The World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) publish recommendations for cancer prevention. The present study aimed to estimate the association between adherence to these cancer-specific prevention recommendations and subsequent development of cancer in a prospective cohort.

A composite adherence score was constructed based on questionnaire data to reflect overall adherence to WCRF/AICR lifestyle-related recommendations on body fatness, physical activity, diet and alcoholic drinks. Multivariable Cox proportional hazard regression models were used to assess the association (hazard ratio; 95 % CI) between the adherence score and risk of developing cancer.

Alberta’s Tomorrow Project, a prospective cohort study.

Men and women (n 25 100, mean age at enrolment 50·5 years) recruited between 2001 and 2009 with no previous cancer diagnosis were included in analyses.

Cancer cases (n 2066) were identified during a mean follow-up of 11·7 years. Participants who were most adherent to the selected WCRF/AICR recommendations (composite score: 4–6) were 13 % (0·87; 0·78, 0·98) less likely to develop cancer compared with those who were least adherent (composite score: 0–2). Each additional recommendation met corresponded to a 5 % (0·95; 0·91, 0·99) reduction in risk of developing cancer. When stratified by sex, the associations remained significant for women, but not for men.

Adherence to lifestyle-related cancer prevention recommendations was associated with reduced risk of developing cancer over the follow-up term in this Canadian cohort.

To explore cross-sectional adherence to cancer prevention recommendations by adults enrolled in a prospective cohort in Alberta, Canada.

Questionnaire data were used to construct a composite cancer prevention adherence score for each participant, based on selected personal recommendations published by the World Cancer Research Fund/American Institute for Cancer Research (2007). Data were self-reported on health and lifestyle, past-year physical activity and past-year FFQ. The scores accounted for physical activity, dietary supplement use, body size, and intakes of alcohol, fruit, vegetables and red meat. Tobacco exposure was also included. Scores ranged from 0 (least adherent) to 7 (most adherent).

Alberta’s Tomorrow Project; a research platform based on a prospective cohort.

Adult men and women (n 24 988) aged 35–69 years recruited by random digit dialling and enrolled in Alberta’s Tomorrow Project between 2001 and 2009.

Of the cohort, 14 % achieved adherence scores ≥5 and 60 % had scores ≤3. Overall adherence scores were higher in women (mean (sd): 3·4 (1·1)) than in men (3·0 (1·2)). The extent of overall adherence was also associated with level of education, employment status, annual household income, personal history of chronic disease, family history of chronic disease and age.

Reported adherence to selected personal recommendations for cancer prevention was low in this cohort of adults. In the short to medium term, these results suggest that more work is required to identify behaviours to target with cancer prevention strategies at a population level. Future work will explore the associations between adherence scores and cancer risk in this cohort.

To characterise the diets of pregnant women in the Republic of Seychelles and to determine the contribution of fish to intakes of nutrients important for fetal and neonatal development.

Observational, prospective study.

Seychelles Child Development Centre, Mahé, Republic of Seychelles.

Pregnant women (n 300) were recruited at their first visit to an antenatal clinic. At 28 weeks’ gestation subjects completed a 4 d diet diary (n 273) and intakes were analysed using dietary analysis software.

Mean (sd) energy intake was 9·0 (2·5) MJ/d and fat intakes were higher than UK recommendations for almost two-thirds of the cohort. Fish consumption was lower than in previous surveys, suggesting a move towards a more Westernised diet. Low intakes of a number of nutrients important during pregnancy for fetal development (Fe, Zn, Se and iodine) were observed. However, women who met the current recommendations for these nutrients consumed significantly more fish than those who did not (97 v. 73 g/d).

The present study highlights the importance of fish in the diet of pregnant Seychellois women for ensuring adequate intakes of micronutrients important in fetal development. Dietary patterns in Seychelles, however, are in a state of transition, with a move towards a Western-style diet as evidenced by higher fat and lower fish intakes. If these dietary trends continue and fish consumption declines further, micronutrient status may be compromised. These findings suggest caution in establishing public health policies that promote limitation of fish intake during pregnancy.

To establish the Fe status of pregnant women and their neonates in the Republic of Seychelles.

A prospective study.

Republic of Seychelles.

Pregnant women were recruited and blood samples taken at enrolment and post-delivery along with cord blood samples. Ferritin and soluble transferrin receptor (sTfR) were measured in maternal (n 220) and cord blood (n 123) samples.

Maternal Fe deficiency (ferritin < 15 ng/ml, sTfR > 28 nmol/l) was present in 6 % of subjects at enrolment and in 20 % at delivery. There was no significant decrease in maternal ferritin. A significant increase in sTfR was observed between enrolment and delivery (P < 0·001). Maternal BMI and use of Fe supplements at 28 weeks’ gestation were associated with improved maternal Fe status at delivery, whereas parity had a negative effect on sTfR and ferritin at delivery.

Fe status of pregnant Seychellois women was, on average, within normal ranges. The incidence of Fe deficiency throughout pregnancy in this population was similar to that in a Westernised population. Increased awareness of the importance of adequate Fe intake during pregnancy, particularly in multiparous women, is warranted.

To determine the extent to which differences in sociodemographic, dietary and lifestyle characteristics exist between users of different types of dietary supplements and supplement non-users.

We analysed cross-sectional data obtained from self-administered questionnaires completed at baseline by participants in The Tomorrow Project; a prospective cohort study in Alberta, Canada. Participants who used at least one type of dietary supplement at least weekly in the year prior to questionnaire completion were defined as supplement users, while the remainder were classified as non-users. Seven discrete user categories were created: multivitamins (+/− minerals) only, specific nutritional supplements only, herbal/other supplements only, and all possible combinations. Differences in sociodemographic, dietary and lifestyle characteristics between different groups of supplement users and non-users were analysed using Rao–Scott χ2 tests and multinomial logistic regression.

Subjects were 5067 men and 7439 women, aged 35–69 years, recruited by random digit dialling throughout Alberta.

Supplement use was extensive in this study population (69·8 %). Users of herbal/other supplements only, and women who used multivitamins only, tended to report dietary and lifestyle characteristics that were not significantly different from non-users. In contrast, those who reported using a combination of multivitamins, specific nutritional and herbal/other supplements were more likely than non-users to report behaviours and characteristics consistent with current health guidelines.

Dichotomizing participants as supplement users or non-users is likely to mask further differences in sociodemographic, dietary and lifestyle characteristics among users of different types of supplements. This may have implications for analysis and interpretation of observational studies.

For effective healthy eating promotion, it is necessary to understand the attitudes towards and beliefs about nutrition of the general public. The objective of this study was to provide data on attitudes towards eating a healthy diet and the perceived need to alter eating habits from a random sample of adults in the Republic of Ireland and in Northern Ireland, using a self-administered questionnaire.

Cross-sectional survey using a self-administered attitudinal questionnaire on beliefs and attitudes to healthy eating.

The survey was carried out between October 1997 and October 1999 in the Republic of Ireland and in Northern Ireland.

A randomly selected sample of 1256 adults from the Republic of Ireland and Northern Ireland completed the attitudinal questionnaire.

A majority of subjects (62%) perceived that they make conscious efforts to eat a healthy diet either most of the time or quite often, while just over half (52%) agreed that they do not need to make changes to their diet as it is healthy enough. Subjects most likely to make conscious efforts to try to eat a healthy diet were females, older subjects (51-64 years) and those with the highest intakes of fruit and vegetables and lowest quartile of fat (% food energy). When self-assessed adequacy of fruit and vegetables was examined, two-thirds of the total sample felt they ate too little fruit while just one-third felt they ate too little vegetables.

Results of the present study, in general, revealed good agreement between attitude and behaviour with respect to healthy eating. This suggests that people appear to be reasonably accurate at evaluating their own diet in terms of how healthy it is. In terms of the two food groups examined in this study, some optimistic bias was evident for vegetables but not for fruit. It may be useful therefore to assess attitudes and beliefs about healthy eating by way of examining attitudes to such food groups individually.

To evaluate the errors incurred by young adults using single portion size colour food photographs to quantify foods and nutrients consumed at six meals on two non-consecutive days.

Breakfast menus remained the same for the 2 days; but lunch and dinner menus varied. The amounts of food eaten by individuals were determined by weighing individual serving dishes pre- and post-consumption. The day after eating, all foods consumed were quantified in terms of fractions or multiples of the amounts shown in the food photographs.

Thirty adult volunteers (15 male, 15 female), aged 18–36 years, completed the protocol for day one; 27 (90%) completed day two.

Some foods were more difficult to quantify accurately than others. The largest error range was −38.9% to +284.6% (cheese), whereas the smallest errors were incurred for juice (−21.5% to +34.6%, day one). All subjects who consumed muesli (day one) overestimated (+3.7% to +113.7%). No other foods were consistently over-or underestimated. For foods consumed at breakfast by the same subjects on both days, individual estimation errors were inconsistent in magnitude and/or direction. At the group level, most nutrients were estimated to within ±10% of intake; exceptions were thiamin (+10.5%, day one) and vitamin E (−10.1%, day one; −15.3%, day two). Between 63% and 80% of subjects were correctly classified into tertiles on the basis of estimated intakes.

Despite some large food quantification errors, single portion size food photographs were effective when used to estimate nutrient intakes at the group level. It remains to be established whether, under the conditions used in this study, more photographs per food would improve estimates of nutrient intake at the individual level.