Nutrient profiling can be defined as the ‘the science of categorising foods according to their nutritional composition’. The purpose of the present paper is to describe a systematic and logical approach to nutrient profiling.

A seven-stage decision-making process is proposed and, as an illustration of how the approach might operate in practice, the development of a nutrient profiling model for the purpose of highlighting breakfast cereals that are ‘high in fat, sugar or salt’ is described.

The nutrient profile model developed for this paper calculates scores for foods using a simple equation. It enables breakfast cereals to be compared with each other and with other foods eaten at breakfast.

Nutrient profiling is not new, but hitherto most nutrient profiling models have been developed in an unsystematic and illogical fashion. Different nutrient profiling models are needed for different purposes but a key requirement should be that they are developed using a systematic, transparent and logical process. This paper provides an example of such a process; approaches to validating nutrient profiling models are described elsewhere.

To compare nutrient profile models with a standard ranking of 120 foods.

Over 700 nutrition professionals were asked to categorise 120 foods into one of six positions on the basis of their healthiness. These categorisations were used to produce a standard ranking of the 120 foods. The standard ranking was compared with the results of applying eight different nutrient profile models to the 120 foods: Models SSCg3d and WXYfm developed for the UK Food Standards Agency, the Nutritious Food Index, the Ratio of Recommended to Restricted nutrients, the Naturally Nutrient Rich score, the Australian Heart Foundation's Tick scheme, the American Heart Association's heart-check mark and the Netherlands tripartite classification model for foods. Rank correlation was assessed for continuous models, and dependence was assessed for categorical models.

The continuous models each showed good correlation with the standard ranking (Spearman's ρ = 0.6–0.8). The categorical models achieved high χ2 results, indicating a high level of dependence between the nutrition professionals' and the models' categorisations (P < 0.001). Models SSCg3d and WXYfm achieved higher scores than the other models, implying a greater agreement with the standard ranking of foods.

The results suggest that Models SSCg3d and WXYfm rank and categorise foods in accordance with the views of nutrition professionals.

This paper describes the development of an online questionnaire for testing nutrition professionals' perceptions of the ‘healthiness’ of individual foods and the results of administering that questionnaire. The questionnaire was designed to produce a standard ranking of foods that can be used as a tool for testing nutrient profile models.

The questionnaire asked respondents to categorise 40 foods (from a master list of 120) in one of six positions, ranging from less to more healthy. The 120 foods were selected to be representative of the British diet. The questionnaire was sent via email to nutrition professionals from the British Dietetic Association and the (British) Nutrition Society.

Eight hundred and fifty responses were received. These responses were used to rank the 120 foods by the average score which they received from the nutrition professionals. A regression analysis was also carried out to examine the relationship between the scores awarded by the nutrition professionals and various features of the foods: their nutritional content, their average serving size, their frequency of consumption, whether they were drinks or foods, etc. Nearly 50% of the variance in the average scores was explained by the nutritional content of the foods. When other variables were included in the analysis the percentage of variance that was explained increased to 64%.

The average scores of the foods produce a standard ranking, which can be used as a tool for validating and comparing nutrient profile models. The regression analysis provides some information about how nutrition professionals rank the ‘healthiness’ of individual foods.

Dietary surveys of 11- to 12-year-old Northumbrian children in 1980 and 1990 revealed that consumption of non-milk extrinsic sugars (NMES) was 16–17% of energy intake. This study reports dietary sugars consumption in 2000 and compares it with data collected in 1980 and 1990, using identical methods.

A repeat cross-sectional dietary survey of children aged 11–12 years attending the same schools as in the 1980 and 1990 surveys.

Seven middle schools in south Northumberland.

All children aged 11–12 years old attending the seven schools.

Food consumption was recorded using two 3-day diet diaries. Food composition tables were used to calculate energy and nutrient intakes. NMES, and milk and intrinsic sugars were calculated using previously described methods.

The numbers of children completing the surveys in 1980, 1990 and 2000 were 405, 379 and 424, respectively; ~60–70% of eligible children. Total sugars provided 22% of energy consistently over the three surveys. NMES consumption in 2000 provided 16% of energy compared with 16% in 1980 and 17% in 1990. Sources of NMES changed over the three surveys. NMES from soft drinks doubled from 15 to 31 g day− 1, and from breakfast cereals increased from 2 to 7 g day− 1 over the 20 years. Confectionery and soft drinks provided 61% of NMES. Over 20 years, the proportion of energy from fat decreased by 5% and from starch increased by 4%, creating a welcome tilt in the fat–starch see-saw, without an adverse effect on sugars intake.

Consumption of NMES in 2000 was substantially higher than recommended, and there has been little change over 20 years. Continued and coordinated efforts are required at a national, community and individual level to reduce the intake of NMES.

To investigate the relationships between food poverty and food consumption, health and life satisfaction among schoolchildren.

Analysis of the 2002 Health Behaviour in School-aged Children (HBSC) study, a cross-sectional survey that employs a self-completion questionnaire in a nationally representative random sample of school classrooms in the Republic of Ireland.

A total of 8424 schoolchildren (aged 10–17 years) from 176 schools, with an 83% response rate from children.

Food poverty was found to be similarly distributed among the three social classes (15.3% in the lower social classes, 15.9% in the middle social classes and 14.8% in the higher social classes). It was also found that schoolchildren reporting food poverty are less likely to eat fruits, vegetables and brown bread, odds ratio (OR) from 0.66 (95% confidence interval (CI) 0.45–0.87) to 0.81 (95% CI 0.63–0.99); more likely to eat crisps, fried potatoes and hamburgers, OR from 1.20 (95% CI 1.00–1.40) to 1.62 (95% CI 1.39–1.85); and more likely to miss breakfast on weekdays, OR from 1.29 (95% CI 0.33–1.59) to 1.72 (95% CI 1.50–1.95). The risk of somatic and mental symptoms is also increased, OR from 1.48 (95% CI 1.18–1.78) to 2.57 (95% CI 2.33–2.81); as are negative health perceptions, OR from 0.63 (95% CI 0.43–0.83) to 0.52 (95% CI 0.28–0.76) and measures of life dissatisfaction, OR from 1.88 (95% CI 1.64–2.12) to 2.25 (95% CI 2.05–2.45). Similar results were found for life dissatisfaction in an international comparison of 32 countries. All analyses were adjusted for age and social class.

Food poverty in schoolchildren is not restricted to those from lower social class families, is associated with a substantial risk to physical and mental health and well-being, and requires the increased attention of policy makers and practitioners.

Food insecurity and undernutrition remain particularly severe in developing countries where improvements in economic conditions have tended to benefit the advantaged groups and resulted in widespread inequalities in health. This study examined how economic inequality is associated with chronic childhood undernutrition.

A child was defined as chronically undernourished (stunted) if his or her height-for-age index was more than two standard deviations below the reference median. Household economic status was measured by an index based on household ownership of durable assets. Bivariate and multivariate analyses were used to estimate the effects of household economic status on stunting.

A nationally representative sample of 6251 household interviews in Ghana.

A total of 3077 children aged 0–59 months included in the 2003 Ghana Demographic and Health Survey.

Children in the poorest 20% of households are more than twice as likely to suffer from stunting as children in the richest 20% of households independent of the child's age, sex, birth order, breast-feeding duration, birth weight; mother's age at childbirth, body mass index, education; and household access to safe drinking water, hygienic toilet facilities, residence and geographic region (odds ratio = 2.3; 95% confidence interval 1.4–3.7). Also children in the next poorest and in the middle quintiles are significant more likely to be chronically undernourished than children in the richest 20% of households.

This study concludes that economic inequality is strongly associated with chronic childhood undernutrition; and reducing economic inequalities and making services more accessible to the poor will be key to improving the health and nutritional status of children in Ghana.

To measure dietary intakes of young children aged 12–24 months and to determine the impact of poor diets on stunting.

A quantitative food-frequency questionnaire was adapted, tested and standardised. Trained enumerators conducted in-depth interviews with the mothers/caregivers of the children. Forty stunted children in urban informal settlements and 30 stunted children in rural areas were selected and pair-matched with controls. The data were captured on the Food Finder Program of the Medical Research Council.

In both urban and rural areas, the diet of stunted and non-stunted groups did differ significantly and all diets were of poor nutritional quality.

Diets in both areas resembled the recommended prudent diet, i.e. low in fat and high in carbohydrates. Poor quality diets were not the primary cause of stunting.

To measure rates of hunger and food insecurity among young US-born Latino children with Mexican immigrant parents (Latinos) compared with a non-immigrant non-Latino population (non-Latinos) in a low-income clinic population.

A repeated cross-sectional survey of 4278 caregivers of children < 3 years of age in the paediatric clinic of an urban county hospital for a 5-year period from 1998 to 2003. A total of 1310 respondents had a US-born child with at least one parent born in Mexico. They were compared with a reference group comprised of non-Latino US-born participants (n = 1805). Child hunger and household food insecurity were determined with the US Household Food Security Scale.

Young Latino children had much higher rates of child hunger than non-Latinos, 6.8 versus 0.5%. Latino families also had higher rates of household food insecurity than non-Latinos, 53.1 versus 15.6%. Latino children remained much more likely to be hungry (odds ratio (OR) = 13.0, 95% confidence interval (CI) = 5.9–28.7, P < 0.01) and in household food-insecure households (OR = 6.6, 95% CI = 5.2–8.3, P < 0.01) than non-Latinos after controlling for the following variables in multivariate analysis: child's age, sex, maternal education level, single-headed household status, family size, young maternal age ( < 21 years), food stamp programme participation, TANF (Temporary Assistance to Needy Families, or ‘welfare’) programme participation and WIC (Women, Infants, and Children) usage, and reason for clinic visit (sick visit versus well-child).

Young children in Mexican immigrant families are at especially high risk for hunger and household food insecurity compared with non-immigrant, non-Latino patients in a low-income paediatric clinic.

This study investigates how lifecourse, immigrant status and acculturation, and neighbourhood of residence influence food purchasing and preparation among low-income women with children, living in the USA. This research sought to understand physical and economic access to food, from both ‘individual’ and ‘community’ perspectives.

This study used qualitative methodology (focus groups) to examine the mechanisms and pathways of food preparation and purchasing within the context of daily life activity for US- and foreign-born women, living in the USA. The study methodology analysed notes and verbatim transcripts, summarised recurring responses and identified new themes in the discussions.

A total of 44 women were purposively sampled from two metropolitan areas in Massachusetts, USA, based on (1) neighbourhood of residence and (2) primary language spoken. All focus groups were conducted in community health centres and community centres co-located with offices of the special supplemental nutritional programme for Women, Infants, and Children.

Analysis of key response themes suggested that scarcity of food and physical access to food purchasing points did not influence food purchasing and preparation as much as (1) limited time for food shopping, cooking and family activities; and (2) challenges in transportation to stores and childcare. The study results demonstrated differing attitudes toward food acquisition and preparation between immigrant and US-born women and between women who lived in two metropolitan areas in the western and eastern regions of the state of Massachusetts, USA.

The findings illustrate ‘hidden’ constraints that need to be captured in measures of physical and economic access and availability of food. US policies and programmes that aim to improve access, availability and diet quality would benefit from considering the social context of food preparation and purchasing, and the residential environments of low-income women and families.

To assess the occurrence and severity of food insecurity, and examine associations between food insecurity and measures of socio-economic status and indicators of acculturation.

Structured interviews among a non-probability sample of West African refugees at baseline and 6 months' follow-up.

Mid-sized city in north-eastern USA.

One hundred and one caregivers with children under the age of 5 years and who have been living the USA for fewer than 4 years.

Food insecurity was indicated in approximately half of households (53%). The occurrence of food insecurity was associated with measures of socio-economic status such as income, employment status and participation in the Food Stamp Program (P < 0.05). Measures of acculturation such as difficulty in the shopping environment and language difficulty were also associated with the occurrence and severity of food insecurity, as was time lived in the USA (P < 0.05). Among households who had been in the USA for 1 year or less, food insecurity was indicated in 73%, whereas among households who had been in the USA for at least 3 years food insecurity was indicted in 33%.

Refugees are a potentially vulnerable group and our results echo others in suggesting a need for more thorough monitoring of the health and well-being of recently resettled refugees. These results also suggest that reliance on employment as the sole indicator of success in the resettlement process may be too narrow an indicator. Future research should focus on a wider range of measures of health and well-being.

To describe breakfast consumption patterns, on a nutrient and food item level, in Belgian adolescents.

A 7-day estimated food record was administered in a cross-sectional survey.

Secondary schools in Ghent, Belgium.

A total of 341 adolescents (13–18 years old), multistage clustered sampling.

The energy contribution of breakfast to daily energy intake was on average 15.7% in boys and 14.9% in girls. Significantly more overweight girls and significantly more girls following vocational training were categorised as eating a low-quality breakfast. In boys, the energy contribution of polysaccharides was significantly higher in consumers of good-quality breakfasts. The intake of all selected micronutrients was significantly higher in consumers of good-quality breakfasts. In girls, the total energy intake and the proportional intake of proteins and polysaccharides were significantly higher in consumers of good-quality breakfasts, while the proportional contribution of total fat, monounsaturated and polyunsaturated fatty acids was significantly lower in these girls. The intake of all micronutrients was significantly higher in girls consuming a good-quality breakfast. In all adolescents, consumers of a good-quality breakfast had significantly higher intakes of bread, fruit, vegetables, milk and milk products, and fruit juice, while intake of soft drinks was significantly lower than in consumers of low-quality breakfasts.

Consumers of a good-quality breakfast had a better overall dietary pattern – on a nutrient and food group level – than consumers of a low-quality breakfast. A daily breakfast, including whole-grain products, fruit and (semi-) skimmed milk products or an alternative source of calcium, is recommended.

To examine the relationship between mental distress, academic performance and regular breakfast consumption across gender and immigration status.

Cross-sectional population-based study. Two four-page questionnaires were filled in during two school sessions.

All junior high schools in Oslo, Norway using the classroom as the setting for the study.

All 10th grade students 15–16 years olds in 2000 and 2001. Of 8316 eligible students, 7343 (88.3%) participated in the study.

All immigrant groups, except the Western countries group, are skipping breakfast more often than Norwegian students, and girls more often than boys (27 versus 19%). After adjustment for possible confounding factors, the odds ratio (OR) for being mentally distressed when eating breakfast seldom/never compared with every day was 3.0 (2.0–4.5) for boys, 1.6 (1.2–2.1) for girls and 1.6 (1.5–2.6) for the immigrant group. The comparable OR for having low school grades was similar for boys and girls, 2.0 (1.3–3.0), and 1.6 (1.5–2.6) for the immigrant groups.

Skipping breakfast is a common feature among 10th grade students. The implications of skipping breakfast on mental distress and academic performance are stronger for boys than girls and stronger for Norwegians compared with immigrants.