To develop and integrate the assessment of functional foods (FuF; manufactured foods with altered composition carrying a health claim) consumption into an existing risk factor surveillance system.

FuF market research followed by an experimental FuF intake study incorporated into an ongoing community-based survey. Concurrent completion of a self-administered semi-quantitative FFQ and a self-administered, qualitative FuF frequency questionnaire (FuFFQ) followed by a face-to-face control step using FuF photographs and combined food group-based data analyses.

‘Bus Santé’ risk factor surveillance programme, Geneva/Switzerland.

Population-based random sample of 639 residents (52 % women, aged 35–74 years) surveyed from September 2003 to April 2004.

Local Geneva/French neighbourhood market research identified 148 FuF in five major FuF food groups which were compiled into a functional ingredient database. Prior to the face-to-face verification, 210 (33 %) individuals categorized themselves as FuF consumers, 429 (67 %) as non-consumers. The control step revealed that 70 % of the 639 participants were already familiar with the FuF concept, and thus were correctly self-categorized as FuF consumers or non-consumers. For the remaining 30 % of participants the true FuF consumption status was established, resulting in a final number of 285 FuF consumers (45 %; 12 % net increase) and 354 (55 %) non-consumers.

The developed self-administered, brief, qualitative food group-based FuF frequency check list in combination with an FFQ and a photo-assisted control step provides a flexible assessment tool for measuring FuF consumption in the context of a specific fluctuating FuF market and may be applicable to other population settings and times.

To evaluate the validity of the Northern Sweden eighty-four-item FFQ to estimate intake of fatty acids relative to 24 h diet recalls (24-HDR) and fatty acids in erythrocyte membranes.

Participants, randomly recruited from the population-based Västerbotten Intervention Project, answered the eighty-four-item FFQ. During the following year each participant carried out ten 24-HDR. Intake of fatty acids measured by the FFQ was compared with intake by the 24-HDR and fatty acid levels in erythrocytes.

The county of Västerbotten in northern Sweden.

Ninety-six men and ninety-nine women.

Spearman correlation coefficients (rs) between intakes of the fatty acids 14 : 0, 15 : 0, 16 : 0, 17 : 0, 18 : 2n-6, 18 : 3n-3, 20 : 5n-3 and 22 : 6n-3 estimated by the FFQ and the 24-HDR were all significant and ranged from 0·29 (22 : 6n-3 in men and women) to 0·60 (16 : 0 in men), whereas significant correlations between FFQ-estimated intake and erythrocyte membrane content were only seen for milk fatty acids 14 : 0, 15 : 0 and 17 : 0 (rs = 0·23–0·34) and fish fatty acids 20 : 5n-3 and 22 : 6n-3 (rs = 0·42–0·51).

The Northern Sweden eighty-four-item FFQ gives a satisfactory estimate of the intake of fish fatty acids (20 : 5n-3 and 22 : 6n-3) and milk fatty acids (15 : 0 and 17 : 0), whereas its validity for fatty acids 18 : 2n-6 and 18 : 3n-3, derived mainly from vegetable oils, cannot be shown.

To describe pathways through which trade liberalisation affects the food environment, relevant to the nutrition transition, in order to enable public health nutritionists to understand trade policy as a macro-level influence on food consumption.

The pathways mapped in the present paper are based on the agreements of the World Trade Organization, which shape national policy. Implications for nutrition are presented based on a comprehensive literature review, and case studies are used to illustrate the various pathways.

Developing countries are currently experiencing a nutrition transition, resulting in dietary patterns associated with chronic disease. Chronic diseases are amenable to prevention, and trade policy has been highlighted as a potential avenue for nutrition-related prevention.

Trade liberalisation influences the food environment through facilitating trade in goods and services, enabling investment and decreasing support/protection for domestic industry. These policy outcomes facilitate the nutrition transition particularly through increasing the availability and affordability of processed foods and animal products. The framework highlights the complex relationship between trade policy and the nutrition transition, with both negative and positive outcomes arising from different aspects of trade liberalisation.

Policy change associated with trade liberalisation has created incentives for consumption patterns associated with the nutrition transition, but has also had some positive nutritional outcomes. As a result, it is important for public health nutritionists to consider the implications of trade policy decisions in their efforts to prevent and control diet-related chronic diseases.

The purpose of the present study was to investigate the distribution of hypertension, its nutritional and other determinants and their association in Croatia.

Population-based, cross-sectional study.

Croatia.

Representative random sample of 9070 adults (18 years and older) from all Croatian regions, selected using multistage sampling.

Overall prevalence of hypertension (arterial blood pressure ≥140/90 mmHg) in Croatia was 45·5 %, of which 40 % were newly diagnosed hypertensives. There was no difference in the percentage of hypertensives between the continental and Mediterranean parts of Croatia. Newly diagnosed hypertension was found to be positively associated with increased BMI, age and alcohol consumption in the total sample and with moderate consumption of coffee in women, as well as inversely associated with regular consumption of fruits and vegetables in the total sample and high consumption of coffee in the total sample and in men. No association with newly diagnosed hypertension was recorded for use of animal fat, consumption of whole milk, smoked meat products, for adding salt, smoking and leisure-time physical activity.

Hypertension is a major public health problem in both continental and Mediterranean parts of Croatia. Maintenance of normal body mass, its reduction if already increased, and regular consumption of fruits and vegetables are proposed as priorities for primary prevention of hypertension in Croatia.

To determine the prevalence and usage of food gardens in primary schools in three distinct climatic regions of north-eastern Australia.

Cross-sectional surveys combining quantitative and qualitative data collection. Two separate telephone questionnaires were developed and implemented, according to the presence or absence of a food garden within the school. Main outcome measures were answers to scaled response and open-ended questions related to factors supporting and inhibiting the establishment and sustainability of school food gardens.

All state primary schools in three disparate regions of the north-eastern Australian state of Queensland were asked to participate in the study.

A total of 71 % (n 128) of schools agreed to participate. Of these, thirty-seven primary schools had functioning food gardens. The variations in prevalence between regions combined with respondent views indicated climate as a major factor affecting the success of food gardens. Gardens were often used as a tool by schools to teach science, environment or social skills. Gardening activities were generally linked to curriculum studies on plants, fruit and vegetable intake, and healthy eating. The main issues for schools and teachers in establishing food gardens were the time required and the lack of personnel to coordinate garden activities. Of the schools with food gardens, 92 % believed their garden had been a success.

The study revealed strong grass-roots support for school-based food gardens. Although climate and location were important factors associated with the presence of a functioning food garden, respondents nominated teacher involvement and sustained motivation as essential factors for successful school food gardens.

To assess anaemia prevalence and correlated social and biological determinants among pregnant women in the Occupied Palestinian Territory (oPt).

A cross-sectional survey conducted among pregnant women attending/accessing UNRWA (United Nations Relief and Works Agency for Palestine Refugees in the Near East) health centres in the Gaza Strip and the West Bank in September and October 2006.

Fifty-five UNRWA health centres in the oPt (eighteen in the Gaza Strip and thirty-seven in the West Bank).

A random sample of 1740 pregnant women.

Overall anaemia prevalence was 38·6 % (95 % CI 36·3, 40·9 %). A substantial difference in anaemia prevalence was observed between the Gaza Strip and the West Bank (44·9 % v. 31·1 %, respectively), as well as a significant increase in anaemia prevalence in the Gaza Strip compared with an Agency-wide survey conducted in 2004 (44·9 % v. 35·7 %, respectively). Anaemia prevalence was found to increase with age, parity and trimester of gestation.

Anaemia still appears to be a public health problem among pregnant women in spite of UNRWA interventions. The West Bank shows prevalence rates similar to those observed in neighbouring countries, while the Gaza Strip has higher rates. Prevalence rates of anaemia among pregnant Palestinian women are more than two times higher than those observed in Europe.

To assess whether the Bangladesh Integrated Nutrition Programme (BINP) correctly identified which pregnant women should be enrolled in the food supplementation programme, whether supplementation commenced on time and was taken on a regular basis. A second objective was to determine whether food supplementation led to enhanced pregnancy weight gain and reduction in the prevalence of low birth weight.

A one-year community-based longitudinal study.

A rural union of Bhaluka Upazila, Mymensingh, located 110 km north-west of Dhaka City, the capital of Bangladesh.

A total of 1104 normotensive, non-smoking pregnant women who attended Community Nutrition Centres were studied from first presentation at the centre until child delivery.

Pregnant women who had a BMI of <18·5 kg/m2 on first presentation should have been selected for supplementary feeding (2512 kJ (600 kcal)/d for six days per week) starting at month 4 (16 weeks) of pregnancy. However, of the 526 women who had BMI < 18·5 kg/m2, only 335 received supplementation; so the failure rate was 36·3 %. In addition, of those receiving supplementation, only 193 women (36·7 % of 526 women) commenced supplementation at the correct time, of whom thirty-two (9·6 % of 335 women) received supplementation for the correct number of days (100 % days). There were no significant differences in mean weight gain between BMI < 18·5 kg/m2 supplemented or non-supplemented groups or between the equivalent groups with BMI ≥ 18·5 kg/m2. Weight gain was inversely related to initial weight, so lighter women gained relatively more weight during their pregnancy than heavier women. The mean birth weight in the supplemented and non-supplemented groups was 2·63 kg and 2·72 kg, respectively. Mothers with BMI < 18·5 kg/m2 who were or were not supplemented had almost equal percentages of low-birth-weight babies (21 % and 22 %, respectively).

The study raises doubt about the efficiency of the BINP to correctly target food supplementation to pregnant women. It also shows that food supplementation does not lead to enhanced pregnancy weight gain nor does it provide any evidence of a reduction in prevalence of low birth weight.

To investigate the comparative effect of social, economic, health and environmental characteristics on the nutritional status of children aged <3 years in Central Asia.

Cross-sectional analysis using data from Demographic and Health Surveys.

Uzbekistan, Kyrgyzstan and Kazakhstan.

Information on demographic health was gathered by Macro International Inc., Uzbekistan, Kyrgyzstan and Kazakhstan governments from a random sample of 14 067 households in the three countries. Anthropometric measurements were performed using standardized procedures on all children <3 years of age (n 2358). Only children with plausible Z-scores (n 1989) were selected for subsequent analyses.

The main results indicated that country of residence, number of people in household, household wealth, birth weight, age of child, knowledge of oral rehydration therapy, maternal education, number of children <5 years of age and source of drinking water were strong predictors of child nutritional status in these countries. Furthermore, chronic malnutrition was most prevalent in all three countries but at varied levels. An unexpected finding was that fully vaccinated children were more likely to be malnourished than children who were partially vaccinated. A further unexpected finding was that breast-feeding especially in children >6 months old had a strong negative association with stunting and underweight.

In summary, the results from both the descriptive and binary logistic regression analysis are similar in terms of the explanatory variables and the statistical significance in the models.

To examine the relationship between dietary patterns and metabolic syndrome.

Population-based cross-sectional study. The K-means clustering method was used to identify dietary patterns and logistic regression models were used to compare the adjusted prevalence rates of metabolic syndrome factors, stratifying by obesity status.

The 1992–3 Italian Bollate Eye Study, a population-based survey carried out in the town of Bollate (Milan), Italy.

A total of 1052 non-diabetic Italian subjects, 527 men and 525 women, aged 42–74 years.

Five dietary clusters were identified: common, animal products, starch, vegetal/fat and vitamin/fibre. After adjusting for potential confounders, the starch group showed the highest prevalence of metabolic syndrome (36 %) followed by the animal products group (30 %); the vitamin/fibre (20 %) and vegetal/fat groups (19 %) showed the lowest prevalence. The starch group had more dyslipidaemia (higher TAG and lower HDL cholesterol levels) and the animal products group had a higher prevalence of impaired fasting glucose. The vitamin/fibre group had the lowest prevalence of abdominal obesity. The beneficial effect of the vegetal/fat and vitamin/fibre dietary patterns seemed stronger among the obese.

Our results confirm the deleterious effect of a very-low-fat, high-carbohydrate diet and also of high intakes of animal products. The consumption of a diet high in vegetal fats or rich in fruits and vegetables is associated with a healthier metabolic profile. Reducing obesity is essential to prevent metabolic syndrome, but even among the obese dietary habits are important for preserving healthy lipid and glycaemic profiles.

The aim of the present study was to develop (phase 1) and validate (phase 2) a screening questionnaire to assess the adequacy of micronutrient intake of economically active South African adults.

For identification of indicator foods to be included in the screening questionnaire (phase 1), a comprehensive, eighty-six-item, quantified FFQ that reflected the food sources of thirteen selected micronutrients associated with the nutrition-related health status of South Africans was developed and completed by 554 adults of all four major ethnic groups. Resulting dietary data were subjected to stepwise regression analyses to identify indicator foods to be included in the final screening questionnaire. For validation of frequency of intake reporting of specific food items included in the screening questionnaire (phase 2), a sample of sixty-six African and eighty-four white adult volunteers of both genders completed a 7 d record as well as the screening questionnaire. The frequency of intake of specific food items derived from the two methods was then compared using Spearman correlation coefficients.

Phase 1 identified thirty indicator foods that formed the basis of the screening questionnaire. In phase 2, significant correlations were found for the total group for twenty-two out of the thirty items in the questionnaire, with correlations being the best for white females and the poorest for African males and females.

A screening questionnaire (thirty-item FFQ) that can be used by researchers and health professionals to assess an individual’s risk of inadequate micronutrient intake was developed and validated.

To evaluate the long-term effects of the Schoolgruiten Project, a Dutch primary school-based intervention providing free fruit and vegetables (F&V). In addition, we assessed whether children’s appreciation of the project mediated these intervention effects.

Participating schoolchildren (mean age 9·9 years at baseline) and their parents completed parallel questionnaires at baseline, at 1-year and at 2-year follow-up, including questions on usual F&V intake of the child, potential behavioural determinants, their appreciation of the project and general demographics. Primary outcomes were usual F&V intakes as assessed by parent and child self-reported food frequency measures. Secondary outcome measures were taste preference, knowledge of daily recommendations, availability and accessibility for fruit intake. Multilevel linear regression analyses were used to assess differences at second follow-up adjusted for baseline values between control and intervention groups.

Reports were available for 346 intervention children (148 parents) and 425 control children (287 parents).

Both child and parent reports indicated that the intervention group had a significantly higher fruit intake at 2-year follow-up (difference, servings/d: 0·15; 95 % CI 0·004, 0·286 for child reports; 0·19; 95 % CI 0·030, 0·340 for parent reports). No significant effects on vegetable intake were observed. Significant positive intervention effects were also found for knowledge of fruit recommendations among boys. Some evidence was found for partial mediation analyses of the effects on fruit intake.

The present study indicates that the Schoolgruiten scheme was effective in increasing children’s fruit intake and that appreciation of the project partially mediated this effect.

The present study aimed to estimate the lutein concentration in human milk during early lactation and its relationship with dietary lutein intake measured through the administration of a short FFQ.

A cross-sectional study in which an FFQ was administered twice: on day 3 (T0) and day 30 (T1) postpartum; meanwhile two breast milk samples were collected. Maternal plasma samples were obtained at T0. The comparison of dietary lutein intakes and likewise lutein concentrations in breast milk at T0 and T1 were analysed with Student’s t test. Pearson’s correlation coefficient was used to determine the association between dietary lutein intake and lutein concentration in milk and plasma, respectively, as well as the correlation between breast milk and plasma lutein concentrations at T0.

Pavia, northern Italy.

Twenty-one pregnant women, age range 24–42 years, were recruited during their last trimester on a voluntary basis.

Both breast milk and plasma lutein concentrations were significantly correlated with dietary lutein intake (r = 0·86, P = 0·0001 and r = 0·94, P = 0·0001, respectively). There was a clear significant correlation between milk and plasma lutein concentrations (r = 0·87, P = 0·0001). Mature milk lutein concentration, although significantly reduced at T1 (P < 0·01), maintained a fairly high correlation with dietary lutein intake (r = 0·82, P = 0·0001).

Even though milk lutein concentration decreased during early lactation, it remained significantly correlated with daily lutein intake. Therefore, while awaiting further research, dietary recommendations advising intake of fresh fruit and vegetables rich in lutein, throughout the whole duration of pregnancy and lactation, are extremely useful.