart.

Spearman rank correlation coefficients between the two administrations varied from 0.14 for calcium to 0.75 for alcohol. The mean percentage difference between intakes was 8.5 (standard deviation = 9.9). Energy, protein, carbohydrate and calcium gave differences within 10%. Few significant differences among correlation coefficients or percentage difference for gender, age group or strata of urbanization were present. Bland–Altman plots showed significant proportional bias for protein, fibre and vitamin C. More than 70% of the participants were classified into adjacent quintiles for all nutrients. For food groups, correlation coefficients ranged from 0.25 for milk to 0.45 for vegetable and maize meal groups and 80% of participants were classified into adjacent quintiles.

The QFFQ appeared to be a reproducible dietary intake assessment instrument.

Attitudes towards food varied markedly between children and their mothers. Children viewed food primarily as a necessity of life, whereas mothers viewed food primarily as a pleasure for their child, with necessity and nutrition given a lower importance. Contrary to popular belief children's enjoyment of [unhealthy] and [healthy] foods was similar. French-fries were the favourite food for 92% of children, closely followed by pasta (89%). Fruit and candy received similar scores (82% and 81% respectively), suggesting that external factors such as convenience are the prime barrier to fruit consumption rather than the enjoyment factor. Over the three surveys a strong persistence of the traditional French meal pattern has been demonstrated, with breakfast, lunch and evening meals eaten by 97%, 96% and 99% of children respectively. One increasing occurrence is the viewing of television during meal times with 25% of breakfasts, 46% of afternoon snacks and 41% of evening meals consumed in front of the television. Children's attitudes towards food demonstrated an overwhelming trust of their mother and her ability to provide them with nourishing foods. Mothers often found it difficult to reconcile the demands of family life, employment, healthy eating and the maintenance of a pleasurable atmosphere at mealtimes.

Overall, children and mothers appeared to have divergent attitudes towards food. An understanding of children's enjoyment of foods considered more 'healthy' or less [healthy] enables effective nutrition messages to be developed for children. However, further work is needed to explore the long-term impact of mothers' attitudes towards food and mealtimes on a child's relationship to food and eating habits during adolescence through to adulthood.

To define the average food consumption per capita in the Czech population and to investigate food consumption development during the years of economic transition.

Three studies based on the household budget survey (HBS) were conducted in the 1990s. The primary data originated from so-called diaries of reporting households loaned out from the Czech Statistical Office (CSO). The arranging of representative samples has been done and is guaranteed by the CSO. Complementary inquiry was conducted to supplement the HBS data. The average consumption of basic food groups is presented.

All regions of the Czech Republic.

The primary data came from the years 1991, 1994 and 1997. The basic sample representing the Czech population included 420 households and was arranged with regard to the region, size and socio-economic type of households.

The changes in food consumption during the 1990s were reflected, above all, in meat, milk and dairy products, added fats, fruit and beverages. The consumption of poultry meat, fish, fresh fruit and vegetables has increased. The proportion of added fats has changed in favour of vegetable fats. On the other hand, a negative feature may be the permanent reduction in milk consumption.

Most of the changes in eating patterns that appeared in the Czech population after 1989 can be interpreted as positive ones.

The purpose of this study was to validate a quantitative food-frequency questionnaire (QFFQ) created for assessing the usual intake of foods and nutrients in the prevailing season in Western Mali.

Intake of foods and nutrients over the week preceding the interview was measured with a 69-item QFFQ. Intakes were compared with intakes as measured with 2-day combined weighed and recalled diet records.

A rural village in Western Mali, West Africa.

Twenty-seven men and 48 women (15–59 years of age) representing 18 households.

Spearman rank correlations between intake of food groups from the QFFQ and the diet record ranged from 0.09 (meat/fish) to 0.58 (tea/coffee). Median coefficient was 0.37. Median Spearman correlation coefficient for nutrient intake was 0.40. Men had higher median correlation coefficients than did women. The proportion of subjects being classified into the same quartile of food intake was on median 33%, while a median of 7% was misclassified into extreme quartiles. Correct classification into the same quartile for intake of nutrients was on median 34% while a median of 4% was grossly misclassified. Intakes of most food groups and nutrients as measured by the QFFQ were higher than those measured by the diet records. However, while men had higher estimated intakes for foods eaten in-between meals, women in general had higher intake of foods eaten in the main meals.

This QFFQ can be used for comparing the intake of foods and nutrients between groups within this study population. It therefore represents a useful tool in the surveillance of food intake in the population, both in identifying vulnerable groups and for tracking food intake over time. The differences between men and women in overestimating food intake need to be taken into account when using the method.

To compare individualised household budget survey (HBS) data with food consumption values derived from individual nutrition surveys (INSs).

Four European countries: Belgium, 1980–85 and 1987–88; Greece, 1993–94; Norway, 1992–94; and the United Kingdom, 1985–88.

Household budget survey data were individualised with non-parametric models. Individual nutrition survey data were converted into ‘HBS-like’ estimates, with the application of recipe-based calculations and yield factors for weight changes during food preparation. To correct for over- and underreporting or recording in both surveys, quantities (in g day−1) of 14 principal food groups were expressed as fractions of total food quantity (in g day−1). For each food group, INS and HBS-derived mean values were calculated for 24 research units, jointly defined by country (four countries involved), gender (male, female) and age (younger, middle-aged and older). Pearson correlation coefficients were calculated and correlation diagrams were drawn.

The results of this preliminary analysis show that there is value in the nutritional information derived from HBSs. However, additional and more sophisticated work is required, in order to derive reliable point and interval estimates of individual food consumption based on HBS data.