Dietary starch contains rapidly (RAG) and slowly available glucose (SAG). To establish the relationships between the RAG:SAG ratio and postprandial glucose, insulin and hunger, we measured postprandial responses elicited by test meals varying in the RAG:SAG ratio in n 160 healthy adults, each of whom participated in one of four randomised cross-over studies (n 40 each): a pilot trial comparing six chews (RAG:SAG ratio 2·4–42·7) and three studies comparing a test granola (TG1-3, RAG:SAG ratio 4·5–5·2) with a control granola (CG1–3, RAG:SAG ratio 54·8–69·3). Within studies, test meals were matched for fat, protein and available carbohydrate. Blood glucose, serum insulin and subjective hunger were measured for 3 h. Data were subjected to repeated-measures analysis of variance (ANOVA). The relationships between the RAG:SAG ratio and postprandial end points were determined by regression analysis. In the pilot trial, 0–2 h glucose incremental areas under the curve (iAUC0–2; primary end point) varied across the six chews (P = 0·014) with each 50 % reduction in the RAG:SAG ratio reducing relative glucose response by 4·0 %. TGs1-3 elicited significantly lower glucose iAUC0–2 than CGs1–3 by 17, 18 and 17 %, respectively (similar to the 15 % reduction predicted by the pilot trial). The combined means ± sem (n 120) for TC and CG were glucose iAUC0–2, 98 ± 4 v. 118 ± 4 mmol × min/l (P < 0·001), and insulin iAUC0–2, 153 ± 9 v. 184 ± 11 nmol × h/l (P < 0·001), respectively. Neither postprandial hunger nor glucose or hunger increments 2 h after eating differed significantly between TG and CG. We concluded that TGs with RAG:SAG ratios <5·5 predictably reduced glycaemic and insulinaemic responses compared with CGs with RAG:SAG ratios >54. However, compared with CG, TG did not reduce postprandial hunger or delay the return of glucose or hunger to baseline.

The present study explored whether motivational constructs for diet and physical activity (PA) cluster and how these motivational constructs relate to dietary and PA behaviour. Data of 1142 participants were used from a randomised controlled trial examining the effects of a web-based diet and PA promotion intervention based on self-determination theory and motivational interviewing. Motivation was assessed using the Treatment Self-Regulation Questionnaire and Behavioural Regulation in Exercise Questionnaire. The dietary outcomes were measured using an adapted Food Frequency Questionnaire. PA was assessed using the Short QUestionnaire to ASsess Health. Spearman rank-order correlations showed large correlation coefficients (rs ≥ 0⋅63) between similar motivational constructs between the two lifestyle domains, except for intrinsic motivation where a medium correlation coefficient was found (rs = 0⋅41). Furthermore, the exploratory factor analysis illustrated that more self-determined forms of motivation seem to be more domain-specific. In contrast, non-self-determined forms of motivation seem to be domain-independent. Last, regression analyses demonstrated that intrinsic motivation towards PA was the only motivational construct significantly positively associated with all PA sub-behaviours (standardised regression coefficients ranging from 0⋅17 to 0⋅28, all P < 0⋅0125). Intrinsic motivation to eat healthily was significantly positively associated with fruits, vegetables and fish intake (standardised regression coefficients ranging from 0⋅11 to 0⋅16, all P < 0⋅0125), but not with unhealthy snacks. Insight of this exploratory study is useful for understanding the interrelationships of motivational induced behaviours, the development of interventions targeting multiple behaviours, and the construction of questionnaires.

Mid-upper arm circumference (MUAC) is an age-sensitive anthropometric measurement in infants. However, exact age is difficult to know, particularly in low-income countries. We evaluated the diagnostic accuracy of an age-independent mid-upper arm circumference-to-length (MUAC/L) ratio measurement in detecting wasting among infants aged 1–6 months in Ethiopia. A facility-based diagnostic accuracy study was conducted on 467 in-patient infants aged 1–6 months from March to May 2019. The receiver operating characteristic (ROC) curve was used to evaluate the ability of MUAC/L to detect wasting. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and positive and negative predictive values were calculated. The magnitude of severe wasting was 21⋅6 % and moderate wasting was 13⋅0 %. The area under the ROC curve (AUC) of MUAC/L was 0⋅77 (95 % CI 0⋅73, 0⋅81) for detecting moderate wasting and 0⋅92 (95 % CI 0⋅89, 0⋅94) for detecting severe wasting. MUAC/L had a sensitivity of 91⋅1 % (95 % CI 81⋅3, 94⋅4), a specificity of 84⋅7 % (95 % CI 80⋅6, 88⋅2), a positive likelihood ratio of 5⋅82 (95 % CI 4⋅53, 7⋅48) and a negative likelihood ratio of 0⋅13 (95 % CI 0⋅07, 0⋅22) in total infants. The optimal MUAC/L cut-off was <0⋅190 for boys and <0⋅185 for girls. MUAC/L had an AUC of 0⋅77 and 0⋅92 in predicting moderate and severe wasting in infants aged 1–6 months, respectively. Using MUAC/L to treat Ethiopian infants with severe wasting and infants with similar characteristics in other countries could improve treatment coverage.

Despite the high burden of neural tube defects (NTD) in eastern Ethiopia, there is no evidence that it is related to maternal dietary practice. The aim of the present study was to compare dietary practice between women who gave birth to newborns with and without NTDs. A comparative cross-sectional study was performed on a total of 276 (138 in each group) mothers who delivered neonates with or without NTD. Study participants were selected from three hospitals found in the eastern part of Ethiopia. The dietary practice was determined using the indicators including meal frequency, dietary diversity score (DDS), food variety score (FVS) and consumption of animal source food (ASF) generated from the dietary data collected using validated and pre-tested Food Frequency Questionnaire (FFQ). A multivariable logistic regression model was fitted to isolate independent predictors of dietary practices. The prevalence of good dietary practice was 29 % (95 % CI 23·6 %, 34·3 %). There was a significant difference in dietary practices (P = 0·034), in FVS (P = 0·01), in DDS (P = 0·045) between the two groups. In multivariable logistic regression, independent predictors of having good dietary practice were: not being the mother of a newborn with NTDs [adjusted odds ratio (AOR) 2·1, 95 % CI 1·07, 4·1], being from a rural residence area (AOR 0·29, 95 % CI 0·1, 0·7) and being illiterate (AOR 0·16, 95 % CI 0·03, 0·8). The present study found that dietary practice is associated with the development of NTDs. Nutrition education, food fortification and supplementation are needed to address this issue, and further research is needed to explore the mechanism.

Complete nutrition drinks with a low glycemic index (GI) provide nutritional support and prevent hyperglycaemia. The present study identified GI and factors predicting individual glucose response to a new complete nutrition drink. A randomised cross-over controlled trial was conducted in eighteen healthy volunteers (FPG < 100 mg/dl). Complete nutrition drinks containing retrograded starch, glucose solution and white bread were assigned in a random sequence with 14-day wash-out intervals. Plasma glucose and insulin levels were measured from baseline to 180 min after consuming each food. Results show the adjusted GIs of the drink was 48.2 ± 10.4 and 46.7 ± 12.7 with glucose and white bread as the reference, respectively. While the drink has low GI (<55), the individual glucose responses varied (GI: 7–149). Comparing characters in individual GI < 55 (n = 12) and GI ≥ 55 (n = 6) groups revealed significantly higher baseline insulin in the low GI group (14.86 ± 16.51 μIU/ml v. 4.9 ± 3.4 μIU/ml, P < 0·05). The correlation matrix confirms only two predictive factors for having individual GI <55 were baseline insulin (r = 0·5, P = 0·03) and HOMA-IR (r = 0·55, P = 0·02). ROC curve reveals fasting insulin above 1.6 μIU/ml and HOMA-IR above 1.05 as the cut-off values. The findings suggest that the complete nutrition drink has a low GI, but there was wide variability in individual responses partly explained by fasting insulin levels and HOMA-IR. Screening for fasting insulin and HOMA-IR may be encouraged to maximise the functional benefit of the drink.

There is limited knowledge about the associations between intakes of different foods and inconsistency in the literature of the relation between the quality of food intake and bodyweight in adolescents. The aim of this study is to explore how healthy self-reported food intakes are associated with each other and with overweight/obesity in adolescents. This is a cross-sectional study of seven cohorts of adolescents (n 13 451) who turned sixteen from 2009/2010 up to 2015/2016 and responded to a health questionnaire used by the School Health Services in southeast Sweden. Associations between intakes of ten self-reported foods as well as between food intakes and weight groups based on the International Obesity Task Force standards (isoBMI) were explored by multivariable logistic regression. Healthy intakes of different foods were mostly associated with each other with the strongest association between a high intake of fruit and a high intake of vegetables (odds ratio (OR) = 25 (95 % confidence interval (CI) 20⋅0–33⋅1)). A low-frequency intake of sweets/snacks (OR = 2⋅35 (95 % CI 1⋅84–3⋅00)) was associated with overweight/obesity as well as a healthy choice of butter/margarine (≤40 % fat) (OR = 1⋅82 (95 % CI 1⋅39 to 2⋅41)), but a high-frequency intake of vegetables was negatively associated with overweight/obesity 0⋅77 (0⋅62–0⋅95). To promote health and achieve a healthy weight among adolescents, it is important to take both diet quality and total food amount into consideration.

The development of technologies for children's dietary assessment shows important potential for reducing the occurrence of inherent errors in traditional methods. The present study aimed to describe the development of a mobile app for the dietary assessment of Brazilian schoolchildren. The mobile app assesses schoolchildren's diet with self-report by their parents or guardians in the home environment, through multiple-pass 24-hour recall coupled with a food propensity questionnaire; and by an adult in the school environment, through a food record. The tool presents a database of food items usually consumed by Brazilian schoolchildren, including modes of preparation, probing foods and types of food quantification such as digital photos of household measurements and food portions. The CADE app (food consumption at home and at school) contains 2125 food items, 9 options for preparation methods and 18 options for probing items. There are 75 options for household measurements, also including 26 digital photos of four types of household measurements and 440 photos of portion sizes of 90 foods from the Brazilian Manual of Child Food Portion Quantification. Some innovative features include an interface to take photos of the child's meals and report seconds and leftover food consumption, besides the possibility of receiving notifications on the mobile device to remember to report the diet. The CADE app can assist the standardisation and automation of dietary data collection from schoolchildren, support food and nutrition data in childhood and promote research in nutritional epidemiology while reducing data collection costs.

Adequate nutrition is essential for early childhood to ensure healthy growth, proper organ formation, and function, a strong immune system, neurological and cognitive development. The main aim of the present study was to assess the effect of maternal employment on nutritional status among children aged 6–23 months in the town of Bale Robe, Ethiopia. A community-based comparative cross-sectional study was conducted on about 597 (293 unemployed and 304 employed) having children aged 6–23-month-old children sampled were employed with a multistage sampling technique. A face-to-face interview was conducted using a structured pretested questionnaire. Descriptive statistics, binary and multivariable logistic regression analyses were used for the statistical analysis. The magnitude of stunting (39.9 %), underweight (39⋅9 %) and wasting (22⋅2 %) was greater in 6–23-month-old children born to employed mothers than their counterparts in unemployed ones [stunted (31⋅3 %), underweight (24⋅0 %) and wasted (11⋅8 %)]. Being a girl [AOR 0⋅31; 95 % CI (0⋅17, 0⋅54)] in employed mothers and [AOR 0⋅29; 95 % CI (0⋅16, 0⋅51)] in unemployed people significantly protected stunting. This study demonstrated that the nutritional status of 6–23-month-old children is better among unemployed mothers than among employed mothers. Therefore, concerted efforts may decrease child undernutrition in a study area.

Dietary supplements can be used to compensate for an inadequate diet. However, some studies indicate that supplement users consume healthier diets than non-users, although such data are lacking in Japanese children. The aim of the present study was to investigate the food and nutrient intake of dietary supplement users among school-aged children in Japan. A nationwide school dietary survey was conducted at fourteen elementary schools and thirteen junior high schools in twelve prefectures in Japan. Three-day non-consecutive semi-weighed dietary records were obtained on two weekdays and one weekend day. Analysis of covariance was performed to investigate differences in food and nutrient intake from meals consumed at school and outside of school between dietary supplement users and non-users, adjusted for socio-demographic and health-related characteristics. Of the 910 children included in this analysis, 80 (8⋅8 %) reported supplement use. Based on 3-d dietary records, dietary supplement users consumed higher mean amounts of oils and lower amounts of fruits and vegetables than non-users. In school lunches, users consumed significantly higher amounts of oils and lower amounts of protein than non-users. In meals consumed outside of school, dietary supplement users consumed significantly higher amounts of confectioneries and lower amounts of fruits and vegetables, folate, vitamin C and dietary fibre than non-users. Collectively, our findings indicate that dietary supplement users consumed less healthy diets than non-users. Additional studies are warranted to confirm these results and identify factors contributing to poorer dietary habits in supplement users.

Recommendations for protein intake are based on total body weight; however, these recommendations do not consider lean body mass (LBM). The purpose of the present study was to identify the average protein intake in g/kg LBM in a group of healthy Masters Athletes (≥26 years of age, exercising ≥2 d/week). Data were obtained from a cross-sectional study. Body weight (kg), height (cm) and LBM via dual-energy X-ray absorptiometry were measured. Dietary intake was measured using a 2005 Block Food Frequency Questionnaire. The average energy intake, the percent energy from protein and the average protein intake in g/kg LBM were calculated. Differences between protein intake and the US Recommended Dietary Allowance (US RDA) (0⋅8 g/kg body weight) were determined. Alpha levels were set a priori to P < 0⋅05. A total of 176 participants (94 women, 82 men; 39 ± 11 years of age; body mass index: 24⋅6 ± 3⋅4 kg/m2) were analysed. The average energy intake, the percent protein energy and the average protein intake were 7996⋅9 ± 110⋅9 kilojoules (kJ)/d (1,910⋅4 ± 26⋅5 kcal), 15⋅5 ± 2⋅6 % and 1⋅43 ± 0⋅53 g/kg LBM, respectively. No differences existed between women and men for protein intake/kg LBM. Both sexes had significantly higher protein intakes than the US RDA (P < 0⋅001). We identified the average protein intake (g/kg LBM) in healthy Masters Athletes that may contribute to evolving perspectives on the determination of protein needs. The present study helps establish the relationship between protein intake and LBM so that we may further increase our accuracy when developing future protein recommendations.

Constipation can greatly impact the quality of life (QoL), which can be relieved by dietary fibres; however, preserving a higher fibre intake remains a challenge. We investigated the effects of a personalised dietary advice (PDA) on fibre intake and mild constipation complaints. A total number of twenty-five adults with mild constipation complaints were included in a 4-week observation period followed by a 4-week personalised intervention. The PDA provided high-fibre alternatives via a web tool. In weeks 1, 4 and 8, dietary intake, constipation complaints and QoL were assessed. Furthermore, participants collected a faecal sample at weeks 1, 4 and 8 to determine microbiota diversity and composition, and short-chain fatty acids (SCFA). Participants completed questions daily for 8 weeks regarding abdominal complaints, stool frequency and stool consistency. Fibre intake in week 8 was significantly higher compared to week 1 (Δ = 5·7 ± 6·7 g, P < 0·001) and week 4 (Δ = 5·2 ± 6·4 g, P < 0·001). Constipation severity and QoL significantly improved at week 8 compared to the observation period (P < 0·001). A higher fibre intake significantly reduced constipation severity (β = −0·031 (−0·05; −0·01), P = 0·001) and the QoL (β = −0·022 (−0·04; −0·01), P = 0·009). Stool consistency (P = 0·040) and abdominal pain (P = 0·030) improved significantly during the intervention period (P = 0·040), but stool frequency did not. Average microbial alpha diversity and composition and SCFA concentrations did not change over time, but indicated individual-specific dynamics. Several SCFAs were associated with constipation complaints. To conclude, a PDA effectively increased fibre intake and subsequently reduced constipation complaints, indicating that guided dietary adjustments are important and feasible in the treatment of mild constipation complaints.

The present study explored nursing and medical students’ perceptions of food security, their access to healthy food and the circumstances that affect their access to healthy food in Qatar. The photovoice method was adopted in the present study. Students submitted their photos pertaining to food security and their access to healthy food in Qatar. Afterwards, the students completed an online synchronous semi-structured interview. The interviews were transcribed verbatim and thematically analysed. After the data analysis, a focus group discussion was conducted for member checking. The present study is a collaborative project between two universities in Qatar: The University of Calgary in Qatar (UCQ) and Qatar University (QU). Undergraduate students (seven nursing students and nine medical students) were recruited, asked to collect photos and interviewed. Four themes emerged from the data. First, food retail environments promoted unhealthy eating. Second, fast food under stressful circumstances: a sense of comfort. Third, food as a symbol of culture and socialisation. Finally, the paradox of access to affordable and healthy food in Qatar. Undergraduate students highlighted various circumstances that affect their perceptions of food security and their access to healthy food in Qatar. Future research that aims at understanding the facilitators and barriers to access healthy food at the university campus may help to improve nutrition interventions targeting those students. Future initiatives should focus on leveraging various resources to assist universities in tailoring their food initiatives to suit their students’ local needs.

Undernutrition in children is a challenging problem in developing countries, including Ethiopia. Stunting is the most prevalent form of undernutrition. The majority of studies on childhood stunting and its associated factors focused on children, maternal and socioeconomic components. However, a few studies reported poor WaSH status and antibiotic exposure as environmental risk factors for child stunting, and the case of socio-demographic factors also lacks consistency. Concerning this, there is a lack of information in Ethiopia. Therefore, the present study assessed the association of socio-demographic, WaSH, and antibiotic exposure with stunting among under-five children. A cross-sectional study was conducted involving 340 mother–child pairs. Anthropometric data were collected using standard and calibrated height and weight scales. For factorial data, an interviewer-guided standard questionnaire was used. Logistic regression analyses were used to identify factors determining childhood stunting. In the present study, the prevalence of stunting, underweight and wasting was 14⋅7 % (95 % CI 10⋅9, 18⋅5), 4⋅4 % (95 % CI 2⋅4, 6⋅8) and 2⋅1 % (95 % CI 0⋅6, 3⋅5), respectively. Low dietary diversity, being born from a mother with an education level of secondary school, and belonging to a female-headed household were positively associated (P < 0⋅05) with stunting. The prevalence of overall undernutrition was lower (21⋅2 %) in the study area. Stunting was significantly associated with dietary diversity, maternal educational level and sex of households head. The government policy should focus on enhancing the dietary diversity of households, and encouraging women's education.

Despite mounting evidence that dietary factors might have a protective role against risk of cancer, few studies have assessed the relationship between diet diversity with colorectal cancer (CRC) and colorectal adenoma (CRA). Thus, we examined the relationship between dietary diversity score (DDS) and the odds of CRC and CRA. Overall, 129 CRC diagnosed patients, 130 CRA diagnosed cases and 240 healthy hospitalised controls were studied. DDS was calculated based on information on the usual diet that was assessed by a valid and reliable food frequency questionnaire (FFQ). Multivariate logistic regression was used to estimate the relationship between DDS and odds of colorectal cancer and adenoma. After adjusting for potential confounders, the diversity of grains is associated with the increased odds of CRC (ORgrains: 2·96 (1·05–8·32); P = 0·032), while the diversity of vegetables and fruits are associated with decreased odds of CRC (ORvegetables: 0·31 (0·16–0·62); P = 0·001, ORfruits: 0·37 (0·23–0·61); P < 0·001). The diversity of vegetables, fruits and dairy are inversely associated with odds of CRA (ORvegetables: 0·41 (0·21–0·78); P = 0·007, ORfruits: 0·58 (0·36–0·93); P = 0·021, ORdairies: 0·56 (0·37–0·83); P = 0·004). Also, higher DDS was related to decreased odds of both CRC (OR: 0·41 (0·23–0·72); P for trend = 0·002) and CRA (OR: 0·36 (0·21–0·65); P for trend = 0·001). Our results indicated that higher dietary diversity and particularly a diet varied in fruits and vegetables may reduce the odds of CRC and CRA. Also, the consumption of dairy products may decrease the odds of CRC, whereas the consumption of grains may increase the odds of CRC.

The present study was conducted to determine nutritional anaemia using haemoglobin levels of female nursing undergraduates studying at Farasan Island with the purpose to intervene at a point, before the potential problems become serious later in life. In total, 130 apparently healthy, female students of Department of Nursing were recruited by a random sampling method to collect information on socio-demographic, lifestyle and anthropogenic characteristics, and dietary habits including breakfast skipping. Haemoglobin content was estimated using Sahli's Haemoglobinometer and observations were interpreted as per WHO's criteria for anaemia. Body mass index (BMI) was recorded using a digital weighing machine. Correlation between haemoglobin concentration, breakfast skipping and body mass index of study participants was assessed by Pearson's correlation. Data analyses were done using Origin software. Overall, 51⋅6 % (n = 67) students were all together anaemic with 28⋅5 % (n = 37) had mild anaemia, 15⋅4 % (n = 20) moderate and 7⋅69 % (n = 10) had severe anaemia. Of these, 20⋅8 % (n = 27) were underweight, 63⋅8 % (n = 83) normal weight and 15⋅4 % (n = 20) were above normal weight (over weight and obese). The Hb content showed a positive correlation with the BMI and exhibited an increasing trend with increase in the BMI among study participants (P < 0⋅05). Questionnaire analyses revealed that the majority (96⋅9 %, n = 126) of students were taking junk food as bulk of their meal. A strong negative correlation was recorded between Hb contents and breakfast skipping tendencies (r = −0⋅987, P < 0⋅05). Findings of the present study are of high significance for public health professionals and educators to prioritise actions that could motivate these future nurses to adapt healthy lifestyles to strategically combat nutritional anaemia.

Introduction: Optimal breast-feeding practices make a major contribution to the promotion of healthy growth and development through much prevention of diarrheal and respiratory diseases which majorly cause morbidity and mortality in under-five children. However, breast-feeding practices remain suboptimality in Ethiopia. Objective: The study objective was to determine the effect of maternal nutrition education on early initiation and exclusive breast-feeding practice in the Hawela Tulla sub-city. Methods: A cluster randomised, parallel-group, single-blinded trial was used. About 310 pregnant women (155 for the intervention group and 155 for the control group) were included. Result: An early initiation of breast-feeding was significantly higher among women who received breast-feeding education than those who did not receive (104(72·7 %) v. 85(59·9 %), P = 0·022) and exclusive breast-feeding practice was also significantly higher among women who received breast-feeding education than those who did not receive (106(74·1 %) v. 86(60·6 %), P = 0·015). Breast-feeding education [AORs 1·55, 95 % CI (1·02, 2·36)], institutional delivery [AOR 2·29, 95 % CI (1·21, 4·35)], vaginal delivery [AOR 2·85, 95 % CI (1·61, 5·41)] and pre-lacteal feeding [AOR 0·47, 95 % CI (0·25, 0·85)] were predictors of early initiation of breast-feeding. Breast-feeding education [AOR 1·72, 95 % CI (1·12, 2·64)] and institutional delivery [AOR 2·36, 95 % CI (1·28, 4·33)] were also determinants of exclusive breast-feeding practices. Conclusion: Breast-feeding education improved early initiation of breast-feeding and exclusive breast-feeding practices. Providing sustained education to women regarding early initiation and exclusive breast-feeding practice should be strengthened.

We studied ethnic differences in terms of iron status during pregnancy between Dutch women and other ethnicities and explore to what extent these differences can be explained by environmental factors. This cross-sectional population-based study (2002–2006) was embedded in the Generation R study and included a total of 4737 pregnant women from seven ethnic groups (Dutch, Turkish, Moroccan, Cape Verdean, Surinamese-Hindustani, Surinamese-Creole and Antillean). Ethnicity was defined according to the Dutch classification of ethnic background. Ferritin, iron and transferrin were measured in early pregnancy. The overall prevalence of iron deficiency was 7 %, ranging from 4 % in both Dutch and Surinamese-Creoles, to 18 % in Turkish, Moroccan and Surinamese-Hindustani women. Iron overload was most prevalent in Surinamese-Creole (11 %) and Dutch (9 %) women. Socioeconomic factors accounted for 5–36 % of the differences. Income was the strongest socioeconomic factor in the Cape Verdean and Surinamese-Hindustani groups and parity for the Turkish and Moroccan groups. Lifestyle determinants accounted for 8–14 % of the differences. In all groups, the strongest lifestyle factor was folic acid use, being associated with higher iron status. In conclusion, in our population, both iron deficiency and iron overload were common in early pregnancy. Our data suggest that ethnic differences in terms of socioeconomic and lifestyle factors only partly drive the large ethnic differences in iron status. Our data support the development of more specific prevention programmes based on further exploration of socioeconomic inequities, modifiable risk and genetic factors in specific ethnic subgroups, as well as the need for individual screening of iron status before supplementation.

We aimed to investigate the effects of a long-term, individualised, family-based lifestyle intervention on food consumption and nutrient intake from childhood to adolescence. We conducted an 8-year diet and physical activity intervention study in a population sample of children aged 7–9 years at baseline in 2007–2009. We allocated the participants to the intervention group (n 306) and the control group (n 198). We assessed diet by 4-d food records at baseline, 2-year follow-up and 8-year follow-up. We analysed the data using linear mixed-effects models adjusted for age at baseline and sex. The consumption of vegetables and vegetable oil-based spreads (fat ≥60 %) increased in the intervention group but did not change in the control group (P < 0⋅001 for time×group interaction). The consumption of fruits and berries increased in the intervention group but decreased in the control group (P = 0⋅036). The consumption of high-fat cheese (P = 0⋅029), butter-based spreads (P = 0⋅001) and salty snacks (P = 0⋅028) increased less, and the consumption of low-fat cheese (P = 0⋅004) increased more in the intervention group than in the control group. Saturated fat intake (P = 0⋅001) increased less, and the intakes of dietary fibre (P = 0⋅003), vitamin D (P = 0⋅042) and vitamin E (P = 0⋅027) increased more in the intervention group than in the control group. The intakes of vitamin C (P < 0⋅001) and folate (P = 0⋅001) increased in the intervention group but decreased in the control group. To conclude, individualised, family-based lifestyle intervention altered food choices towards more recommended diet and resulted in enhanced diet quality from childhood to adolescence.