Obesity prevalence among Chilean children is 19·4 %. The present study aimed to assess the effectiveness of a school-based obesity prevention programme.

Non-randomized controlled study. The intervention included activities in nutrition and physical activity, fully applied the first year and partially in the second one. Primary outcomes were BMI Z-score (BMIZ) and obesity prevalence; secondary outcomes were waist circumference and triceps skinfold thickness. Time effects were assessed by changes in BMI-related variables by gender and period (ANOVA and Tukey test), while intervention effects were determined by comparing changes in (i) obesity prevalence by gender and period (PROC GENMOD) and (ii) BMIZ according gender, age and period (PROC MIXED).

Primary schools in the Chilean cities of Casablanca (intervention group) and Quillota (control group).

One thousand seven hundred and fifty-nine children from three schools (intervention group) and 671 from one school (control group).

Over the two years, obesity prevalence and BMIZ declined significantly in the intervention group; from 17·0 % to 12·3 % and 14·1 % to 10·3 % in boys and girls, respectively, and from 0·62 to 0·53 and 0·64 to 0·58, respectively. In the control group, obesity remained stable at about 21 % and 15 %, while BMIZ increased significantly in the second year. BMIZ declined in both genders and all age categories in the intervention group during the first year (significant only in younger boys). No changes occurred during the summer, while during the second year, BMIZ increased in boys and girls from both groups (significant only in the younger control boys). Obesity declined significantly only in boys during the first year.

Effectiveness was greater in the first school year and more evident in younger boys.

Anaemia currently affects 40–80 % of women in Africa. While risk factors for anaemia have been intensively studied, research has rarely compared risk factors between mild anaemia and moderate/severe anaemia. Also, the contribution of neighbourhood to the prevalence of anaemia has been rarely studied. The aim of the present study was to identify and compare individual and contextual factors associated with various levels of anaemia among women.

A multilevel analysis of data from the 2001 Mali Demographic and Health Survey (n 3763) was carried out. Outcomes variables were mild anaemia, moderate-to-severe anaemia and any anaemia. Multilevel regression analyses were performed for each outcome.

Mali, West Africa.

Women (n 3763) aged 15 to 49 years, including 512 pregnant women.

Among the eleven potential risk factors included in the models, two factors were associated with mild anaemia (BMI and education), three with any anaemia (pregnancy, BMI and education) and six with moderate-to-severe anaemia (pregnancy, BMI, education, wealth, childhood residency and region of residence). Clustering of anaemia within communities was 20 % for moderate-to-severe anaemia and 13 % for mild anaemia. Despite significant differences in the prevalence of anaemia across regions in Mali, no difference between regions in the risk of mild anaemia was found and only the region of Gao showed a significantly higher risk of moderate-to-severe anaemia.

The findings indicate that sociodemographic risk factors as well as clustering of anaemia varies with the severity of anaemia. Specific studies are needed to identify risk factors of mild anaemia as well as its consequences, as mild anaemia accounts for 20–40 % of total prevalence of anaemia in Africa.

To introduce community-specific modifications in the conventional 24 h recall method for objectively estimating maternal dietary intake and validate it with a reference method.

A modified 24 h recall method was developed with the visit of trained local girls at the subject’s home to weigh portion sizes at each mealtime over the 24 h recall period. This was validated with the reference method in which weighed records of the foods consumed were obtained and their laboratory analysis was done to obtain nutrient intakes.

Rural areas located 40–50 km from Pune City, India.

Forty-one pregnant women participated willingly.

The estimates of intake obtained from the reference method were comparable to those obtained from the modified 24 h recall method for energy (7795 (sd 1841) kJ (1863 (sd 440) kcal) v. 7615 (sd 1824) kJ (1820 (sd 436) kcal), respectively), protein (48·6 (sd 12·9) g v. 45·3 (sd 12·6) g, respectively) and fat (35·3 (sd 16·6) g v. 36·0 (sd 14·2) g, respectively). Significant correlation was observed between the estimates obtained by the two methods for energy (0·75, P < 0·001), protein (0·71, P < 0·001) and fat (0·56, P < 0·001) and differences in nutrient intake did not reveal any systematic bias. When compared with the reference method, the modified method showed >80 % sensitivity and specificity for identifying inadequate maternal energy intakes.

Simple modifications to conventional methods backed by understanding of community specifics and nutritional peculiarities are of immense importance in obtaining objective estimates of daily nutritional intakes of individuals in free-living populations. The approach would be adaptable in similar settings in other developing countries.

To evaluate the validity of the Northern Sweden eighty-four-item FFQ to estimate intake of fatty acids relative to 24 h diet recalls (24-HDR) and fatty acids in erythrocyte membranes.

Participants, randomly recruited from the population-based Västerbotten Intervention Project, answered the eighty-four-item FFQ. During the following year each participant carried out ten 24-HDR. Intake of fatty acids measured by the FFQ was compared with intake by the 24-HDR and fatty acid levels in erythrocytes.

The county of Västerbotten in northern Sweden.

Ninety-six men and ninety-nine women.

Spearman correlation coefficients (rs) between intakes of the fatty acids 14 : 0, 15 : 0, 16 : 0, 17 : 0, 18 : 2n-6, 18 : 3n-3, 20 : 5n-3 and 22 : 6n-3 estimated by the FFQ and the 24-HDR were all significant and ranged from 0·29 (22 : 6n-3 in men and women) to 0·60 (16 : 0 in men), whereas significant correlations between FFQ-estimated intake and erythrocyte membrane content were only seen for milk fatty acids 14 : 0, 15 : 0 and 17 : 0 (rs = 0·23–0·34) and fish fatty acids 20 : 5n-3 and 22 : 6n-3 (rs = 0·42–0·51).

The Northern Sweden eighty-four-item FFQ gives a satisfactory estimate of the intake of fish fatty acids (20 : 5n-3 and 22 : 6n-3) and milk fatty acids (15 : 0 and 17 : 0), whereas its validity for fatty acids 18 : 2n-6 and 18 : 3n-3, derived mainly from vegetable oils, cannot be shown.

To determine the prevalence and usage of food gardens in primary schools in three distinct climatic regions of north-eastern Australia.

Cross-sectional surveys combining quantitative and qualitative data collection. Two separate telephone questionnaires were developed and implemented, according to the presence or absence of a food garden within the school. Main outcome measures were answers to scaled response and open-ended questions related to factors supporting and inhibiting the establishment and sustainability of school food gardens.

All state primary schools in three disparate regions of the north-eastern Australian state of Queensland were asked to participate in the study.

A total of 71 % (n 128) of schools agreed to participate. Of these, thirty-seven primary schools had functioning food gardens. The variations in prevalence between regions combined with respondent views indicated climate as a major factor affecting the success of food gardens. Gardens were often used as a tool by schools to teach science, environment or social skills. Gardening activities were generally linked to curriculum studies on plants, fruit and vegetable intake, and healthy eating. The main issues for schools and teachers in establishing food gardens were the time required and the lack of personnel to coordinate garden activities. Of the schools with food gardens, 92 % believed their garden had been a success.

The study revealed strong grass-roots support for school-based food gardens. Although climate and location were important factors associated with the presence of a functioning food garden, respondents nominated teacher involvement and sustained motivation as essential factors for successful school food gardens.

To examine the relationship between dietary patterns and metabolic syndrome.

Population-based cross-sectional study. The K-means clustering method was used to identify dietary patterns and logistic regression models were used to compare the adjusted prevalence rates of metabolic syndrome factors, stratifying by obesity status.

The 1992–3 Italian Bollate Eye Study, a population-based survey carried out in the town of Bollate (Milan), Italy.

A total of 1052 non-diabetic Italian subjects, 527 men and 525 women, aged 42–74 years.

Five dietary clusters were identified: common, animal products, starch, vegetal/fat and vitamin/fibre. After adjusting for potential confounders, the starch group showed the highest prevalence of metabolic syndrome (36 %) followed by the animal products group (30 %); the vitamin/fibre (20 %) and vegetal/fat groups (19 %) showed the lowest prevalence. The starch group had more dyslipidaemia (higher TAG and lower HDL cholesterol levels) and the animal products group had a higher prevalence of impaired fasting glucose. The vitamin/fibre group had the lowest prevalence of abdominal obesity. The beneficial effect of the vegetal/fat and vitamin/fibre dietary patterns seemed stronger among the obese.

Our results confirm the deleterious effect of a very-low-fat, high-carbohydrate diet and also of high intakes of animal products. The consumption of a diet high in vegetal fats or rich in fruits and vegetables is associated with a healthier metabolic profile. Reducing obesity is essential to prevent metabolic syndrome, but even among the obese dietary habits are important for preserving healthy lipid and glycaemic profiles.

To explore the relationship among children’s diet quality, weight status and food environment in subarctic Canada.

In the cross-sectional study, children’s BMI was calculated, diet quality was assessed using three 24 h dietary recalls and children were asked about their home food environment and source of meals.

Two Aboriginal Cree communities in northern Québec.

Two hundred and one children in grades 4–6.

The majority (64·2 %) of children were overweight (29·9 %) or obese (34·3 %). Weight status was not associated with reported restaurant meal frequency or the home food environment. The 18 % of children who consumed three or more restaurant meals in the three days of recall consumed, on average, 2004 kJ (479 kcal) more energy daily than children consuming no restaurant meals and had higher intakes of fat, saturated fat, Ca and soda. Most foods contributing to energy and dietary fat were energy-dense market foods of low nutritional value such as sweetened beverages and snack foods. Only 68 % of children reported often having fruits and vegetables in the home and 98·5 % of children consumed less than 5 fruits and vegetables daily. Many children (42·8 %) were at risk of Zn inadequacy. Only 19 % of children consumed 2 or more servings of milk daily, and the mean intakes of Ca and vitamin D were below the recommended adequate intake. Traditional game meat was consumed infrequently, but contributed significantly to Fe and Zn intake.

Childhood obesity in subarctic communities prevailed in a food environment typified by high-energy-density commercial foods of low nutritional value.

To evaluate the iodine nutritional status of children living on the island of Tanna, Republic of Vanuatu.

Cross-sectional study. Urine and household salt samples were collected for iodine measurement. Thyroid volumes were measured by ultrasound. A food consumption frequency survey was carried out, particularly in relation to salt, iodine-rich foods and foods that containing thiocyanate, a potentially goitrogenic substance. Urinary thiocyanate levels were also measured.

Island rural communities in Tanna, Vanuatu.

One hundred and fifty-three schoolchildren between 8 and 10 years of age from four locations on the island participated.

The median urinary iodine excretion (UIE) among the children was 49mg/l, indicating moderate iodine deficiency. This was corroborated by 27% of boys and 33% of girls having thyroid glands greater than the international standard for their age, and 36% of boys and 45% of girls having thyroid glands greater than the international standard for their body surface area based on ultrasonography. There was a highly statistically significant inverse correlation between thyroid volume and UIE for boys and girls (r = −0·444, P = 0·001 and r = −0·319, P = 0·005, respectively). There was no correlation between thiocyanate and UIE or thyroid volume. Only 34% of children reported to consume fish (tinned or fresh) on a weekly basis.

Against the common perception, the study has demonstrated that the children on the island of Tanna were in a state of moderate iodine deficiency. More data need to be collected from other Pacific Island countries in order to provide evidence for formulating public policy in prevention and control of iodine deficiency disorders in these nations.

To evaluate the association between wholegrain products intake and other dietary, lifestyle, anthropometric and socio-economic factors.

Cross-sectional study, with data on diet, lifestyle and socio-economic factors obtained from questionnaires. Anthropometric measurements were collected by trained professionals. Multiple linear and principal components regression analyses were used in statistical analyses.

Part of the Diet, Cancer and Health study, a prospective cohort study to evaluate the aetiological role of diet on cancer risk, conducted in the greater Copenhagen and Aarhus area, Denmark.

Men and women (n 54 720) aged 50–64 years.

In multiple linear regression analyses focusing on individual dietary factors, intake of wholegrain products was associated with intake of all dietary factors studied (fish, red meat, poultry, processed meat, dairy products, fruits, vegetables, cakes and refined-grain products). The strongest positive associations were seen for intake of vegetables and processed meat, whereas the strongest negative associations were seen for intake of red meat and refined-grain products. Regression analyses on dietary patterns identified by principal components analysis yielded similar results. Also, wholegrain products intake was positively associated with cycling, taking dietary supplements and high school education, and negatively associated with intake of alcohol, BMI and smoking.

Intake of wholegrain products is associated with other dietary factors, healthier lifestyle habits and higher socio-economic status. Therefore future studies need to account for the possible confounding by other dietary and lifestyle-related parameters when investigating relationships between wholegrain products intake and disease risk.

Nutrient Reference Values (NRV) are evidence-based benchmarks for assessing the dietary adequacy of individuals and population groups as well as informing public health nutrition policies and programmes. The present paper presents the findings of an analysis of the views of submitters to a draft document associated with the development of the 2006 NRV for Australia and New Zealand. The aim of the study was to explore how these views were reflected in the policy-making process and final policy document.

The information necessary to fulfil this aim required access to stakeholder submissions to the NRV development process and this necessitated exploiting the provisions of the Commonwealth of Australia’s Freedom of Information (FOI) Act 1982. We understand that the present research represents the first time that an FOI request seeking information about a National Health and Medical Research Council food and nutrition policy process has been made and therefore is novel in its approach to public health nutrition policy analysis.

The analysis of stakeholder submissions identified that stakeholders had particular concerns about the conduct of the review process and the future application of the nutrient values to policy and programmes. There is a lack of evidence that the majority of stakeholder comments were addressed in the final NRV document.

Although these findings cannot be interpreted to assess the validity or otherwise of the set nutrient values, they do raise questions about the process for their development and the adequacy of the final document to reflect the views of key stakeholders.

To investigate the possible dietary risk factors for anaemia in rural elderly women.

Case–control study conducted in 2005. Cases and matched controls were interviewed in person to elicit information on lifestyle, diet and individual health. Main foods and nutrients were calculated by three 24 h recalls; intake data of tea, edible oils and spices were from an FFQ.

Fourteen villages in two counties of Guangxi Province, south-west China.

Four hundred and twenty anaemic cases and 433 matched controls, aged 50–75 years.

The mean consumption of animal foods for cases (82·4 g/d) was significantly lower than for controls (91·0 g/d), similarly for egg consumption (3·8 g/d for cases and 5·8 g/d for controls; P < 0·05). The absolute value of the Dietary Balance Index, low bound score (DBI_LBS) was significantly higher for cases than for controls (P < 0·05). Intakes of energy, protein, carbohydrate, vitamin A (retinol equivalents, RE), vitamin B1, riboflavin and Ca were significantly lower in cases than in controls (P < 0·05). There was no significant difference in Fe intake between the two groups. High intake of vitamin A (RE) was inversely associated with anaemia (quartile 4 v. quartile 1: OR = 0·6, P for linear trend = 0·02). The absolute value of DBI_LBS was positively related to anaemia (quartile 4 v. quartile 1: OR = 0·4, P for linear trend < 0·0001).

For rural elderly women in south-west China, anaemia had a strong positive association with undernutrition and a negative association with vitamin A intake. Dietary Fe intake was not found to be an independent risk factor for anaemia.

Folic acid food fortification has successfully reduced neural tube defect-affected pregnancies across Canada. The effect of this uncontrolled public health intervention on folate intake among Canadian children is, however, unknown. Our objectives were to determine folic acid intake from food fortification and whether fortification promoted adequate folate intakes, and to describe folic acid-fortified food usage among Ontario preschoolers.

Cross-sectional data were used from the NutriSTEP™ validation project with preschoolers recruited using convenience sampling. Mean daily total folate and folic acid intakes were estimated from 3 d food records, which included multivitamin supplement use. Comparisons were made to Dietary Reference Intakes, accounting for and excluding fortificant folic acid, to determine the prevalence of inadequate and excessive intakes.

Canada.

Two hundred and fifty-four preschoolers (aged 3–5 years).

All participants (130 girls, 124 boys) ate folic acid-fortified foods and 30 % (n 76) used folic acid-containing supplements. Mean (se) fortificant folic acid intake was 83 (2) μg/d, which contributed 30 % and 50 % to total folate intake for supplement users and non-users, respectively. The prevalence of total folate intakes below the Estimated Average Requirement was <1 %; however, excluding fortificant folic acid, the prevalence was 32 %, 54 % and 47 % for 3-, 4- and 5-year-olds, respectively. The overall prevalence of folic acid (fortificant and supplemental) intakes above the Tolerable Upper Intake Level was 2 % (7 % among supplement users).

Folic acid food fortification promotes dietary folate adequacy and did not appear to result in excessive folic acid intake unless folic acid-containing supplements were consumed.

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 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.

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.

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.