To examine the association between dietary patterns (DP) and risk for metabolic syndrome (MetS); and to identify differences in DP by socio-economic, demographic and lifestyle factors.

Dietary intake (from an FFQ), anthropometric/biochemical parameters and sociodemographic/lifestyle information (from a self-reported questionnaire) were evaluated, using a cross-sectional design. Statistical methods included principal component factor analysis, analysis of covariance and linear regression. All analyses were covariate-adjusted.

The Bogalusa Heart Study (1995–1996), USA.

Young adults (19–39 years; n 995; 61 % females/39 % males; 80 % whites/20 % blacks) from a semi-rural southern US community were examined.

The ‘Western Dietary Pattern’ (WDP) consisted of refined grains, French fries, high-fat dairy foods, cheese dishes, red meats, processed meats, eggs, snacks, sweets/desserts, sweetened beverages and condiments. The ‘Prudent Dietary Pattern’ (PDP) consisted of whole grains, legumes, vegetables, fruits, 100 % fruit juices, low-fat dairy products, poultry, clear soups and low-fat salad dressings. The DP explained 31 % of the dietary intake variance. Waist circumference (P = 0·02), triceps skinfold (P = 0·01), plasma insulin (P = 0·03), serum TAG (P = 0·05), and the occurrence of MetS (P = 0·03) were all inversely associated with PDP. Insulin sensitivity (P < 0·0005) was positively associated with PDP. Serum HDL cholesterol (P = 0·05) was inversely associated with WDP. Blacks consumed more servings from WDP than whites (P = 0·02). Females consumed more servings from PDP than males (P = 0·002). Those with >12 years of education consumed more servings from PDP than their counterparts (P < 0·0001). Current smokers consumed more servings from WDP than current non-smokers (P < 0·0001). Physically very active young adults consumed fewer servings from WDP than their sedentary counterparts (P = 0·02).

More studies are warranted to confirm these findings in other populations.

The present study describes the trajectory of the energy gap (energy imbalance) in the Canadian population from 1976 to 2003, its temporal relationship to adult obesity, and estimates the relative contribution of energy availability and expenditure to the energy gap. It also assesses which foods contributed the most to changes in available energy over the study period.

Annual estimates of the energy gap were derived by subtracting population-adjusted per capita daily estimated energy requirements (derived from Dietary Reference Intakes) from per capita daily estimated energy available (obtained from food balance sheets). Food balance sheets were used to assess which foods contributed to changes in energy availability. Adult obesity rates were derived from six national surveys. The relationship to the energy gap was assessed through regression analysis.

Between 1976 and 2003, per capita daily estimated energy availability increased by 18 % (1744 kJ), and increased energy availability was the major driver of the increased energy gap. Salad oils, wheat flour, soft drinks and shortening accounted for the majority of the net increase in energy availability. Adult obesity was significantly correlated with the energy gap over the study period.

The widening energy gap is being driven primarily by increased energy availability. The food commodities driving the widening energy gap are major ingredients in many energy-dense convenience foods, which are being consumed with increasing frequency in Canada. Policies to address population obesity must have a strong nutritional focus with the objective of decreasing energy consumption at the population level.

To assess the association of time spent viewing television, videos and video games with measures of fat mass (BMI) and distribution (triceps and subscapular skinfold thicknesses (TSF, SSF)).

Cross-sectional validated survey, self-administered to students to assess screen time (television, videos and video games) and lifestyle variables. Trained personnel obtained anthropometry. The association of screen time with fat mass and distribution, stratified by sex, was modelled with multivariable linear regression analysis, adjusting for potential confounders and correlation of observations within schools.

State of Morelos, Mexico.

Males (n 3519) and females (n 5613) aged 11 to 18 years attending urban and rural schools in Morelos.

In males, screen time of >5 h/d compared with <2 h/d was significantly associated with a 0·13 (95 % CI 0·04, 0·23) higher BMI Z-score, 0·73 mm (95 % CI 0·24, 1·22) higher SSF and 1·08 mm (95 % CI 0·36, 1·81) higher TSF. The positive association of screen time with SSF was strongest in males aged 11–12 years. Sexual maturity appeared to modify the association in females; a positive association between screen time and SSF was observed in those who had not undergone menarche (P for trend = 0·04) but not among sexually mature females (P for trend = 0·75).

Screen time is associated with fat mass and distribution among adolescent males in Mexico. Maturational tempo appears to affect the relationship of screen time with adiposity in boys and girls. Findings suggest that obesity preventive interventions in the Mexican context should explore strategies to reduce screen time among youths in early adolescence.

Despite a strong relationship between household food security and the health and nutritional status of adults and older children, the association of household food security with the growth of infants and young children has not been adequately studied, particularly in developing countries. We examined the association between household food security and subsequent growth of infants and young children in rural Bangladesh.

We followed 1343 children from birth to 24 months of age who were born in the Maternal and Infant Nutrition Intervention in Matlab (MINIMat) study in rural Bangladesh. A food security scale was created from data collected on household food security from the mothers during pregnancy. Data on weight and length were collected monthly in the first year and quarterly in the second year of life. Anthropometric indices were calculated relative to the 2006 WHO child growth standards. Growth trajectories were modelled using multilevel models for change controlling for possible confounders.

Household food security was associated (P < 0·05) with greater subsequent weight and length gain in this cohort. Attained weight, length and anthropometric indices from birth to 24 months were higher (P < 0·001) among those who were in food-secure households. Proportions of underweight and stunting were significantly (P < 0·05) lower in food-secure households.

These results suggest that household food security is a determinant of child growth in rural Bangladesh, and that it may be necessary to ensure food security of these poor rural households to prevent highly prevalent undernutrition in this population and in similar settings elsewhere in the world.

To examine the effect of the new Canadian labelling regulations on the fat composition and prices of margarines.

A survey of all margarines sold in major supermarkets in the Greater Toronto area was conducted in 2006, and results were compared with those of a similar survey conducted in 2002. Average fat composition, proportion of ‘trans fat-free’ margarines and average prices of margarines were compared. A general linear model procedure was used to compare the relationship between price and fat composition in 2002 and 2006.

Average amounts of trans fatty acids (TFA) and MUFA decreased, while average amounts of PUFA increased significantly from 2002 to 2006. The proportion of margarines with less than 0·2 g TFA/10 g serving rose significantly from 31 % in 2002 to 69 % in 2006. Margarines lower in TFA on average cost significantly more than margarines with greater amounts of these fats, and this relationship appeared stronger in 2006 relative to 2002.

There is evidence of reductions in TFA in margarines since new labelling regulations came into effect in Canada; however, TFA reductions appeared to be restricted to higher-priced margarines. Results suggest that voluntary approaches (i.e. manufacturer incentives via labelling) to reduce population intakes of TFA will yield little changes in TFA content of low-cost products and thus may have limited benefit for lower-income groups, who are at higher risk of heart disease.

To assess the adequacy of periconceptional intake of key micronutrients for perinatal health in relation to regular cereal consumption of pregnant women.

Low-income pregnant women (n 596) in Pittsburgh, Pennsylvania, USA, who enrolled in a cohort study at <20 weeks’ gestation. These women reported usual dietary intake in the three months around conception on an FFQ. Cereal consumers were women who reported consuming any dry cereal at least three times per week. High risk for nutrient inadequacy was defined as intake less than the Estimated Average Requirement.

About 31 % of the women regularly consumed cereal. After adjusting for energy intake, race/ethnicity, marital status, breakfast consumption and supplement use, cereal eaters had significantly higher intakes of folate, Fe, Zn, Ca, fibre and vitamins A, C, D and E (all P < 0·01) and were approximately two to six times more likely to have intakes in the highest third of the distribution for folate, Fe, Zn, Ca, vitamins A and D, and fibre (all P < 0·01) than cereal non-eaters. Cereal consumption was also associated with reductions of 65–90 % in the risk of nutrient inadequacies compared with non-consumption (all P < 0·01).

Encouraging cereal consumption may be a simple, safe and inexpensive nutrition intervention that could optimize periconceptional intake for successful placental and fetal development.

To identify approaches for interventions to improve the nutrition of low-income women and children.

Seven focus groups were conducted with low-income women caring for young children in their households. They discussed shopping, eating at home, eating out and healthy eating. The discussions were recorded and subjected to qualitative thematic analysis.

A semi-rural community in Oregon, USA.

There were seventy-four women (74 % White), most of whom were 18–29 years old.

Four broad themes were identified, i.e. cost-consciousness, convenience, social influences and health issues.

The target population would benefit from improved understanding of what constitutes a balanced diet, with a greater emphasis on a more central role for fruit and vegetables. To persuade this population to change their eating habits, it will be necessary to convince them that healthful food can be low-cost, convenient and palatable for children. Comparing findings from the present study with a similar one in the UK suggests that the US women faced many of the same barriers to healthy eating but displayed less helplessness.

Obesity is an increasingly prevalent nutritional disorder throughout the world. In particular, abdominal obesity is associated with cardiovascular and metabolic risk. The present study aimed to evaluate the effects of skin colour and life-course socio-economic indicators on waist circumference (WC), hip circumference (HC) and waist:hip ratio (WHR) in young adults.

Population-based birth cohort study. Individuals born in 1982 in Pelotas (southern Brazil) were visited on a number of occasions from birth to age 23–24 years. A sample of the cohort was sought in 2006 and 972 individuals were located. The analysis was restricted to individuals with complete data available (442 males, 414 females).

In men, family income at birth and in 2004–5 were positively associated with WC and HC, but not with WHR. Regardless of current income, men born to wealthier families had larger WC and HC as adults. Skin colour was not associated with any of the outcomes. In women, early poverty was associated with smaller HC, and current poverty with larger WC. Poverty at any age thus led to higher WHR. Black women had larger WC and HC than white women, but there were no differences in WHR. All the associations were partially mediated by education and behavioural variables.

The effects of early socio-economic position on WC and HC persist even after adjustment for adult socio-economic position, highlighting the importance of interventions during the first years of life.

As part of a larger study designed to understand how to protect the food and nutrition security of individuals living in a protected area of Gabon, we assessed their nutritional status and its relationship to dietary adequacy and health status.

A 7 d food consumption survey was conducted during each of the two major seasons using a weighing method. Data were also collected on weight, height and health of individuals as well as on sociodemographic characteristics and potential determinants of the nutrition situation.

Four rural communities were intentionally selected to represent both inland and coastal settings and access to food markets.

Approximately 500 individuals representing over 90 % of the population of these communities participated in the survey during each season.

Undernutrition was present in the area, particularly among children <5 years of age and the elderly. Health was generally good and under-fives were most frequently ill. Energy, Fe and vitamin A requirements of individuals were generally not satisfied; the opposite was true for protein. The estimated prevalence of inadequate intakes of energy and vitamin A was very high in most age groups. Global nutrient adequacy was associated with nutritional outcome.

Individuals do not eat enough and breast-feeding practices are poor. Many suffer from undernutrition, particularly young children and the elderly. The results confirm the need to investigate the determinants of this poor nutrition situation to ensure that protection of natural resources will not be associated with harm to the well-being of the population.

The current paper aims to present the main results of the Italian National Food Consumption Survey INRAN-SCAI 2005–06.

A cross-sectional study was performed. Households were randomly selected after geographical stratification of the national territory. Food consumption was assessed on three consecutive days through individual estimated dietary records.

Italy.

The final study sample comprised 3323 subjects (1501 males and 1822 females) aged 0·1 to 97·7 years belonging to 1329 households: fifty-two infants (0–2·9 years), 193 children (3–9·9 years), 247 teenagers (10–17·9 years), 2313 adults (18–64·9 years) and 518 elderly (65 years and above).

Participation rate was 33 %. The mean ratio of estimated energy intake to estimated BMR was 1·41 in adults. Indicators of mean and high individual consumption are presented for fifteen large categories and fifty-one subcategories of foods and beverages, in the total population and in consumers, by age and sex categories. The overall consumption of fruit and vegetables was 418 g/d. The consumption of red meat was approximately 700 g/week, expressed as raw weight. Some specific aspects of the Italian food consumption pattern were confirmed: a large contribution from bread, pasta and pizza to cereals, from olive oil to fats and from wine to alcoholic beverages.

The database obtained from the survey will be the key reference for Italian food consumption during the coming years and will be utilized for a variety of purposes including the assessment of nutrient intakes and risk analysis.

The present study aimed to examine associations between availability of outlets where takeaway or fast food could be purchased and consumption of takeaway or fast food among children.

Cross-sectional. Parents completed a questionnaire regarding the frequency per week their child usually ate takeaway or fast foods. The availability of outlets where these foods could be purchased close to home and en route to school was determined with a Geographic Information System (presence of any outlets and density of outlets within 800 m from home and along the route to school, and distance from home to closest outlet).

Greater Melbourne and Geelong, Australia.

Three hundred and fifty-three children aged 5–6 years and 463 children aged 10–12 years.

Overall, 69·4 % of children consumed takeaway or fast foods once weekly or more often. Only one measure of availability of outlets close to home was associated with consumption; each additional outlet within 800 m was associated with 3 % lower odds of consuming takeaway or fast foods at least once weekly (OR = 0·97, 95 % CI 0·95, 1·00). There were no associations between availability en route to school and the likelihood of consuming takeaway or fast food at least once weekly.

Access to outlets where takeaway or fast food could be purchased did not predict frequency of consumption of takeaway or fast food in the expected direction. Such relationships appear to be complex and may not be adequately captured by the measures of access included in the current study.

The study aimed to assess differences in dietary intake and growth of pre-schoolers and schoolchildren living in two limitary Greek islands; Samos, situated on the eastern border, and Corfu, situated on the western border.

Cross-sectional two-site study.

A total of 248 children aged 3–12 years from the two islands participated in the survey. Body weight and height were recorded and Z-scores were calculated. A 3 d food record was collected for each child, computer-analysed and compared with the Recommended Daily Allowances (RDA). Intakes ≤70 % of the RDA were considered inadequate.

The prevalence of overweight in participants from Samos and Corfu was 10·7 % and 6·5 % respectively, according to the Centers for Disease Control and Prevention growth charts. In Corfu, the diet comprised 52 % carbohydrate, 34 % fat and 14 % protein, all different from the composition of the Samian diet (42 % carbohydrate, 39 % fat, 19 % protein; P ≤ 0·05). Inadequacies in micronutrient intake were evident only in the diet of Samos and concerned folate and P of the pre-schoolers and biotin of the school-aged participants. The diet in Corfu was more similar to the overall Mediterranean pattern as well as that of Italian children. Growth and overweight trends in Corfu resembled the ones in Italy, whereas in Samos, similarities were identified with trends from Turkey.

Border areas at a distance from the mainland exhibit different dietary intakes compared with rest of the country; thus when designing nutrition surveys the setting should also include such limitary areas.

The WHO has recommended that prevention of overweight and obesity should begin early and target adults, including those with an acceptable BMI. The aim of the present paper was to systematically review published interventions with a specific stated aim to prevent weight gain.

Five databases were searched to July 2008. The reference lists of review articles and obesity society meetings abstracts were hand searched. Interventions were included if the primary aim was to prevent weight gain and they included a comparison group.

Ten publications were included, describing nine separate interventions in adults of various ages and target populations. All interventions incorporated diet and physical activity with behaviour change strategies. Most studies were between 1 and 3 years in duration. Five studies reported a significant difference in weight between intervention and control subjects of between 1·0 and 3·5 kg, due largely to an increase in weight in the control group. However, there was a lack of consistent, clear, psychological models and a failure to identify successful components. More intensive interventions were not always successful, nor were mail-only or clinic-based interventions. In contrast, interventions that included mixed modes of delivery with some personal contact were successful.

There were relatively few trials aimed at the prevention of weight gain. Existing trials varied by intensity, delivery methods, target groups and study components, and therefore provide limited opportunities for comparison of effect size. Further large, effective, evidence-based programmes are urgently needed in the general population as well as high-risk groups.

To use data from a published validation study concerning retention interval and school food-service production records to examine intrusions (uneaten items reported eaten) in the school-meal parts of 24 h recalls.

For that study, children were observed eating two school meals (breakfast, lunch) and interviewed under one of six conditions from two target periods (previous day (PDTP), prior 24 h (24TP)) crossed with three interview times (morning, afternoon (AIT), evening). For the present article, a catalogue was constructed of foods available for that study’s school meals. The study’s intrusions were classified as stretches (on children’s meal trays but uneaten), internal confabulations (in children’s school food-service environments for that meal but not on children’s trays) or external confabulations (not in children’s school food-service environments for that meal). Occurrence, types and amounts of intrusions were investigated.

Six schools; sixty fourth-grade children (ten per condition).

For breakfast, for the 24TP v. PDTP, reported items were less likely to be intrusions, internal confabulations and external confabulations; and intrusions were more likely to be stretches. For lunch, for the 24TP-AIT condition v. the other five conditions, reported items were less likely to be intrusions and external confabulations. Mean amounts reported eaten were smaller for stretches than for internal confabulations or external confabulations at breakfast, and for stretches than for internal confabulations at lunch.

Accuracy was better for the 24TP (with fewer intrusions of which proportionally more were stretches which had smaller amounts reported eaten) than for the PDTP. Studies with 24 h recalls should minimize retention interval to improve accuracy.

All previous studies on monetary diet cost have examined the relationship of monetary cost of self-reported diet to self-reported, rather than biomarker-based, estimates of dietary intake. The present cross-sectional study examined the association between monetary costs of self-reported diet and biomarker-based estimates of nutrient intake.

Monetary diet cost (Japanese yen/1000 kJ) was calculated based on dietary intake information from a self-administered, comprehensive diet history questionnaire using retail food prices. Biomarker-based estimates of nutrient intake (percentage of energy for protein and mg/1000 kJ for K and Na) were estimated based on 24 h urinary excretion and estimated energy expenditure.

A total of fifteen universities and colleges in Japan.

A total of 1046 female Japanese dietetic students aged 18–22 years.

Total monetary diet cost showed a significant positive association with biomarker-based estimates of protein, K and Na. Vegetables and fish were not only the main contributors to total monetary diet cost (16·4 % and 15·5 %, respectively) but also were relatively strongly correlated with total monetary diet cost (Pearson’s correlation coefficient: 0·70 and 0·68, respectively). Monetary cost of vegetables was significantly positively associated with all three nutrients, while that of fish showed a significant and positive association only with protein.

Total monetary cost of self-reported diet was positively associated with biomarker-based estimates of protein, K and Na intake in young Japanese women, and appeared mainly to be explained by the monetary costs of vegetables and fish.

The potential role of allium vegetables on endometrial cancer risk has been scarcely investigated and the results of previous Chinese studies are not easily applicable to Western populations. Therefore, we evaluated the relationship between onion and garlic intake and endometrial cancer, using data from an Italian case–control study.

We analysed data from a multi-centre case–control study of 454 endometrial cancer cases and 908 controls, admitted to the same hospitals for a wide spectrum of acute, non-neoplastic conditions. Information was collected by trained interviewers using a validated and reproducible FFQ. Multivariate odds ratios and 95 % confidence intervals were obtained after allowance for recognized confounding factors.

Compared with non-users, the OR of endometrial cancer for successive categories of onion intake were 0·94 (95 % CI 0·72, 1·21) for <2 portions/week and 0·40 (95 % CI 0·22, 0·72) for ≥2 portions/week, with a significant inverse trend in risk (P = 0·01). The OR for an increment of one portion (i.e. 80 g) of onions per week was 0·81 (95 % CI 0·70, 0·95). For garlic, the OR for successive categories of intake were 0·89 (95 % CI 0·68, 1·15) for intermediate use and 0·62 (95 % CI 0·42, 0·92) for high use, with a significant inverse trend in risk (P = 0·02).

Our study found a moderate protective role of allium vegetables on the risk of endometrial cancer.