To estimate the impact of choosing food products labelled either as low or high in salt on salt intake in the Finnish adult population.

The National FINDIET 2002 survey with 48-hour recalls from 2007 subjects aged 25–64 years. Sodium intake was calculated based on the Fineli® food composition database including the sodium content of natural and processed foods as well as the salt content of recipes. The distribution of salt intake was calculated in different ways: the present situation; assuming that all breads, cheeses, processed meat and fish, breakfast cereals and fat spreads consumed would be either ‘lightly salted’ or ‘heavily salted’ based on the current labelling practice; and, in addition, assuming that all foods would be prepared with 50% less or more salt.

Excluding underreporters, the mean salt intake would be reduced by 1.8 g in men and by 1.0 g in women if the entire population were to choose lightly salted products and further by 2.5 and 1.8 g, respectively, if also salt used in cooking were halved. Choosing heavily salted products would increase salt intake by 2.1 g in men and by 1.4 g in women. In the worst scenarios, salt intake would be further increased by 2.3 g in men and by 1.6 g in women.

These calculations show that the potential impact of labelling and giving consumers the possibility to choose products with less salt is of public health importance. In addition, strategies to reduce the salt content of all food groups are needed.

To discuss factors which have underpinned the nutrition transition in the countries of East Africa, including Kenya, Uganda and Tanzania, from early colonisation to the current, oppressive political–economic structure.

Colonisation and neocolonisation in accordance with the desires of the New World Order have ensured the systematic extirpation of indigenous and traditional food habits in East Africa. These indigenous and traditional food habits, associated with myriad health benefits, have been progressively replaced by the globalised food system of the multinational corporations, a system inherently associated with the creation of non-communicable disease (NCD) epidemics throughout this region and globally. While the simplification of the East African food culture may be most apparent today, the nutrition transition has actually occurred over the past 400 years, since the onset of colonial occupation.

It is imperative that greater efforts be directed towards exposing the colonial and neocolonial forces which have undermined food security and health status in East Africa. Heightened awareness of these forces is essential for proposing genuine solutions to the nutrition transition and related NCD epidemics throughout this region and, indeed, worldwide.

Intake and status of carotenoids have been associated with chronic disease. The objectives of this study were to examine the association between carotenoid intakes as measured by two regional food-frequency questionnaires (FFQs) and their corresponding measures in serum, and to report on dietary food sources of carotenoids in Jackson Heart Study (JHS) participants.

Cross-sectional analysis of data for 402 African American men and women participating in the Diet and Physical Activity Sub-Study (DPASS) of the JHS.

Mean serum carotenoid concentrations and intakes in this population were comparable to those reported for the general US population. After adjustment for covariates, correlations between serum and dietary measures of each carotenoid, for the average of the recalls (deattenuated), the short FFQ and the long FFQ, respectively, were: 0·37, 0·35 and 0·21 for α-carotene; 0·35, 0·26 and 0·28 for total (diet plus supplements) β-carotene; 0·25, 0·17 and 0·20 for dietary β-carotene; 0·42, 0·34 and 0·26 for β-cryptoxanthin; 0·33, 0·15 and 0·17 for lutein plus zeaxanthin; and 0·37, 0·19 and 0·14 for lycopene. Major dietary sources of α-carotene were orange vegetables; of β-carotene and lutein plus zeaxanthin, mustard, turnip and collard greens; of β-cryptoxanthin, orange juice; and of lycopene, tomato juice.

On average, carotenoid intakes and serum concentrations are not lower in this southern African American population than the general US population. The two regional FFQs developed for a southern US population and used as dietary assessment tools in the JHS appear to provide reasonably valid information for most of these carotenoids.

To investigate factors influencing the practices of partial breast-feeding (PBF) and exclusive breast-feeding (EBF).

A national, cross-sectional survey was conducted among married women aged 15–49 years from May to August 2003.

South Korea.

A total of 865 mothers answered questions regarding the feeding practices of their youngest baby, born between January 2001 and May 2003.

The initiation rates of PBF and EBF were 81% and 63%, respectively. However, the median durations of PBF and EBF were very short: 12 and 8 weeks, respectively. According to stepwise logistic and Cox regression analyses, the more prenatal care women received, the more likely they were to initiate PBF and EBF but the less likely to continue EBF. Delivery by Caesarean section decreased the initiation of PBF and EBF. The mother’s education level and employment status before marriage, the amount of prenatal care, delivery method and baby’s status at birth affected breast-feeding initiation, whereas the amount of prenatal care influenced breast-feeding duration.

To promote breast-feeding, education and campaigning on the importance of continued breast-feeding should be provided to the general public, particularly to health workers in maternity units.

Low-income households in the UK concentrate factors associated with poor record-keeping such as lower literacy, numeracy and English language skills. The present study aimed to (1) compare the validity and acceptability of three dietary survey methods against appropriate reference measures and (2) identify a method which was both valid and acceptable in low-income households.

Cross-sectional design comparing three 4-day dietary survey methods (multiple-pass 24-hour recall, food checklist and semi-weighed method) against a 4-day weighed inventory and other reference measures within subjects.

London, UK, 2001.

Low-income households were selected using a doorstep screening questionnaire in 18 of the 60 most deprived neighbourhoods in London. Results are based on 384 respondents (159 males, 225 females) aged 2–90 years in 240 households. Respondents were mainly White (48%), Black or Black British (31%) or Asian or Asian British (9%).

The dietary survey method preferred by interviewers was the 24-hour recall. Most respondents preferred the food checklist. Compared with the weighed inventory, repeat 24-hour recalls and the food checklist yielded higher estimates of energy and nutrient intakes. The semi-weighed method was least liked and yielded the lowest estimates of intake.

Based partly on evidence presented here and partly on evidence to be presented in later publications, four multiple-pass 24-hour recalls were recommended as the most appropriate method for a national study of diet and nutrition in low-income households in the UK.

Renewed focus on public health has brought about considerable interest in workforce development among public health nutrition professionals in Canada. The present article describes a situational assessment of public health nutrition practice in Canada that will be used to guide future workforce development efforts.

A situational assessment is a planning approach that considers strengths and opportunities as well as needs and challenges, and emphasizes stakeholder participation. This situational assessment consisted of four components: a systematic review of literature on public health nutrition workforce issues; key informant interviews; a PEEST (political, economic, environmental, social, technological) factor analysis; and a consensus meeting.

Information gathered from these sources identified key nutrition and health concerns of the population; the need to define public health nutrition practice, roles and functions; demand for increased training, education and leadership opportunities; inconsistent qualification requirements across the country; and the desire for a common vision among practitioners.

Findings of the situational assessment were used to create a three-year public health nutrition workforce development strategy. Specific objectives of the strategy are to define public health nutrition practice in Canada, develop competencies, collaborate with other disciplines, and begin to establish a new professional group or leadership structure to promote and enhance public health nutrition practice. The process of conducting the situational assessment not only provided valuable information for planning purposes, but also served as an effective mechanism for engaging stakeholders and building consensus.

Countries in the Commonwealth of Independent States made little progress in child nutrition and mortality between 1990 and 2005. The present paper assesses the nutritional status of children <5 years of age and discusses possible strategies for improvement.

Data on low birth weight, infant and young child feeding, underweight, overweight and micronutrient deficiencies were compiled from available reports and databases, complemented through questionnaires to UNICEF Country Offices, and analysed by country, age, gender, urban/rural residence, maternal education and wealth quintiles.

Exclusive breast-feeding in the first 6 months and continuing breast-feeding up to 2 years fall short of WHO and UNICEF recommendations. Complementary foods are introduced too early and may be poor in protein and micronutrients. Stunting and underweight are prevalent, especially in children aged 12 to 35 months; overweight is even more prevalent. Vitamin A and I deficiencies are still present in some countries, despite current control efforts. Anaemia ranges between 20 % and 40 %. Higher rates of malnutrition are found in rural areas, children of less educated mothers and lower-income families.

Current public health strategies should be redirected to address: (i) overall protection, promotion and support of infant and young child feeding, in addition to breast-feeding; (ii) overweight, in addition to underweight and stunting; and (iii) malnutrition as a whole, in addition to micronutrient deficiencies. An equity lens should be used in developing policies and plans and implementing and monitoring programmes. Capacity building, cross-sectoral action, improved data collection within adequate legal frameworks and community engagement should be the pillars of redirected strategies.

Dietary intake of long-chain (LC) n-3 PUFA in developed countries is low compared with recommendations. Fish is naturally rich in LC n-3 PUFA, but is also a dietary source of heavy metals and organic pollutants. We investigated whether the recommendation for LC n-3 PUFA could be reached through fish consumption, without exceeding the provisional tolerable weekly intake of methylmercury (MeHg) and the tolerable weekly intake (TWI) of dioxin-like compounds. Also, the contribution of margarines enriched with LC n-3 PUFA was assessed.

Published nutrient and contaminant data were used in a probabilistic model to calculate the simultaneous nutrient and contaminant intake for different fish consumption scenarios.

The Belgian recommendation for EPA + DHA (0·3 % of total energy intake) can be reached by consuming fatty fish a minimum of twice a week, or by varying between lean and fatty fish a minimum of three times a week. At this fish consumption level, MeHg intake is not an issue of toxicological concern. The intake of dioxin-like compounds approximates the TWI when consuming fatty fish more than twice a week, this being a potential toxicological risk because other food items also contribute to the weekly intake of dioxin-like compounds. Use of margarine enriched with LC n-3 PUFA can help to increase LC n-3 intake, on average by 159 mg/d.

Combination of regular fish consumption (twice a week) with important contribution of fatty fish species, in combination with regular consumption of margarine enriched with EPA + DHA, can be advised to achieve the recommendation for LC n-3 intake.

Our goal was to assess the potential for evaluating strengths of the Awajún traditional food system using dietary assessment, a traditional food diversity score and ranking of local foods.

The method was used for dietary data obtained from mothers and children in the Awajún culture of the Peruvian Amazon where >90% of the dietary energy is derived from local, traditional food. Traditional food diversity scores were calculated from repeat 24-hour recalls. Group mean intakes of energy, fat, protein, iron, vitamin A and vitamin C from each food item were used to rank foods by nutrient contribution.

The study took place in six remote communities along the lower Cenepa River in the Amazonas District of Peru, South America.

Dietary data were collected from 49 Awajún mothers and 34 children aged 3–6 years, representative of the six communities.

Higher traditional food diversity was associated with greater protein, fibre, vitamin and mineral intakes when controlling for energy (partial correlations = 0.37 to 0.64). Unique sources for iron, total vitamin A and vitamin C were found in the Awajún traditional food system.

A traditional food diversity score was a useful tool for predicting nutrient adequacy for the Awajún. Promotion of the Awajún traditional food system should focus on dietary diversity and unique nutrient-dense local foods.

Recent research indicates that n–3 fatty acids can inhibit cognitive decline, perhaps differentially by hypertensive status.

We tested these hypotheses in a prospective cohort study (the Atherosclerosis Risk in Communities). Dietary assessment using a food-frequency questionnaire and plasma fatty acid exposure by gas chromatography were completed in 1987–1989 (visit 1), while cognitive assessment with three screening tools – the Delayed Word Recall Test, the Digit Symbol Substitution Test of the Wechsler Adult Intelligence Scale–Revised and the Word Fluency Test (WFT) – was completed in 1990–1992 (visit 2) and 1996–1998 (visit 4). Regression calibration and simulation extrapolation were used to control for measurement error in dietary exposures.

Four US communities – Forsyth County (North Carolina), Jackson (Mississippi), suburbs of Minneapolis (Minnesota) and Washington County (Maryland).

Men and women aged 50–65 years at visit 1 with complete dietary data (n = 7814); white men and women in same age group in the Minnesota field centre with complete plasma fatty acid data (n = 2251).

Findings indicated that an increase of one standard deviation in dietary long-chain n–3 fatty acids (% of energy intake) and balancing long-chain n−3/n–6 decreased the risk of 6-year cognitive decline in verbal fluency with an odds ratio (95% confidence interval) of 0.79 (0.66–0.95) and 0.81 (0.68–0.96), respectively, among hypertensives. An interaction with hypertensive status was found for dietary long-chain n–3 fatty acids (g day−1) and WFT decline (likelihood ratio test, P = 0.06). This exposure in plasma cholesteryl esters was also protective against WFT decline, particularly among hypertensives (OR = 0.51, P < 0.05).

One implication from our study is that diets rich in fatty acids of marine origin should be considered for middle-aged hypertensive subjects. To this end, randomised clinical trials are needed.

To define the prevalence of overweight and obesity among school-aged children resident in mountain areas, rural areas and urban areas.

The sample (n = 12 832; 50.7% boys) included 9- and 11-year-old children of the Veneto Region of north-east Italy. Overweight and obesity status were determined using the International Obesity Task Force cut-off points for body mass index. The prevalence of overweight and obese subjects was calculated with a confidence interval of 95%. The Mantel–Haenszel method was used to compare the combined prevalence of overweight and obesity among children resident in mountain areas, rural areas and urban areas.

Among boys the prevalence of overweight was 21.06%, while obesity prevalence was 5.92%; among girls overweight prevalence was 21.30%, while obesity prevalence was 5.15%. The prevalence was higher among 11-year-old boys (odds ratio (OR) = 1.19; 95% confidence interval (CI): 1.06–1.33) and 9-year-old girls (OR = 1.13; 95% CI: 1.01–1.26). Children resident in rural areas presented a higher risk of overweight and obesity compared with children resident in mountain areas (Mantel–Haenszel OR = 1.27; 95% CI: 1.13–1.42; χ2 = 17.55; P < 0.0001) and in urban areas (Mantel–Haenszel OR = 1.18; 95% CI: 1.07–1.31; χ2 = 10.39; P < 0.001).

A relevant prevalence of overweight and obesity was found; the excess weight concerns one child in four. There are differences linked to different geographical areas that must be further investigated.

Evidence suggesting that a diet high in fruits and vegetables may be beneficial to bone health has sparked interest in the potential benefit of a vegetarian diet. However, other studies have raised a question regarding the adequacy of protein in such a diet.

The aim of the present study was to take a whole foods approach in examining the effects of foods high in protein on the risk of wrist fracture (WF) in a cohort with a significant proportion consuming a meat-free diet.

A cohort study of women who completed two lifestyle surveys 25 years apart.

One thousand eight hundred and sixty-five peri- and postmenopausal women at the time of the first survey.

There was a significant interaction between meat consumption and foods high in vegetable protein. Among vegetarians, those who consumed the least vegetable protein intake were at highest risk for fracture. However, increasing levels of plant-based high-protein foods decreased WF risk, with a 68% reduction in risk (hazard ratio (HR) = 0.32, 95% confidence interval (CI) 0.13–0.79) in the highest intake group. Among those with lowest vegetable protein consumption, increasing meat intake decreased the risk of WF, with the highest consumption decreasing risk by 80% (HR = 0.20, 95% CI 0.06–0.66).

The finding that higher consumption frequencies of foods rich in protein were associated with reduced WF supports the importance of adequate protein for bone health. The similarity in risk reduction by vegetable protein foods compared with meat intake suggests that adequate protein intake is attainable in a vegetarian diet.

Whereas there are numerous reports in the literature relating the impact of maternal nutritional status on subsequent birth outcome, much less is known about the long-term impact on infant growth after birth. Therefore, we conducted a prospective cohort study to investigate the association of maternal micronutrient status (vitamins A, C and E, folate) and oxidative stress status in pregnancy with infant growth during the first year of life.

Prospective cohort study.

Outpatient clinic of obstetrics, Ewha Womans University Hospital, Seoul, South Korea.

Two groups were constructed for this study – the Ewha pregnancy cohort (n = 677) and the infant growth cohort comprising follow-up live newborns of all the recruited pregnant women (n = 317). Maternal serum vitamin and urinary oxidative stress levels were collected and infant weights and heights were measured at birth and at 6 and 12 months after birth.

Division of the subjects into folate-deficient and normal groups revealed that infant weight and height at 0, 6 and 12 months were adversely affected by folate deficiency. High maternal vitamin C was associated with increased infant weight and height at birth and after birth.

Our findings indicate the importance of preventing folate deficiency and supplementing vitamin C during pregnancy.

To explore the relationship between subjective mood, folate status and homocysteine in healthy individuals.

Subjective mood assessments were completed twice daily over the course of one week using the Positive and Negative Affect Scale (PANAS). The PANAS is a validated scale which considers mood state on two distinct continua, one reflecting positive mood and the other negative mood, each requiring response to 10 adjectives on a Likert scale. A blood sample was taken on one occasion at the start of the week during which subjective mood was assessed and analysed for red-blood-cell (RBC) folate, serum folate and plasma homocysteine concentrations.

Male volunteers aged 19–47 years (n = 58) were recruited from local industries.

High concentrations of RBC folate were associated with less variability (lower standard deviation) in negative mood (P = 0.023). Subjective mood, however, was not related to serum folate or homocysteine.

This study appears to be the first to uncover an association between long-term folate status and subjective mood (employing the PANAS) in healthy males. More research is needed to further explore the relationship between nutritional status and mood.

To describe the US public health nutrition workforce and its future social, biological and fiscal challenges.

Literature review primarily for the four workforce surveys conducted since 1985 by the Association of State and Territorial Public Health Nutrition Directors.

The United States.

Nutrition personnel working in governmental health agencies. The 1985 and 1987 subjects were personnel in full-time budgeted positions employed in governmental health agencies providing predominantly population-based services. In 1994 and 1999 subjects were both full-time and part-time, employed in or funded by governmental health agencies, and provided both direct-care and population-based services.

The workforce primarily focuses on direct-care services for pregnant and breast-feeding women, infants and children. The US Department of Agriculture funds 81·7 % of full-time equivalent positions, primarily through the WIC Program (Special Supplemental Nutrition Program for Women, Infants, and Children). Of those personnel working in WIC, 45 % have at least 10 years of experience compared to over 65 % of the non-WIC workforce. Continuing education needs of the WIC and non-WIC workforces differ. The workforce is increasingly more racially/ethnically diverse and with 18·2 % speaking Spanish as a second language.

The future workforce will need to focus on increasing its diversity and cultural competence, and likely will need to address retirement within leadership positions. Little is known about the workforce’s capacity to address the needs of the elderly, emergency preparedness and behavioural interventions. Fiscal challenges will require evidence-based practice demonstrating both costs and impact. Little is known about the broader public health nutrition workforce beyond governmental health agencies.

The study aim was to assess the prevalence of Helicobacter pylori infection in Egyptian schoolchildren and its effect on growth parameters.

A cross-sectional population-based study was conducted among 286 schoolchildren (168 boys and 118 girls), with a mean age of 11.04 ± 0.19 years, to determine the prevalence of H. pylori. The presence of the bacterium was assessed using the [13C]urea breath test. Relevant personal and socio-economic data on risk factors for infection were collected. Height and weight were analysed in relation to H. pylori infection.

The overall prevalence of H. pylori infection was 72.38%. Attending school in a socially deprived area and residing in an overcrowded home were the major risk factors for infection. Differences between infected and non-infected children were significant with regard to body weight and height (weight: 39.5 ± 1.0 vs. 44.6 ± 1.8 kg, P = 0.05; height: 139.9 ± 1.3 vs. 144.2 ± 2.1 cm; P = 0.009). The number of children (both boys and girls) falling below the 5th percentile of height-for-age was significantly higher in infected than non-infected children (P = 001), similarly for Z-scores for height-for-age below –2.0 (P = 0.003).

The results demonstrate not only that the prevalence of H. pylori infection is extremely high among Egyptian schoolchildren, but also that the adverse effects of the infection reach far beyond the stomach. Evidence of the burden of infection on growth failure is presented.

To study associations between reported sugar intake and salivary bacteria (mutans streptococci, MS and lactobacilli, LB), and sugar intake in relation to body mass index (BMI), in women and adolescents.

Cross-sectional study. Habitual dietary intake was reported in a questionnaire and whole saliva samples were collected and cultivated.

Stockholm, Sweden.

Four hundred and fourteen mothers and their 16-year-old children (57% girls).

Reported total sugar intake was significantly associated with LB in mothers (P = 0.001), but not in daughters and sons (P = 0.03 for mother–son interaction). When excluding lactose, the associations with LB and MS were significant in daughters (P = 0.032 and 0.005, respectively). High BMI and sugar intake from milk were independently associated with MS counts in mothers in a multiple regression model (R2 = 0.053). In daughters, sugar from beverages, candies/chocolates and fruits were all independently associated with MS counts (R2 = 0.074), whereas in sons, only mothers’ MS counts were associated (R2 = 0.084). High BMI, low intake from cooked meals and high intake of candies/chocolates were all independently associated with LB in mothers (R2 = 0.076), while, except for candies/chocolates in daughters, no significant associations were found in children. BMI was significantly associated with bacteria counts in both mothers and children, whereas reported sugar intake was not.

The associations between reported sugar intake and bacteria were generally weak. In mothers and daughters, some significant associations were found, but not in sons. Bacteria counts, but not reported sugar intake, were positively associated with BMI.

To estimate and compare dietary energy intake (DEI) and total energy expenditure (TEE) among adults, using questionnaires.

Comparative, cross-sectional study.

Community-based, at the demographic surveillance site (DSS) in Butajira District of Ethiopia.

A total of 619 adults, 18–64 years of age, were randomly selected from among the urban and rural population of Butajira using the DSS sampling frame. Habitual dietary intake and physical activity were assessed using questionnaires. BMR was estimated using a regression equation, and TEE was calculated from BMR and the metabolic energy equivalent task (MET) and duration of reported activities. Physical activity level (PAL) was calculated as TEE/BMR, while food intake level (FIL) was calculated as DEI/BMR. The mean DEI:TEE ratio was used to evaluate reported DEI at the population level, while individual misreporters were identified by applying the Goldberg cut-off points at three levels of PAL.

Based on the Goldberg method, 57 % of the study participants were identified as acceptable reporters of DEI, among whom mean TEE was 8·21 (95 % CI 8·01, 8·42) MJ (1963 (95 % CI 1914, 2012) kcal), mean DEI was 8·13 (95 % CI 7·93, 8·34) MJ (1944 (95 % CI 1895, 1993) kcal) and mean DEI:TEE was 1·01 (95 % CI 0·99, 1·04).

The dietary history and physical activity questionnaires provide comparable estimates of mean energy intake and expenditure at a population level. Acceptable reporters have to be identified in order to obtain better estimates. Questionnaire-based estimates of energy intake should not be interpreted without an inherent system of comparison or validation.