To assess maternal diet and nutritional adequacy prior to conception and during pregnancy.

Follow-up of a cohort of pregnant women with collection of questionnaire data throughout pregnancy and after delivery.

Antenatal clinics at two public hospitals in Porto, Portugal.

Two hundred and forty-nine pregnant women who reported a gestational age below 13 weeks at the time they attended their first antenatal visit.

Intakes of energy and macronutrients were within recommended levels for most women. Pregnancy was accompanied by increases in the dietary intake of vitamins A and E, riboflavin, folate, Ca and Mg, but declines in the intake of alcohol and caffeine. The micronutrients with higher inadequacy prevalences prior to pregnancy were vitamin E (83 %), folate (58 %) and Mg (19 %). These three micronutrients, together with Fe, were also those with the highest inadequacy prevalences during pregnancy (91 %, 88 %, 73 % and 21 %, respectively, for folate, Fe, vitamin E and Mg). Ninety-seven per cent of the women reported taking supplements of folic acid during the first trimester, but the median gestational age at initiation was 6·5 (interquartile range 5, 9) weeks. Self-reported prevalences of Fe and Mg supplementation were high, and increased throughout pregnancy.

The study identified low dietary intakes of vitamin E, folate and Mg both in the preconceptional period and during pregnancy, and low intake of Fe during pregnancy only. The low dietary intake of folate and the late initiation of supplementation indicate that current national guidelines are unlikely to be effective in preventing neural tube defects.

To discuss current evidence about the relation between prenatal and childhood Mediterranean diet, and the development of asthma and allergies in children.

Review of the literature.

Four recent studies conducted in Mediterranean countries (Spain, Greece) and one conducted in Mexico evaluated the association between childhood Mediterranean diet and asthma outcomes in children. All of the studies reported beneficial associations between a high level of adherence to the Mediterranean diet during childhood and symptoms of asthma or allergic rhinitis. Individual foods or food groups contributing to the protective effect of Mediterranean diet included fish, fruits, vegetables, legumes, nuts and cereals, while detrimental components included red meat, margarine and junk food intake.

Two studies focused on prenatal Mediterranean diet: the first is a birth cohort in Spain that showed a protective effect of a high adherence to the Mediterranean diet during pregnancy on persistent wheeze, atopic wheeze and atopy at the age of 6·5 years; while the second is a cross-sectional study in Mexico, collecting information more than 6 years after pregnancy, that showed no associations between maternal Mediterranean diet during pregnancy and allergic symptoms in childhood except for current sneezing.

Findings from recent studies suggest that a high level of adherence to the Mediterranean diet early in life protects against the development of asthma and atopy in children. Further studies are needed to better understand the mechanisms of this protective effect, to evaluate the most relevant window of exposure, and to address specific components of diet in relation to disease.

To describe the differences in socio-economic characteristics and body measurements between low, adequate and high energy reporting (LER, AER and HER) teenagers; furthermore, to investigate the relationship to misreporting mothers.

Cross-sectional study. Habitual dietary intake was reported in a questionnaire. Classification into LER, AER and HER using the Goldberg equation within three activity groups based on physical activity questionnaire and calculated BMR.

Stockholm, Sweden.

Four hundred and forty-one 16–17-year-old teenagers (57 % girls) and their mothers.

Of the teenagers, 17–19 % were classified as HER, while 13–16 % as LER. There was a highly significant trend from HER to LER in BMI (P < 0·001) and body fat % (P < 0·001). There was also a trend in number of working hours of mother (P = 0·01), family income (P = 0·008) and number of siblings (among boys only) (P = 0·02), but not in educational level of either father or mother. HER teenagers were lean, had mothers working fewer hours with lower income and had siblings. It was more likely that an LER girl had an LER mother than an AER mother (OR = 3·32; P = 0·002).

The reasons for the high number of over-reporters could be many: misclassification due to growth, lacking established eating pattern due to young age or method-specific. Nevertheless, the inverted characteristic of HER compared to LER indicates that this is a specific group, worth further investigation.

To describe four different methods of identifying indicator foods that are high, medium or low in fat with reference to dietary patterns and to use these indicator foods to test three sets of definitions of ‘high’, ‘medium’ and ‘low’ in fat from ‘banding schemes’ developed by the Coronary Prevention Group (CPG), the Food Standards Agency (FSA) and Sainsbury’s.

Indicator foods were developed using food intake data from the UK National Diet and Nutrition Survey and two parameters: (i) probability of the food being consumed by an individual with a high-fat diet (Method 1); and (ii) the contribution of the food to the fat intake of the average diet of consumers (Methods 3 and 4). Method 2 used both parameters. The three banding schemes were tested by assessing their levels of agreement with methods in categorising indicators.

Sensitivity in identifying high, medium and low fat indicators was highest with the CPG banding scheme (high and medium fat indicators) and Sainsbury’s scheme (low fat indicators) (Methods 2, 3 and 4). The levels of agreement (kappa coefficient) were 0·68 for the CPG scheme; 0·51 for the Sainsbury’s scheme; and 0·41 for the FSA scheme (Method 3).

It is possible to use indicator foods related to dietary patterns of a specific population to generate more rational definitions of ‘high’, ‘medium’ and ‘low’ in fat. This could be the starting point for the development of indicator foods for testing more complex nutrient profile models (i.e. those that consider more than one nutrient).

To investigate long-term trends in dietary intakes of vitamins A, C and E in Japanese adults.

Time series by community-based nutrition survey.

Two rural communities (Ikawa and Kyowa) between 1974 and 2001 in Japan.

A total of 3713 men and 3726 women aged 40–69 years.

Dietary intake data were collected by the 24 h dietary recall.

In Ikawa, mean intake of vitamin A (β-carotene and retinol) increased by 13–40 %; vitamins C and E increased by approximately 23–33 % among men and women from 1974–1977 to 1998–2000. In Kyowa, mean intake of vitamin A, primarily retinol, increased by 13–21 % among men and women; vitamin C from fruits decreased by 16 % among men; and vitamin E increased by 29 % among women from 1982–1986 to 1998–2001. Mean intake of vitamin E in the latest survey period was lower than the Adequate Intake among men and women in both communities. Generally, there were increased intakes of β-carotene and vitamin C from green/yellow and other vegetables; increased retinol intake from fish/shellfish, eggs, milk/dairy products and fats/oils; and increased vitamin E intake from green/yellow and other vegetables, fish/shellfish, eggs, milk/dairy products and fats/oils.

Mean intakes of the antioxidant vitamins A, C and E increased among middle-aged Japanese men and women between the 1970s and the 1990s except for decreased vitamin C among Kyowa men. The lower mean intake of vitamin E than the Adequate Intake should be considered a potential public health issue for the prevention of CVD.

The association between obesity and blood pressure is well documented and a series of obesity indices are used as risk factors or indicators of blood pressure and/or the presence of hypertension.

The aim of the present study was to explore and determine which obesity index is the best indicator of blood pressure and the presence of hypertension among five frequently used simple anthropometric indices.

Subjects (n 29 079) were selected by cluster sampling from fourteen Chinese general populations. Weight, height, waist circumference (WC), hip circumference and blood pressure were measured for each participant. BMI, waist:hip ratio (WHR), waist:stature ratio (WSR) and conicity index (CI) were calculated. Pearson correlation, multiple logistic regression, multivariate linear regression and receiver-operating characteristic (ROC) curve analyses were used.

A total of 13 558 men and 15 521 women were investigated. All five obesity indices were positively correlated with blood pressures and hypertension. After adjusting for age, WSR in men and BMI in women had the greatest association with the presence of hypertension, irrespective of the statistical method used. BMI had the strongest correlation with continuous blood pressures in both genders.

The present results indicate that hypertension is associated with different obesity indices in men and in women. The best indicator for hypertension is WSR in men while it is BMI in women.

To assess the overall diet quality of a sample of adolescents living in Alberta, Canada, and evaluate whether diet quality, nutrient intakes, meal behaviours (i.e. meal skipping and consuming meals away from home) and physical activity are related.

A cross-sectional study design. Students completed the self-administered Web-Survey of Physical Activity and Nutrition (Web-SPAN). Students were classified as having poor, average or superior diet quality based on Canada’s Food Guide to Healthy Eating (CFGHE).

One hundred and thirty-six schools (37 %) within forty-four public and private school boards (75 %) in Alberta, Canada.

Grade 7 to 10 Alberta students (n 4936) participated in the school-based research.

On average, students met macronutrient requirements; however, micronutrient and fibre intakes were suboptimal. Median CFGHE food group intakes were below recommendations. Those with poor diet quality (42 %) had lower intakes of protein, fibre and low-calorie beverages; higher intakes of carbohydrates, fat and Other Foods (e.g. foods containing mostly sugar, high-salt/fat foods, high-calorie beverages, low-calorie beverages and high-sugar/fat foods); a lower frequency of consuming breakfast and a higher frequency of consuming meals away from home; and a lower level of physical activity when compared with students with either average or superior diet quality.

Alberta adolescents were not meeting minimum CFGHE recommendations, and thus had suboptimal intakes and poor diet quality. Suboptimal nutritional intakes, meal behaviours and physical inactivity were all related to poor diet quality and reflect the need to target these health behaviours in order to improve diet quality and overall health and wellness.

To prospectively evaluate growth parameters assessed by weight and length in infected and uninfected infants born to HIV-1-infected mothers and followed from birth to 18 months.

A cohort consisting of ninety-seven uninfected and forty-two infected infants born to HIV-infected mothers enrolled from 1995 to 2004, and admitted during their first 3 months of life at a referral Pediatric AIDS Clinic in Belo Horizonte, Brazil. Infants were followed until 18 months of age. Data were analysed using mixed-effects linear regression models for weight and length fitted by restricted maximum likelihood.

Infected infants contributed to 466 weight and 411 recumbent length measurements. Uninfected infants provided 924 weight and 907 length measurements. Mean birth weight and length were similar in both groups, 3·1 (sd 0·4) and 3·0 (sd 0·5) kg, and 48·7 (sd 1·4) and 48·8 (sd 2·9) cm for uninfected and infected infants, respectively. However, HIV-1 infection had an early impact in growth impairment: at 6 months of age, HIV-infected children were 1 kg lighter and 2 cm shorter than the uninfected.

Growth faltering in weight, but not length, in HIV-infected children in Brazil is more marked than that reported in a European cohort, probably reflecting background nutritional deficiencies and concomitant infections. In these settings, early and aggressive nutritional management in HIV-1-infected infants should be a priority intervention associated with the antiretroviral therapy.

To determine the prevalence and sociodemographic factors related to vegetarians according to different definitions in Finland and to compare the consumption of selected foodstuffs and nutritional intakes among vegetarians and omnivores.

Information about subjects’ identification as vegetarians in a survey was used as a basis for self-defined vegetarianism. Foodstuffs consumed and their frequencies of consumption were obtained, and the reported consumption frequencies of meat, fish, milk and eggs or food portions containing these foodstuffs were used as a basis for an operationalized definition of different types of vegetarianism. Reported consumption was used to estimate foodstuff and nutritional intakes.

Three large nationwide surveys in Finland.

In total, 24 393 participants aged between 18 and 79 years were included.

The proportion of self-identified vegetarians was 3·3 % of the total population in Finland. According to responses to questions on consumption frequency, 1·4 % of the population were pesco-lacto-ovo-vegetarians, 0·43 % were vegans, lacto-vegetarians or lacto-ovo-vegetarians, and 0·18 % were vegans or lacto-vegetarians. Eighty per cent of the self-identified vegetarians did not follow a vegetarian diet according to the operationalized definition, but they consumed fewer meat products (P < 0·01).

Some self-defined vegetarians do consume red meat, poultry or fish, but they follow a healthier diet than self-defined omnivores. In the same sample self-identification indicated more than double the incidence of vegetarianism than the operationalized definition. Therefore self-identification is not a good method for observing the prevalence of vegetarianism.

To determine the criterion validity and user acceptability of the Healthy Eating Self-Monitoring Tool (HEST), a CD-ROM-mediated food record for measuring fruit and vegetable consumption among economically disadvantaged black adolescents.

Item intakes, daily intake measures of fruit, vegetables and juices, and daily and total fruit and vegetable intake assessed with the HEST over a 3 d interval were compared with observed intake using Spearman correlations and Wilcoxon signed ranks tests. Mean ratings of participants’ interest in, enjoyment of and likelihood of recommending the HEST to peers were compared with an a priori criterion rating for establishing user acceptability of the HEST.

Youth services agencies in New York City.

Eighty-nine black adolescents aged 11 to 14 years.

Spearman correlations were significant for 67 % of items, for daily intake measures of fruit (days 1 and 3), vegetables and juices (days 1 and 2), and for fruit and vegetable intake (all three days). Wilcoxon signed ranks tests found non-significant intake differences for 78 % of these items, for daily intake measures of fruit and vegetables, and for fruit and vegetable intake (days 2 and 3). HEST-recorded 3 d intake of 14·65 servings was significantly correlated with and did not differ significantly from observed 3 d intake of 15·21 servings. Youths’ HEST-recorded intake was accurate to within 0·56 of a serving of their observed intake. Mean ratings of the HEST were above the criterion rating across user acceptability dimensions assessed.

The HEST is a promising food record approach that is acceptable to youths.

To assess the magnitude of three micronutrient deficiency disorders (iron, vitamin A and iodine), nutritional deficiencies and their association with related factors.

Using the three-stage sampling technique, a study was conducted in twenty-eight villages of Jodhpur district. A total of 1193 women, 384 pregnant, 400 lactating and 409 non-pregnant non-lactating controls (15 years and above, women who have not attained their family status) were examined for three micronutrient deficiency disorders, nutritional deficiencies, dietary and associated factors.

Majority of the women were anaemic. Anaemia was higher among pregnant and lactating women (80·7 %). Severe anaemia was three-fold higher among pregnant and lactating women in comparison to controls (4·1 %). Vitamin A deficiency was observed to be higher among pregnant women (8·8 %). A high proportion of women (80·8 %) consumed salt, having inadequate iodine content. Median urinary iodine values were less in pregnant and lactating women than the WHO cut-off points. Consumption of pulses and legumes was low besides leafy vegetables. Average intake of nutrients showed deficiency of protein and energy, iron and folic acid and vitamin A deficiency. Anaemia and iodine deficiency disorder were found to be inversely proportional to education and income.

The proportion of anaemia in this study was higher in comparison to national-level studies besides the low consumption of normal iodised salt. Only 19 % of salt samples had adequate iodine content, which calls for caution. In addition to iodisation of salt, the study suggests the development of nutritional packages utilising local dietary aspects.

To investigate the accuracy of self-reported weight status over the adult lifespan.

Estimates of self-report bias were obtained from a linear regression analysis and the magnitude of the discrepancy was studied for demographic groups (based on gender, race and educational attainment), weight status, number of years from the age of the reported weight and current age of the respondent.

A subset of 6101 individuals from the National Health and Nutrition Examination Epidemiological Follow-Up constituted the study sample.

Gender, elapsed time and BMI contributed to self-report bias. Effects of gender and elapsed time were small relative to the effects of BMI, with women tending to underestimate weight by 0·82 kg (1·8 lb), men overestimating by 2·27 kg (5·0 lb) and bias increasing by 0·09 kg (0·2 lb) for each year of retrospection. Every increase of one unit in BMI was associated with an additional 0·91 kg (2·0 lb) underestimate in self-reported weight.

Accuracy of adult self-reported weight profiles will be greatly underestimated if samples have individuals of current or past high relative weight. Adjusting for underestimation based on the respondent’s weight status alone will considerably improve the validity of weight information.

To investigate the associations of BMI and overweight in adulthood with consumption of sweets and sugar-sweetened soft drinks in childhood and with the change in consumption between childhood and adulthood.

Longitudinal 21-year follow-up study of Finnish children and adolescents from childhood to adulthood.

The Cardiovascular Risk in Young Finns Study, comprising participants from both eastern and western Finland.

Boys (n 967) and girls (n 1172) aged 3–18 years at baseline in 1980.

The increase in consumption of sugar-sweetened soft drinks from childhood to adulthood was directly associated with BMI in adulthood in women (b = 0·45, P = 0·0001) but not in men. In women, BMI increased by 0·45 kg/m2 for every 10-unit increase per month. Consumption of sweets and sugar-sweetened soft drinks in childhood and adolescence was not associated with BMI in adulthood. The change in consumption of sweets was not associated with BMI in adulthood. The increase in the consumption of sugar-sweetened soft drinks from childhood to adulthood was associated with being overweight (OR = 1·90, 95 % CI 1·38, 2·61) in women, but not in men. No association was found between overweight (BMI ≥ 25 kg/m2) in adulthood and consumption of sweets in childhood or the change in consumption from childhood to adulthood.

We conclude that direct associations exist between adulthood overweight and BMI and an increase in consumption of sugar-sweetened soft drinks in women. Thus sugar-sweetened soft drinks consumption may be important when considering weight management in women.

The present study was undertaken to compare plasma Se values and glutathione peroxidase (GPX) activity in normal and breast cancer patients.

In a case–control study, forty-five breast cancer patients and the same number of healthy women were randomly selected from their population. Se was measured in plasma by atomic absorption spectrophotometry and GPX activity in erythrocytes was measured using a standard spectrophotometric method.

Plasma Se concentration in healthy women and breast cancer patients was in the normal range, with no statistically significant difference observed between the two groups (138·40 (sd 40·36) μg/l v. 132·15 (sd 35·37) μg/l, respectively). Erythrocyte GPX activity was significantly (P<0·01) higher in breast cancer patients (24·81 (sd 11·66) U/g Hb) compared with healthy women (20·29 (sd 4·24) U/g Hb).

The present study indicated that Se deficiency was not a problem in the participants, and sufficient quantity of this element could increase GPX activity to have a protective effect against oxidative damage.

A school-based nutrition information programme was initiated in 1992 in two towns in northern France (Fleurbaix and Laventie, FL) and was followed by a number of community-based interventions. We took the opportunity to measure the outcomes in terms of childhood obesity and overweight over the next 12 years.

Repeated, cross-sectional, school-based survey. For the school years beginning in 1992, 2000, 2002, 2003 and 2004, the height and weight of all 5- to 12-year-old children attending school were measured in FL. In 2004, the same assessments were made in two comparison towns with similar socio-economic characteristics but no intervention.

Fleurbaix and Laventie (intervention towns), Bois-Grenier and Violaines (comparison towns), northern France.

In 2002, 2003 and 2004, respectively 515, 592 and 633 children were measured in FL (participation rate of 95–98 % of all eligible individuals); in the comparison towns, 349 children were measured in the 2004 school year (98 % of the towns’ school population).

After an initial increase, trends in mean BMI and prevalence of overweight started to reverse. Compared with 2002, the age-adjusted OR for overweight in FL was significantly lower in 2003 and 2004 (but for girls only). In the 2004 school year, the overweight prevalence was significantly lower in FL (8·8 %) than in the comparison towns (17·8 %, P < 0·0001).

These data suggest that, over a long period of time, interventions targeting a variety of population groups can have synergistic effects on overweight prevalence. This gives hope that it is possible to reverse trends towards increasing overweight by actions at the community level.

To investigate differences between dietary habits in Glasgow and those in the rest of Scotland and the role that socio-economic factors have in explaining these.

Data on age, sex, area deprivation, social class, educational qualifications, economic activity, health board region, postcode sector area and informants’ usual intake of foods covering sugary foods, snacks, fibre, starch, meat, fish, spreading fats, dairy products, salt, dietary supplements, fruit and vegetables were available from the 1995, 1998 and 2003 Scottish Health Surveys. Multilevel logistic regression was used to model the relationship between diet and living in Greater Glasgow compared with elsewhere in Scotland, unadjusted and adjusted for age, survey year and socio-economic factors, accounting for the clustering within postcode sector area.

Scotland.

Subjects comprised 11 075 male and 14 052 female respondents.

Lower consumption of high-fibre bread and potatoes/pasta/rice (among men and women), of cakes (men) and of cereals, meat, skimmed/semi-skimmed milk and green vegetables (women) in Glasgow was explained by socio-economic factors, as was higher consumption of non-diet soft drinks among women; lower consumption of ice cream, bread, cereals, meat and green vegetables (men) and high butter and salt consumption (women) in Greater Glasgow were not.

Associations between unhealthy eating and deprivation accounted for much of the tendency of people in Glasgow to have poor diets. Policies are needed to encourage improvements in diet in Glasgow and more effort is required to reduce social inequalities in eating habits. Glasgow’s poor diet will remain unless problems associated with poverty are tackled.

To identify determinants of low birth weight (LBW) in Karachi, Pakistan, including environmental exposures and nutritional status of the mother during pregnancy.

Cross-sectional study.

Five hundred and forty mother–infant pairs. We interviewed mothers about obstetric history, diet and exposure to Pb. We measured birth weight and blood lead level (BLL). We performed multiple log binomial regression analysis to identify factors related to LBW.

Of 540 infants, 100 (18·5 %) weighed ≤2·5 kg. Umbilical cord BLL was not significantly associated with LBW. Maternal poor self-rated health (adjusted prevalence ratio (adjPR) = 1·83; 95 % CI 1·09, 3·07) and none or one prenatal visit (adjPR = 2·18; 95 % CI 1·39, 3·43) were associated with LBW. A statistically significant interaction between mothers’ mid upper-arm circumference (MUAC) and dietary vitamin C intake was noted. Compared with mothers with MUAC above the median and dietary vitamin C intake above the 3rd quartile (>208·7 mg/d), infants of mothers with MUAC less than or equal to the median and dietary vitamin C intake >208·7 mg/d (adjPR = 10·80; 95 % CI 1·46, 79·76), mothers with MUAC above the median and vitamin C intake ≤208.7 mg/d (adjPR = 10·67; 95 % CI 1·50, 76·02) and mothers with MUAC less than or equal to the median and vitamin C intake ≤208·7 mg/d (adjPR = 13·19; 95 % CI 1·85, 93·79) more likely to give birth to an LBW infant.

In Pakistan, poor nutritional status and inadequate prenatal care were major determinants of LBW in this setting. Environmental factors including umbilical cord BLL were not significantly associated with LBW.

We explore the association between a neighbourhood’s ethnic composition and the foods and nutrients consumed by Mexican-Americans.

Cross-sectional survey of a large national sample, from the Third National Health and Nutrition Examination Survey (1988–94), was linked to the 1990 Census. The outcomes were food frequencies and serum levels of micronutrients. The variable of interest was percentage of Mexican-Americans at the census tract level.

United States.

A total of 5306 Mexican-American men and women aged 17–90 years.

Increased percentage of Mexican-Americans at the census tract level was associated with less consumption of fruits, carrots, spinach/greens and broccoli and with lower serum levels of Se, lycopene, α-carotene, vitamin C and folate. By contrast, increased percentage of Mexican-Americans at the census tract level was associated with more consumption of corn, tomatoes, hot red chilli peppers and legumes such as beans, lentils or chickpeas.

An increased percentage of Mexican-Americans at the census tract level was associated with less consumption of selective foods (e.g. some fruits, broccoli) and low levels of serum Se or vitamin C, but it was associated with more consumption of other foods (e.g. legumes, tomatoes, corn products) that may have positive effects on health in this population.

The objective of the present study was to assess whether weight status, nutrient intake and dietary adequacy were associated with breakfast consumption patterns.

A representative sample of the US population was used in a secondary analysis of nutrient intake/diet quality and weight status by breakfast consumption patterns.

The 1999–2002 National Health and Nutrition Examination Survey (NHANES).

The study sample included African-American (AA) children aged 1–12 years (n 1389).

Forty-five per cent of children aged 1–5 years and 38 % of those aged 6–12 years consumed ready-to-eat cereal (RTEC) at breakfast; while 7·4 % and 16·9 % in those age groups skipped breakfast, respectively. The lowest mean BMI (P ≤ 0·05) and mean waist circumference (P ≤ 0·05) was found in children 1–12 years of age who consumed RTEC at breakfast compared with other consumption groups. RTEC breakfast consumers had the highest mean intakes of vitamins A, B6 and B12, thiamine, riboflavin, niacin, folate, Ca, Fe and Zn (P ≤ 0·05) and the highest Mean Adequacy Ratio (P ≤ 0·05). RTEC breakfast consumers also had the highest intake of carbohydrates and total sugars, and the lowest intakes of total fat (P ≤ 0·05).

Consuming RTEC at breakfast was associated with improved weight and nutrient adequacy in AA children. AA children in all breakfast categories still had mean intakes of most nutrients below recommended levels. The implications are that consuming a breakfast meal should be encouraged in these children, and that RTEC at breakfast provides important nutrients and may help promote a healthy weight.

The objective of the present study was to determine the dietary patterns of a Mediterranean cohort and relate them to the observed patterns of beverage consumption.

Prospective cohort study. Dietary habits were assessed with a semi-quantitative FFQ validated in Spain. A principal components factor analysis was used to identify dietary patterns and to classify subjects according to their adherence to these patterns. The association between adherence to each dietary pattern and beverage consumption was assessed cross-sectionally. In a longitudinal analysis (2-year follow-up), the relationship between adherence to the baseline dietary patterns and the likelihood of changing alcohol consumption was ascertained.

The SUN (Seguimiento Universidad de Navarra) study is conducted in Spain.

In total, 15 073 university graduates were included in the analyses.

Two major dietary patterns were identified. We labelled them as ‘Western dietary pattern’ (WDP) and ‘Mediterranean dietary pattern’ (MDP). Higher adherence to the WDP was associated with higher consumption of carbonated beverages and whole-fat milk (P for trend <0·001), while higher adherence to the MDP was associated with higher consumption of decaffeinated coffee, orange juice, other natural juices, diet carbonated drinks, low-fat milk and bottled water (P for trend <0·001). Participants with higher adherence to the WDP were less likely to decrease their alcohol consumption during follow-up (OR between extreme quintiles = 0·68; 95 % CI 0·56, 0·84). By contrast, participants with higher adherence to the MDP were less likely to increase their alcohol consumption (OR = 0·66, 95 % CI 0·46, 0·95).

In this cohort of university graduates, a healthier dietary pattern was associated with a healthier pattern of beverage consumption.