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.

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 explore consumer trust in food, especially people’s experiences that support or diminish trust in the food supply; consumer practices to strengthen trust in food; and views on how trust in the food supply could be increased.

Adelaide, South Australia.

In-depth qualitative research interviews and focus groups.

Women and men who are primary food providers in families (n = 24).

Media coverage of food scares and scandals and personal experience of food-borne illness challenged respondents’ trust in the food system. Poor retail food handling practices and questionable marketing ploys by food manufacturers also decreased trust. Buying ‘Made-in-Australia’ produce and following food safety procedures at home were important practices to strengthen food trust. Knowledge of procedures for local food inspection and for national food regulation to keep food safe was scanty. Having a strong regulatory environment governing food safety and quality was considered by respondents to be of prime importance for trust building.

The dimensions of trust found in this study are consistent with key theoretical aspects of trust. The need for trust in highly complex environments, in this case the food supply, was evident. Trust was found to be integral to food choice, and negative media reports, the sources of which themselves enjoy various levels of dependability, were found to easily damage trust relationships. The lack of visibility of authoritative monitoring and surveillance, misleading food advertising, and poor retail food handling practices were identified as areas that decreased consumer trust. Respondents also questioned the probity of food labelling, especially health claims and other mechanisms designed to guide food choice. The research highlights the role trust plays in food choice. It also emphasises the importance of a visible authoritative presence in the food system to strengthen trust and provide reassurance to consumers.

To assess the national prevalence of overweight and obesity, as well as some associated lifestyle behaviours, for the first time in Iran.

This population-based study was performed in early 2005 as part of the World Health Organization (WHO) STEPwise approach to non-communicable diseases’ risk factor surveillance. Dietary and physical activity habits were assessed by WHO questionnaires.

The study population comprised 89 532 subjects aged over 15 years living in the 28 provinces of Iran.

Overall, 50.4% (n = 45 113) of the participants were male and 64.6% (n = 57 866) were from the urban areas. The national estimates of overweight, obesity and morbid obesity were 28.6%, 10.8% and 3.4%, respectively. Body mass index (BMI) ≥ 25 kg m−2 in men, women, urban residents and rural residents were found in 37%, 48%, 46.7% and 35.5%, respectively. Abdominal obesity was present in 43.4% of women, 9.7% of men, 28.5% of the urban residents and 23% of the rural residents. Overweight as well as generalised and abdominal obesity were more prevalent in the 45–64-year age group. Although there was no significant difference in frequency of consumption of the food groups in subjects with different BMI categories, various kinds of physical activities showed a steady decline with increasing BMI.

The findings of the present study provide alarming evidence for health professionals and policy makers about the very high prevalence of generalised and abdominal obesity in Iran. The unhealthy lifestyle habits, notably sedentary lifestyles in our community, are the major contributing factors for this emerging public health problem.

There is an increasing concern of anaemia in Japanese women, but no national trend data has existed to date. We analysed long-term national trends of anaemia in adult women.

Secondary analyses of 15 consecutive cross-sectional nationwide surveys conducted during the period 1989–2003. Analyses were based on 5-year intervals (1989–1993, 1994–1998, 1999–2003).

Japan.

The subjects included the National Health and Nutrition Survey of Japan (NHNS-J) population. Analyses were based on 50 967 non-pregnant/non-lactating women aged 20 years and over, with complete data sets. We stratified subjects into six age groups (20–29 years, 30–39 years, 40–49 years, 50–59 years, 60–69 years and 70+ years), and three age groups (20–49 years, 50–69 years, 70+ years) for analyses on residential areas (metropolitan, cities and towns).

Decreases in trends of mean haemoglobin values (intravenous) were significant in all age groups. Changes in the prevalence of anaemia were significant only in women aged 30–39 and 40–49 years. Anaemia (haemoglobin < 12.0 g dl−1) increased from 16.8% to 20.6% in women aged 30–39 years, and from 20.2% to 26.9% in women aged 40–49 years, respectively. Prevalence was highest in women aged 70 years and older in all times, but no significant change was observed.

Haemoglobin values have declined significantly in all ages in the last 15 years. Anaemia was especially significant in women aged 30–39 years and 40–49 years. Our findings suggest that a large number of young women in Japan are at risk of anaemia, so continuous monitoring and controlling efforts of this trend are needed.

The aim of this study was to examine whether there are associations between working conditions and the use of staff canteen or packed meals among Finnish employees.

Data were obtained from cross-sectional surveys on working conditions, conducted triennially (1997, 2000, 2003) since 1997.

In each survey, the subjects were 25–64-year-old employed Finnish employees: 3096 men and 3273 women.

Employees at large workplaces used canteens far more often than those at smaller workplaces. Working conditions played a different role in canteen use at small and large workplaces, as well as among the different sexes. At small workplaces, physically demanding jobs held by female employees and low job control encouraged employees to use the canteen. On the other hand, at large workplaces, low social support at work encouraged the use of canteens among men whereas high mental strain at work meant they used the canteen less. Among women, eating packed meals was not related to working conditions, but among men, low social support and high mental strain at work were associated with more frequent use of packed meals.

The use of a staff canteen is largely determined by the size of the workplace and by employee education. The underlying factor could be the availability of canteens, a question which must be confirmed in further studies, since well-planned mass catering at workplaces has major effects on public health, well-being and the nutrition education of employees.

The aim of this study was to assess the behavioural effects of a school-based healthful diet promotion intervention implemented in lower vocational schools.

A cluster-randomised pre-test–post-test experimental design was used, and data were collected by means of written questionnaires.

Students of 18 Dutch lower vocational schools.

The final sample consisted of 10 experimental schools with 13 teachers, 37 classes and 879 students, and eight control schools with 10 teachers, 31 classes and 734 students (total n = 1613).

Fixed regression analyses revealed beneficial effects on the behavioural measures relating to fruit intake (as assessed by a food frequency measure and fruit consumption during the previous day), and most behavioural measures related to high-fat snack intake (food frequency measure, and number of snacks and total fat intake from snacks during the previous day). The behavioural effects relating to breakfast habits were limited. Some positive behavioural effects occurred in the total target population, others mainly or only among students with more unfavourable intakes at baseline. Mixed regression analysis found comparable regression coefficients for the behavioural outcomes, but the effects related to fruit intake were no longer statistically significant.

Although we did not find the expected effects on all outcome indicators, the total pattern of results suggest that Krachtvoer offered a surplus value over existing curricula. However, some programme elements need to be revised to improve effectiveness and prevent negative effects, and more information is needed about the long-term effects of the programme.

To create a general framework for the simulation of intakes from mandatory or voluntary fortification, which will make outcomes of simulation studies more comparable and give insight on uncertainties.

A general framework was developed based on methods used in already published case studies of mandatory fortification. The framework was extended to be suitable for the simulation of voluntary fortification. Case studies of folic acid fortification were used to illustrate the general framework.

The developed framework consists of six steps. First, the definition of the fortification strategy (step 1), followed by the identification of potential carrier products (step 2), and the definition of fortification levels or ranges (step 3). Thereafter, virtual food/supplement composition data are created (step 4) and food/supplement consumption data are required (step 5). Finally, the intake of the functional ingredient from functional foods, other foods and dietary supplements is calculated during the simulation resulting in total habitual intake distributions (step 6).

Simulation of both mandatory and voluntary folic acid fortification in The Netherlands showed that the general framework is applicable. Also with incomplete data or data from different sources, the (habitual) intake distributions can be estimated using assumptions, statistical procedures or probabilistic modelling approaches. It is important that the simulation procedure is described well, so that an insight on uncertainties and knowledge gaps to be filled is given.

To identify the main knowledge gaps and to propose research lines that will be developed within the European Union-funded ‘Healthy Lifestyle in Europe by Nutrition in Adolescence’ (HELENA) project, concerning the nutritional status, physical fitness and physical activity of adolescents in Europe.

Review of the currently existing literature.

The main gaps identified were: lack of harmonised and comparable data on food intake; lack of understanding regarding the role of eating attitudes, food choices and food preferences; lack of harmonised and comparable data on levels and patterns of physical activity and physical fitness; lack of comparable data about obesity prevalence and body composition; lack of comparable data about micronutrient and immunological status; and lack of effective intervention methodologies for healthier lifestyles.

The HELENA Study Group should develop, test and describe harmonised and state-of-the-art methods to assess the nutritional status and lifestyle of adolescents across Europe; develop and evaluate an intervention on eating habits and physical activity; and develop and test new healthy food products attractive for European adolescents.

The impact of acid–base balance on health is widely accepted. Here, we describe the potential renal acid load (PRAL) in the diet of healthy German children and adolescents.

The Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) Study is an ongoing longitudinal (open cohort) study (start 1985) collecting detailed data on diet, growth, development and metabolism in infants, children and adolescents.

Research Institute of Child Nutrition, Dortmund.

Seven hundred and twenty children and adolescents (351 boys and 369 girls), aged 3–18 years, provided 4187 yearly collected 3-day dietary records between 1995 and 2005.

Mean daily PRAL was positive in all age/sex groups (6–21 mEq day−1), and significantly higher in boys than in girls after the age of 8 years, even when calculated as mEq MJ−1. Fruits, vegetables and potatoes had a negative impact on PRAL; cheese, dairy products, cereals/bread and meat/fish/eggs had a positive impact. In a mixed linear model, PRAL, expressed as mEq day−1 and mEq MJ−1, remained stable during the study period, since time trends of PRAL-relevant food groups countervail each other. PRAL intake (mEq MJ−1) was significantly positively associated (P < 0.0001) with fat intake (% of energy intake, %E), but negatively with carbohydrate intake (%E; P < 0.0001).

The analysis of dietary habits in our sample of German children and adolescents showed a moderate excess of acidity. Especially older boys should be encouraged to eat more potatoes and vegetables as good sources of dietary alkalinity. The PRAL concept is compatible with current concepts for a healthy diet.

A national survey found that micronutrient deficiencies are prevalent in South African children, particularly calcium, iron, zinc, riboflavin, niacin, vitamin B6, folate, vitamin A, E and C. Mandatory fortification of maize meal and wheat flour were introduced in 2003 to combat some of the deficiencies found in children. To date however, there has not been a national survey on dietary intake in adults.

The main objectives of this study were to evaluate the micronutrient intake of the diet consumed by the average adult South African by means of secondary data analyses and secondly to evaluate the effects of fortification on selected nutrient intakes.

Secondary data analysis was carried out with numerous dietary surveys on adults to create a database that included sampling (and weighting) according to ethnic/urban–rural residence in line with the population census, of which 79% were black Africans and the majority resided in rural areas. The effect of fortification was evaluated by substituting fortified foods in the diet for the unfortified products.

The combined database used in this study comprised 3229 adults.

Mean calcium, iron, folate and vitamin B6 intakes were very low particularly in women. Mean intakes of most micronutrients were lower in rural areas. Fortification of maize meal and wheat flour (bread) raised mean levels of thiamine, riboflavin, niacin, vitamin B6 and folate above the recommended nutrient intakes (RNIs). In women, despite fortification, mean iron intakes remained below the RNIs, as did calcium since it was not in the fortification mix.

The average dietary intake of adults was of poor nutrient density, particularly in rural areas. Fortification of maize meal and wheat flour (bread) considerably improved mean vitamin B6, thiamine, riboflavin, niacin, folate and iron intakes as well as the overall mean adequacy ratio of the diet.

The Western Australian Health Department’s Go for 2&5® campaign aimed to increase adults’ awareness of the need to eat more fruit and vegetables and encourage increased consumption of one serving over five years.

The multi-strategy fruit and vegetable social marketing campaign, conducted from 2002 to 2005, included mass media advertising (television, radio, press and point-of-sale), public relations events, publications, a website (www.gofor2and5.com), and school and community activities. Campaign development and the evaluation framework were designed using health promotion theory, and assessed values, beliefs, knowledge and behaviour. Two independent telephone surveys evaluated the campaign: the Campaign Tracking Survey interviewed 5032 adults monitoring fruit and vegetable attitudes, beliefs and consumption prior to, during and 12 months after the campaign; and the Health & Wellbeing Surveillance System surveyed 17 993 adults between 2001 and 2006, continuously monitoring consumption.

Population public health intervention–social marketing campaign in Western Australia, population of 2 010 113 in 2005.

Adults in the Perth metropolitan area.

The campaign reached the target audience, increasing awareness of the recommended servings of fruit and vegetables. There was a population net increase of 0.8 in the mean number of servings of fruit and vegetables per day over three years (0.2 for fruit (1.6 in 2002 to 1.8 in 2005) and 0.6 for vegetables (2.6 in 2002 to 3.2 in 2005), significant at P < 0.05).

Sustained, well-executed social marketing is effective in improving nutrition knowledge, attitudes and consumption behaviour. The Go for 2&5® campaign provides guidance to future nutrition promotion through social marketing.

To explore why boys eat less fruit and vegetables (F&V) than girls, using longitudinal data following pupils from the age of 12.5 to 15.5 years, including perceived accessibility, modelling, intention, preferences, self-efficacy and knowledge of recommendations as potential mediators.

A longitudinal study, based on data collected among the control schools within the intervention project ‘Fruits and Vegetables Make the Marks’. This sample contains 896 6th and 7th graders from 20 randomly selected elementary schools within two Norwegian counties. Questionnaires were administered in May 2002 and May 2005 (when the participants were in 9th and 10th grade in 18 secondary elementary schools).

In single mediation analyses all determinants mediated parts of the gender difference, but only preferences decreased the gender difference to a level below statistical significance. Preferences alone explained 81% of the gender difference. In the multiple mediation analyses, the six mediators together explained 91% of the gender difference, but only preferences and perceived accessibility contributed uniquely to the explanation, with 25% and 10% respectively.

Preference appears as the strongest mediator of the difference in F&V intakes between boys and girls. Further research should explore why girls like F&V more than boys.