To show that the practice of wholesome nutrition meets the demands of the concept of the new nutrition science, at present and in the future.

To define ‘wholesome nutrition’, to describe its origin and to discuss its recommendations; and to cite practical examples showing that wholesome nutrition includes the dimensions and domains that are the basis of the concept of the new nutrition science.

The recommendations of wholesome nutrition are an effective implementation of the concept of the new nutrition science.

To facilitate the Food and Agriculture Organization/World Health Organization/United Nations University Joint (FAO/WHO/UNU) Expert Consultation on Energy and Protein Requirements which met in Rome in 1981, Schofield et al. reviewed the literature and produced predictive equations for both sexes for the following ages: 0–3, 3–10, 10–18, 18–30, 30–60 and >60 years. These formed the basis for the equations used in 1985 FAO/WHO/UNU document, Energy and Protein Requirements.

While Schofield's analysis has served a significant role in re-establishing the importance of using basal metabolic rate (BMR) to predict human energy requirements, recent workers have subsequently queried the universal validity and application of these equations. A survey of the most recent studies (1980–2000) in BMR suggests that in most cases the current FAO/WHO/UNU predictive equations overestimate BMR in many communities. The FAO/WHO/UNU equations to predict BMR were developed using a database that contained a disproportionate number – 3388 out of 7173 (47%) – of Italian subjects. The Schofield database contained relatively few subjects from the tropical region.

The objective here is to review the historical development in the measurement and application of BMR and to critically review the Schofield et al. BMR database presenting a series of new equations to predict BMR.

This division, while arbitrary, will enable readers who wish to omit the historical review of BMR to concentrate on the evolution of the new BMR equations.

BMR data collected from published and measured values.

A series of new equations (Oxford equations) have been developed using a data set of 10 552 BMR values that (1) excluded all the Italian subjects and (2) included a much larger number (4018) of people from the tropics.

In general, the Oxford equations tend to produce lower BMR values than the current FAO/WHO/UNU equations in 18–30 and 30–60 year old males and in all females over 18 years of age.

This is an opportune moment to re-examine the role and place of BMR measurements in estimating total energy requirements today. The Oxford equations' future use and application will surely depend on their ability to predict more accurately the BMR in contemporary populations.

To examine if obesity status and socio-economic and lifestyle factors are associated with self-reported past food habit change, and also whether the level of obesity depends on the reason for change.

Cross-sectional analysis within the Malmo Diet and Cancer (MDC) study using data from the baseline examination and the extensive socio-economic and lifestyle questionnaire including questions of past food habit change. The risk of having changed food habits in the past was examined using logistic regression. Mean differences in obesity status across categories of reasons for past food habit change were examined using analysis of variance.

Malmö, the third largest city in Sweden.

A sub-sample (15 282 women and 9867 men) from the MDC cohort recruited from 1992 to 1996.

Individuals with body mass index (BMI) >30 kg m−2 had an increased risk of having reported past food habit change compared with individuals with BMI <25 kg m−2 (odds ratio (OR) = 1.63, 95% confidence interval (CI) = 1.48–1.83 for women; OR = 1.53, 95% CI = 1.32–1.76 for men). The highest level of obesity was observed among individuals who had changed their diet due to reasons related to the metabolic syndrome. Changers were more likely to be highly educated and to live alone, be retired, ex-smokers and non-drinkers at baseline.

Because past food habit change is related to obesity and other lifestyle and socio-economic factors, a complex confounding situation may exist that could seriously influence observed relationships between diet and disease. Studies need to collect information on past food habit change and take this information into account in the analysis and when interpreting study outcomes.

To investigate differences in reported physical activity levels and in perceived environmental and psychosocial correlates of activity between Portuguese and Belgian adults; and to analyse the relative contribution of environmental and psychosocial variables in explaining physical activity within different contexts in Portugal and Belgium.

Cross-sectional study.

One city in Portugal (Oeiras) and one in Belgium (Ghent).

In total 526 participants, 247 from Portugal and 279 from Belgium, completed the long International Physical Activity Questionnaire and a validated questionnaire on environmental and psychosocial correlates.

For the sum of all activities of at least moderate intensity, a significantly higher mean level of activity was found in Belgian adults (P < 0.001). However, comparable percentages of the Belgian (38%) and Portuguese (42%) samples did not meet the recommendation of 30 min per day. The variance explained by environmental factors was lower (1% to 8%) than by psychosocial factors (maximum 42%). Regression analyses showed activity-specific relations with environmental variables which were analogous in both countries. Walking/cycling for transportation and walking for recreation were related to social support from family and/or friends and to walkability and walking facilities in the neighbourhood. Recreational physical activity was mainly determined by social support, self-efficacy, and perceived benefits and barriers.

Activity campaigns addressing psychosocial determinants are needed to encourage leisure-time activity, while a combination of neighbourhood design changes and encouragement of social support in walking is warranted to increase walking in different contexts.

To evaluate the impact of the disaggregation of composite foods on intake estimates of meat and individual meat categories and on the contribution of meat to nutrient intakes in Irish adults.

Data were analysed from the North/South Ireland Food Consumption Survey, which used a 7-day food diary to estimate food intake. Of 742 food codes that contained meat, 320 were codes for meat consumed as an individual portion and 422 were composite foods and were disaggregated to estimate the meat content.

A nationally representative sample of 475 men and 483 women (not pregnant or lactating) from the Republic of Ireland aged 18–64 years.

The mean intake of meat was 134 g day−1 in consumers (98.5%) and men (168 g day−1) consumed significantly more (P < 0.001) than women (102 g day−1). Mean intakes of meat were higher in subjects with manual skilled occupations (P < 0.01) and lower in those with third-level educational qualifications (P < 0.05). Without disaggregating meat from composite foods, meat intake was overestimated by 43% (57 g day−1) and varied widely by meat category. Meat disaggregated from composite foods contributed 25% of meat intake. The contribution meat made to nutrient intakes ranged from 29% for protein, vitamin B12, zinc and niacin to 20% for vitamin D, 16% for vitamin B6, 15% for thiamine and 14% for iron.

Failure to disaggregat meat from composite foods substantially overestimates meat intake, with a large variation between meat categories. This has important implications for estimates of meat intakes in nutritional epidemiological studies and for food safety purposes.

There were two objectives: first, to review the existing data on energy costs of specified activities in the light of the recommendations made by the Joint Food and Agriculture Organization/World Health Organization/United Nations University (FAO/WHO/UNU) Expert Consultation of 1985. Second, to compile existing data on the energy costs of physical activities for an updated annexure of the current Expert Consultation on Energy and Protein Requirements.

Electronic and manual search of the literature (predominantly English) to obtain published data on the energy costs of physical activities. The majority of the data prior to 1955 were obtained using an earlier compilation of Passmore and Durnin. Energy costs were expressed as physical activity ratio (PAR); the energy cost of the activity divided by either the measured or predicted basal metabolic rate (BMR).

The compilation provides PARs for an expanded range of activities that include general personal activities, transport, domestic chores, occupational activities, sports and other recreational activities for men and women, separately, where available. The present compilation is largely in agreement with the 1985 compilation, for activities that are common to both compilations.

The present compilation has been based on the need to provide data on adults for a wide spectrum of human activity. There are, however, lacunae in the available data for many activities, between genders, across age groups and in various physiological states.

To describe an integrated, holistic conceptual framework and research paradigm for a better understanding of the nutrition transition in middle- and low-income countries.

Current inability effectively to prevent the increasing burden related to changes in food consumption patterns and other health behaviours of populations in transition motivates a new approach for nutrition research and practice. In this proposed approach, broader and integrated dimensions of science and practice may be applied for a better understanding of this complex phenomenon.

Examples from our own studies are given and quoted to illustrate how results from transdisciplinary studies were used to design an integrated, holistic programme to improve quality of life of people infected with HIV.

Based on these experiences it is argued that the more holistic and integrated approach should and could lead to more effective and sustainable interventions to prevent the adverse health consequences of the nutrition transition. At the same time such an approach will contribute to efforts to conserve the environment and also human, living and natural resources.

To show that nutrition science is anchored in food systems and is influenced by the social, through the environmental to the cosmological, life's connections and rhythms. To indicate that an integrative approach is now becoming possible with advances in food technology, in the understanding of food choice and of human behaviour, and in a preparedness to recognise nutritional inputs in the full sweep of life-long well-being and health outcomes.

An analysis of the much broader understanding of nutritionally related diseases from an ecological perspective, with attention to economic development, beginning with poverty alleviation. Recognition that the biological dimension of nutrition science is undergoing a profound reappraisal; that technologies will allow us to change the course of nutritionally related diseases for the better; and that nutrition science will find partners in information technology and telecommunications, food technology and energy technology.

A new generation of nutrition scientists can help build a new economy that supports development amongst communities, whether close or distant from each other. The opportunities for this kind of development to be realised between Asia, Latin America and Africa are considerable. At all times, however, nutrition scientists must uphold the paramount importance of good governance, conflict resolution and maternal literacy if their work is to achieve its growing potential.

To assess the use of folic acid supplementation in relation to small-area measures of social deprivation.

Cohort study.

Antenatal clinic, Women's Outpatients Services, Cumberland Infirmary, Carlisle, UK.

Four hundred and fifty women attending their 18-week antenatal clinic appointment. No selection criteria were applied. Townsend scores were allocated using postcodes to provide a small-area measure (enumeration district) of social deprivation.

Eighty-nine per cent of women took folic acid prior to their 18-week antenatal clinic appointment; 48% of women took folic acid before 4 weeks of gestation. Younger women and more socially deprived women were less likely to use folic acid supplements before 4 weeks of gestation. Women with a family history of neural tube defects were no more likely to take folic acid than were women with no family history of neural tube defects.

A high proportion of women reported taking folic acid supplements during pregnancy but less than half took them at the most important time in early pregnancy. Younger women and women who were more socio-economically deprived were much less likely to take folic acid during the critical periconceptional period. Future strategies should promote prenatal folic acid supplementation in women under the age of 24 and in women of low socio-economic status. Further attention should also be given to the use of folic acid supplements in women with a family history of neural tube defects.

To evaluate gender differences for levels of physical activity, for sedentary behaviour and for psychosocial correlates in children, to evaluate whether psychosocial correlates cluster in meaningful ways and to examine whether physical activity and sedentary behaviour differ between children of clusters, differentiated by the level of perceived barriers and benefits, attitudes, social support and self-efficacy.

Cross-sectional study using the Flemish Physical Activity Questionnaire.

Questionnaires to be filled out by the children and one of their parents, contacted through the school system.

A sample of 1124 10- to 11-year-olds (579 boys and 545 girls).

Girls were found to be less active than boys, with boys scoring better for social support, perceived benefits and self-efficacy compared with girls. The way of clustering differed between boys and girls. Boys were allocated to three clusters: one cluster with positive correlates towards physical activity, labelled ‘positives’; one with negative correlates, labelled ‘negatives’; and one characterised mainly by high perceived barriers, labelled ‘hindered’;. In both genders the highest levels of physical activity were found in the ‘positives’;, the lowest in the ‘negatives’;. In girls a fourth cluster was identified, characterised mainly by low perceived barriers and low social support. Physical activity levels in the girls of this cluster, labelled ‘indifferents’;, were the second highest.

More research is needed to further characterise these clusters. To prevent the physical activity decline during the transition from childhood to adulthood, novel interventions need to be explored that focus on children of the clusters with the most negative correlates.

To examine the present methods used to define nutritional needs, and to analyse the intrinsic limitations of the reductionist chemical, biological and medical approaches to assess requirements. To establish the necessity to incorporate the complexities emerging from a broader understanding of the biological sciences as well as to include environmental and social dimensions in addressing nutritional needs.

Examples of the limitations of current approaches and the implications of these in defining potential solutions and policy options to address present nutritional problems are presented and discussed.

The chemical and biological sciences have provided a strong base for nutrition and have been essential in establishing nutrition as a science with public health relevance. However, these approaches are clearly insufficient to address the main challenges that confront nutrition science now in the twenty-first century. There is a pressing need to include the social, economic and human rights aspects in order to define future policies that will secure the right to safe and nutritious food for all.

This study assessed and compared heath-related behaviours and nutrient and food group intakes between US-born and Korea-born Korean American women.

Cross-sectional analyses were performed for ethnic Koreans who participated in the Multiethnic Cohort Study in Hawaii and Los Angeles in 1993–1996. The sample included 492 Korean American women aged 45–75 years who were born in the USA (n = 274) or Korea (n = 218). Participants were recruited using driver's license files as a primary sampling source and completed a self-administered questionnaire, including a quantitative food frequency section.

The proportion overweight or obese was 31.4% in US-born and 9.4% in Korea-born women. US-born women had higher intakes of total fat and fat as a percentage of energy, and lower intakes of sodium, vitamin C, β-carotene and carbohydrate as a percentage of energy, than Korea-born women. Comparing intakes of food group servings from the Food Guide Pyramid, US-born women reported more whole grains, red meat and nuts, and less soy products, than did Korea-born women. US-born women also consumed fewer vegetables and fruit than those born in Korea. Few women in either group reported intakes that met the recommendations for dairy foods. Intake of discretionary fat from the Pyramid tip was higher in US-born than in Korea-born women.

These findings indicate that the acculturation of Korean immigrants affects dietary intakes in ways that may alter risks of several chronic diseases. Further studies will be necessary to examine the effects of dietary acculturation on disease patterns.

To examine the evidence as to whether the relationship between undernutrition and poor child development is causal.

Selected studies from developing countries were discussed. Observational studies were first considered then experimental studies of preventative and remedial supplementation. The type of functions affected, the presence of sensitive periods and the role of protein and energy versus that of micronutrients were reviewed.

Childhood undernutrition is generally associated with concurrent and longer term deficits in cognition, behaviour and motor skills, although the relationship is likely to be confounded by socio-economic factors. Supplementation trials have had many design problems. However, those beginning at any age from pregnancy up to 24 months have consistently had concurrent benefits suggesting a causal relationship. Supplement begun in older children had little or no effect, albeit there are too few studies to conclude with confidence. The limited evidence suggests that benefits are more likely to be sustained if supplementation begins in late pregnancy or at birth and is continued until the child is at least 24 months old.

Deficits in cognition tend to be global and there is insufficient evidence of specific deficits. There is some evidence that the first 2 years of life are most sensitive to the effects of undernutrition. Most studies have failed to separate the effects of energy and protein from those of micronutrients. One study showed that energy and/or protein affects children's development. Psychosocial stimulation has had consistent benefits on undernourished childrens' development

Public health nutrition programmes should include a component in which children who are at risk are targeted during the first 2 years of life with combined interventions involving nutrition, health care and early stimulation.

High-glycaemic-load diets may increase endometrial cancer risk by increasing circulating insulin levels and, as a consequence, circulating oestrogen levels. Given the paucity of epidemiological data regarding the relationship between dietary glycaemic index and glycaemic load and endometrial cancer risk, we sought to examine these associations using data from a prospective cohort study.

We examined the association between dietary glycaemic load and endometrial cancer risk in a cohort of 49 613 Canadian women aged between 40 and 59 years at baseline who completed self-administered food-frequency questionnaires between 1982 and 1985. Linkages to national mortality and cancer databases yielded data on deaths and cancer incidence, with follow-up ending between 1998 and 2000.

During a mean of 16.4 years of follow-up, we observed 426 incident cases of endometrial cancer. Hazard ratios for the highest versus the lowest quartile level of overall glycaemic index and glycaemic load were 1.47 (95% confidence interval (CI) = 0.90–2.41; P for trend = 0.14) and 1.36 (95% CI = 1.01–1.84; P for trend = 0.21), respectively. No association was observed between total carbohydrate or total sugar consumption and endometrial cancer risk. Among obese women (body mass index > 30 kg m−2) the hazard ratio for the highest versus the lowest quartile level of glycaemic load was 1.88 (95% CI = 1.08–3.29; P for trend = 0.54) and there was a 55% increased risk for the highest versus the lowest quartile level of glycaemic load among premenopausal women. There was also evidence to support a positive association between glycaemic load and endometrial cancer risk among postmenopausal women who had used hormone replacement therapy.

Our data suggest that diets with high glycaemic index or high glycaemic load may be associated with endometrial cancer risk overall, and particularly among obese women, premenopausal women and postmenopausal women who use hormone replacement therapy.