The way in which women accommodate for their increased nutritional needs during the lactation period is poorly investigated. In a cross-sectional study involving 220 lactating women (LW), equally distributed in economic quintiles (Q2, Q3, Q4), we investigated whether habitual dietary intake of LW differed from that of 200 pre-pregnant women (PPW) studied using the same methodology. Differences in dietary intake and nutrition sufficiency according to economic status were also investigated. Dietary intake data were collected using 2×24-h dietary recalls and FFQ. Energy, protein, Fe, Ca, Zn and vitamins A and C intakes were calculated utilising local food composition tables and were compared against Indonesian recommendations for adequacy. Energy and protein intakes <70 % of the recommendation and Fe, Ca, Zn and vitamins A and C intakes <77 % of the recommendation were considered insufficient. Except for Zn, dietary intakes of all studied nutrients were higher in LW compared with PPW. However, for all studied nutrients, dietary intake was insufficient in >25 % of LW. For Q2-LW, this proportion was >50 %, except for protein. LW across all studied economic quintiles approximately doubled their vegetable intake, and 71 % of LW indicated a belief that this enhances lactation performance. Biochemical status parameters were analysed in a subset of forty-five women. Anaemia as well as Fe, Zn and Se deficiencies were prevalent among LW, supporting the nutrient intake deficiency data. Despite increasing intakes in LW compared with PPW, habitual diets in the study area do not provide for daily nutrient requirements in substantial proportions for both LW and PPW across all investigated economic groups.

The diet of Indonesian women of childbearing age is relatively poor, posing increased risk for suboptimal pregnancy outcome. In a cross-sectional study including 403 women in three economic quintiles (Q), we investigated differences in dietary intake and nutrition sufficiency according to economic status and whether regular dietary intakes of pregnant women (PW, n 203) differ from that of pre-pregnant women (PPW, n 200). Dietary intake data were collected using 2×24 h dietary recall and FFQ. Energy, protein, Fe, Ca, Zn, vitamin A and vitamin C intakes were calculated utilising Food Composition Tables and compared with Indonesian recommendations for adequacy. Energy and protein intakes <70 % and Fe, Ca, Zn, vitamin A and vitamin C intakes <77 % of the local recommendation were considered insufficient. A higher intake of milk/dairy products (Q3, Q4), fruits and vegetables (Q2) and snacks (Q3) in PW was observed compared with PPW, but insufficient to meet nutrient requirements. Nutrient intake calculations showed insufficiency in 26 % of PPW for protein and up to 70 % for Fe. Deficient nutrient intakes in PW were found in 49 % of the subjects for energy and up to 85 % for Fe. Energy and protein intakes decreased with decreasing economic quintiles in PPW and PW. Ca and vitamin A intakes were lower in Q2 compared with Q4. The proportion of animal protein in Q2-PW was low (31 %). Biochemical status parameters in a subset showed that anaemia and Fe and Zn deficiencies were prevalent among PPW and PW. Habitual diets in the study area did not meet the nutrient requirements for both PPW and PW across the investigated economic groups.

A diet rich in fruits and vegetables has been associated with several health benefits. However, the effects on body weight (BW) and metabolic markers are not fully known. The present study investigated the effects of increased intake of fruits and vegetables in overweight and obese men and women on dietary habits, anthropometry and metabolic control. In a 16-week controlled intervention, thirty-four men and thirty-four women aged 35–65 years (BMI>27 kg/m2) were randomised to an intervention (IN) or a reference (RG) group. All participants received general dietary advice, and subjects in the IN group received fruits and vegetables for free, of which ≥500 g had to be eaten daily. BW, waist circumference (WC), sagittal abdominal diameter (SAD), plasma insulin, blood glucose, glycated Hb (HbA1c), serum lipids, blood pressure, plasminogen activator inhibitor-1 activity, urinary isoprostane (iso-8-PGF 2α) and serum carotenoids were measured. Diet was assessed using 3-d weighed food records. In all, thirty subjects in the IN group and thirty-two in the RG group completed the intervention. Intake of fruits and vegetables doubled in the IN group, whereas intake of fruits increased in the RG group. Serum α- and β-carotene concentrations and intakes of folate and vitamin C increased significantly in the IN group. Energy intake, BW, WC and SAD decreased significantly in both groups. Supine systolic blood pressure decreased significantly in the IN group, with no between-group differences. No significant changes were observed for other metabolic markers. Provision of fruits and vegetables led to substantially increased intakes, with subsequent favourable changes in anthropometry and insulin levels, which tended to be more pronounced in the IN group. The observed improvements may, in combination with improved nutritional markers, have health benefits in the long term.

Weight loss results from an energy deficit, although the quality of food choices making up the diet may also be important. The aim of the present study was to develop and validate a diet quality tool based on food categories to monitor dietary change in clinical weight-loss settings. The Food Choices Score (FCS) was based on seventeen food categories, each scoring up to five points, totalling 85. In addition to content validity, the tool was validated using (1) two energy-deficit diet models (6500 and 7400 kJ) assuring nutrient and food-group targets and (2) dietary data from two weight-loss trials (n 189). First, the diet models confirmed that an optimal score of 85 was achievable. Second, change in scores was compared with weight loss achieved at 3 months. The trial data produced a mean FCS of 42·6 (sd 8·6), increasing to 49·1 (sd 7·6) by 3 months. Participants who lost weight achieved a higher FCS at 3 months than those who did not (P= 0·027), and there was an even greater improvement in the FCS (P= 0·024) in participants losing ≥ 5 % body weight than in those losing < 5 %. A greater change in the FCS (Δ ≥ 7) resulted in a greater change in BMI (P =0·044), and score change was correlated with weight change (P= 0·023). Participants with the highest scores ( ≥ 56 v. ≤ 44/85) consumed more fruit (P< 0·001) and low-fat dairy foods (P =0·004), less fatty meat (P< 0·001), non-whole-grain cereals (P< 0·001), non-core foods and drinks (NCFD) (P< 0·001), less energy (P =0·018), less dietary fat (P< 0·001) and more dietary fibre (P= 0·013). Weight loss was 35·5 % less likely to be achieved with every increase in the serves of NCFD (P =0·004) in the study sample. The FCS is a valid tool for assessing diet quality in clinical weight-loss settings.

Indonesia is currently facing the double burden of malnutrition. While undernutrition is still a major public health problem, the prevalence of overnutrition is increasing. The objective of the South East Asian Nutrition Survey (SEANUTS) was to provide up-to-date data on nutritional status, food consumption and biochemical parameters related to nutrition for children aged 0·5–12 years. The SEANUTS study in Indonesia was conducted in a nationwide representative sample of 7·211 children using multistage cluster sampling based on probability proportional to size, stratified for geographical location, in forty-eight out of 440 districts/cities. The results show that the growth (weight for age, height for age, weight for height and BMI for age) of Indonesian pre-school- and school-aged children is below the WHO standards. The older the children, the more the deviation from the WHO standard curves. Underweight was more prevalent in rural areas (28·9 v. 19·2 %) and overweight/obesity was observed to be more widespread in urban areas (5·6 v. 3·2 %). The prevalence varied with age groups and sexes. The overall prevalence of stunting was 25·2 and 39·2 % in urban and rural areas, respectively. The prevalence of anaemia was nearly 55 % in children aged 0·5–1·9 years and ranged from 10·6 to 15·5 % in children aged 2–12 years. Fe deficiency was observed in 4·1–8·8 % of the children. The percentage of children with dietary intakes of energy, protein, and vitamins A and C below the Indonesian RDA was high and differed across urban and rural areas and age groups.

Relationships between Se and Hg in erythrocytes, and between these indices and intakes of fish and other foods, were studied as an adjunct to the British National Diet and Nutrition Survey (NDNS) of young people aged 4–18 years. Hg was measured in 965 packed erythrocyte samples by inductively coupled plasma mass spectrometry. Fe measurements permitted the calculation of whole-blood Hg. Erythrocyte and plasma Se, and 7d weighed dietary intake estimates, were available. Erythrocyte Hg was positively skewed, normalised by log-transformation. It was 20% higher in girls than boys (3·17 v. 2·65nmo/, P=0·004), and increased with age in boys but not girls. It was directly and strongly correlated with erythrocyte or plasma Se. Hg and Se concentrations were directly correlated with fish intake. Certain other food groups were also directly correlated with Se and Hg concentrations, but less strongly than for fish. The strength and consistency of the relationship between erythrocyte Hg and Se suggests an important chemical link. Previous studies suggest that Se protects against the toxicity of Hg, and that fish is an important source of both. No toxic levels of Hg were found, which is reassuring because of the known health benefits of fish consumption, especially oily fish. Hg intakes need to be monitored, especially in women of child-bearing age, to ensure that Food Standards Agency guidelines are met.

Patterns of food and nutrient intakes in Italy were estimated starting from a nationwide food survey carried out by the National Institute of Nutrition (NIN) in 1994–6, called INN-CA 1995. The present analysis looks at food and nutrient intakes of the subsample of the adults (18–60-year-old individuals). In particular, the two extreme quartiles of the distribution of total fat intake expressed as percentage of energy were considered in the analysis. The results showed that the subjects included in the fourth quartile (high-fat consumers) consumed fewer vegetables than the subjects in the first quartile (low-fat consumers). Furthermore, high-fat consumers had a tendency to have an unbalanced diet, whereas the low-fat consumers present a better pattern. In synthesis, 50% of the adults reach the goal of at least 400g of vegetables and fruit daily, and 25% consume less than 30 % of energy from total fats. Convincing that part of the population whose diet does not comply with dietary goals to come back to the Mediterranean tradition might be a priority for nutrition education in Italy.

The aim of the present study was to analyse the different food and nutrient intakes of the adult Irish population from the lowest and highest quartiles of intake for total fat (%energy) dietary fibre (g/MJ) and fruit and vegetables (g/day). Data on Irish adults (n = 715) from the Irish National Nutrition Survey conducted in 1989 were used for the analyses and showed that the average diet is low in dietary fibre, with fruit and vegetables being only half the recommended level of 400 g. Comparisons of people with low or high intakes (from lowest and highest quartiles) of total fat (%energy), dietary fibre (g/MJ) and fruit and vegetables (g/day) show patterns of food intake differing in both the percentage of consumers and in the mean intakes among consumers only. This analysis provides data which may be useful as a first step towards the development of food-based dietary guidelines for Ireland. In particular, the low intake of fruit and vegetables in the adult Irish population deserves special attention.

Development of food-based dietary guidelines relies on correct identification and interpretation of current dietary intake patterns. The process involves assessing which foods discriminate between those with desirable and undesirable intakes of particular nutrients. It is therefore important that those involved in this task are aware of any source of variability in the underlying food consumption data that cannot be attributed to true differences between individuals. A short survey duration can introduce a high degree of within-person variation and not reflect usual or more long-term food or nutrient intakes. As survey duration increases, the % consumers identified by a survey increases and the intakes among consumers only decrease while the total population intakes do not change. A short survey duration may also lead to misclassification of individuals into high and low consumers. Survey duration is therefore an issue that should be considered in the interpretation of dietary data when developing food-based dietary guidelines.