To analyse the association between family structure and adiposity in children.

Cross-sectional and longitudinal analysis of the IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) study cohort.

Primary schools and kindergartens.

Children (n 12 350; aged 7·9 (sd 1·8) years) for the cross-sectional analysis and children (n 5236; at baseline: normal weight, aged 5·9 (sd 1·8) years) for the longitudinal study underwent anthropometry. Family structure was analysed as (i) number and type of cohabiting adults and (ii) number of siblings.

In the cross-sectional analysis, after controlling for covariates, children living with grandparents had significantly higher BMI Z-score than those living with both parents (0·63; 95 % CI 0·33, 0·92 v. 0·19; 95 % CI 0·17, 0·22; P < 0·01); in addition, the higher the number of siblings, the lower the BMI Z-score (only child = 0·31; 95 % CI 0·24, 0·38; 1 sibling = 0·19; 95 % CI 0·16, 0·23; 2 siblings = 0·15; 95 % CI 0·09, 0·20; >2 siblings = 0·07, 95 % CI 0·04, 0·19; P < 0·001). Over the 2-year follow-up, differences in weight gain were observed across family-structure categories. Further, the risk of incidence of overweight/obesity was significantly lower the higher the number of siblings living in the household (v. only child: 1 sibling = 0·74, 95 % CI 0·57, 0·96; 2 siblings = 0·63, 95 % CI 0·45, 0·88; >2 siblings = 0·40, 95 % CI 0·21, 0·77), independently of confounders.

The study suggests that an independent association between family structure and childhood obesity exists.

To investigate the association of regional fat depots with metabolic risk factors in Chinese women.

Total and regional fat depots including android fat and gynoid fat were measured by dual-energy X-ray absorptiometry. Central fat distribution was defined as android:gynoid fat ratio. Metabolic risk factors were defined as elevated TAG, reduced HDL-cholesterol, elevated blood pressure and elevated fasting plasma glucose. Logistic regression analyses were performed to examine the associations of regional fat depots with metabolic risk factors. The odds ratios of metabolic risks were further calculated according to tertiles of android fat and gynoid fat.

Participants were recruited from a community-based cross-sectional study. Face-to-face questionnaires, anthropometric and dual-energy X-ray absorptiometry measures were conducted.

Chinese women (n 609) aged 18–79 years.

Android fat and android:gynoid fat ratio were associated with significantly increased odds (OR = 1·4–3·7; P < 0·01) for almost all risk factors, whereas gynoid fat was independently associated with significantly decreased odds (OR = 0·3–0·6; P < 0·01). The inverse associations of gynoid fat with metabolic risk factors remained after adjusting for android fat. Even if their android fat level was in high, women in the highest tertile of gynoid fat had lower odds of having at least two metabolic risk factors compared with women in the lowest gynoid fat tertile (P for trend < 0·01).

There were opposite associations of android and gynoid fat with metabolic risks in Chinese women. Gynoid fat rather than android fat might be a more important inclusion in metabolic disease risk evaluation in female Asians.

The present study was conducted to investigate reasons for the high prevalence of anaemia among adolescent schoolgirls and to elucidate the role of vitamin A in contributing to Fe-deficiency anaemia (IDA).

Among 1269 schoolgirls who were previously screened for anaemia (Hb < 120 g/l), 391 anaemic girls were further assessed for Fe, vitamin A and subclinical inflammation status. Fe and vitamin A indicators were corrected for inflammation and were compared in the Fe-deficient and non-deficient groups as well as between those with and without inflammation. Logistic regression was done to determine whether vitamin A status and subclinical inflammation were risk factors for Fe deficiency. The differences in Fe status among tertiles of vitamin A concentrations were assessed using ANOVA.

Myanmar.

Adolescent schoolgirls (n 391).

One-third of the anaemia (30·4 %) was IDA. Prevalence of low vitamin A status (serum retinol <1·05 μmol/l) was 31·5 %. Fe and vitamin A status were significantly different between the IDA and non-IDA groups and also based on their inflammation status. Logistic regression showed that low vitamin A status was a significant predictor for being Fe deficient (OR = 1·81; 95 % CI 1·03, 3·19 and OR = 2·31; 1·31, 4·07 in the middle (1·056–1·298 μmol/l) and low (≤1·056 μmol/l) vitamin A tertiles, respectively). ANOVA showed that better Fe status was associated with a higher concentration of serum retinol but only in IDA.

Fe deficiency was not the main cause of anaemia in the present population. The role of vitamin A as well as other micronutrients should be taken into account in addressing the problem of anaemia.

In contrast to non-vegetarians, vegetarians consume more legumes and meat analogues as sources of protein to substitute for meat intake. The present study aimed to assess the association between foods with high protein content (legumes, meat, meat analogues) by dietary pattern (vegetarians, non-vegetarians) and hip fracture incidence, adjusted for selected lifestyle factors.

A prospective cohort of Adventist Health Study-2 (AHS-2) enrollees who completed a comprehensive lifestyle and dietary questionnaire between 2002 and 2007.

Every two years after enrolment, a short questionnaire on hospitalizations and selected disease outcomes including hip fractures was sent to these members.

Respondents (n 33 208) to a baseline and a follow-up questionnaire.

In a multivariable model, legumes intake of once daily or more reduced the risk of hip fracture by 64 % (hazard ratio = 0·36, 95 % CI 0·21, 0·61) compared with those with legumes intake of less than once weekly. Similarly, meat intake of four or more times weekly was associated with a 40 % reduced risk of hip fracture (hazard ratio = 0·60, 95 % CI 0·41, 0·87) compared with those whose meat intake was less than once weekly. Furthermore, consumption of meat analogues once daily or more was associated with a 49 % reduced risk of hip fracture (hazard ratio = 0·51, 95 % CI 0·27, 0·98) compared with an intake of less than once weekly.

Hip fracture incidence was inversely associated with legumes intake and, to a lesser extent, meat intake, after accounting for other food groups and important covariates. Similarly, a high intake of meat analogues was associated with a significantly reduced risk of hip fracture.

Neural tube defects are among the most common birth defects worldwide. Folic acid intake from one month before to three months after conception reduces the likelihood of neural tube defects by at least 50 %. Since 1995, several campaigns have been organised in the Netherlands which resulted in 51 % of pregnant women using folic acid supplements during the entire recommended period in the northern part of the Netherlands in 2005. Our research question was to gain insight into the current prevalence and factors associated with inadequate pregnancy-related use of folic acid supplements.

Data from the DELIVER study were used, which is a population-based cohort study.

Twenty midwifery practices across the Netherlands in 2009 and 2010.

In total 5975 pregnant women completed a questionnaire covering items on sociodemographic and lifestyle factors, including folic acid intake.

Of our study population, 55·5 % (3318/5975) used folic acid supplements before conception. Several sociodemographic and lifestyle factors were associated with no preconception use of folic acid, of which non-Western ethnicity and not having a partner had the largest effect size.

In the Netherlands, the folic acid intake before conception is suboptimal and has not improved over recent years. Fortification of staple foods with folic acid should be reconsidered as it would provide a more effective means of ensuring an adequate intake, especially for those groups of women who are unlikely to plan their pregnancies or to receive or respond to health promotion messages.

To describe the knowledge, attitudes and practices of type 2 diabetics in Yakeshi City and to assess the effect of implementation of nutritional and eating education in enhancing knowledge and practices regarding a healthy diet.

A questionnaire-based survey was conducted with 162 diabetics to determine their nutrition knowledge, attitudes and practices; fifty-four participants received nutritional and eating education for 6 months. Diabetes-related nutrition knowledge, awareness, practice accuracy, dietary intake and glycaemic control were assessed before and after education.

Yakeshi, a remote city in northern China.

A total of 162 type 2 diabetics recruited from three hospitals, fifty-four of whom were selected randomly to receive education.

Among the 162 respondents, most diabetics (75 %) considered that controlling diet was important in the methods of controlling blood glucose. Scores for knowledge, practices and overall KAP (knowledge–attitude–practice) were low, but scores for attitude were high. Participants with diabetes education experiences, practice duration over 1 year or high education level all had higher scores for KAP (P < 0·001, P < 0·05 and P < 0·001, respectively) than their counterparts. After education, patients’ nutrition knowledge, awareness and practice accuracy improved significantly (P < 0·05). The rates of patients with recommended daily intake of vegetables, grains and dairy were boosted (P < 0·05). Various nutrient intakes increased (P < 0·05) but not protein, Fe, Zn and Se. Significant improvements were also found in glycaemic control (P < 0·05).

Diabetics in Yakeshi had positive attitudes, but relatively poor nutrition knowledge and practices. Nutritional and eating education was effective in improving diabetics’ nutrition knowledge and practices, and this optimal practice helped them control blood glucose effectively.

The present study examines seasonal and temporal patterns in food-related content of two UK magazines for young women focusing on food types, cooking and weight loss.

Content analysis of magazines from three time blocks between 1999 and 2011.

Desk-based study.

Ninety-seven magazines yielding 590 advertisements and 148 articles.

Cluster analysis of type of food advertising produced three clusters of magazines, which reflected recognised food behaviours of young women: vegetarianism, convenience eating and weight control. The first cluster of magazines was associated with Christmas and Millennium time periods, with advertising of alcohol, coffee, cheese, vegetarian meat substitutes and weight-loss pills. Recipes were prominent in article content and tended to be for cakes/desserts, luxury meals and party food. The second cluster was associated with summer months and 2010 issues. There was little advertising for conventional foods in cluster 2, but strong representation of diet plans and foods for weight loss. Weight-loss messages in articles focused on short-term aesthetic goals, emphasising speedy weight loss without giving up nice foods or exercising. Cluster 3 magazines were associated with post-New Year and 2005 periods. Food advertising was for everyday foods and convenience products, with fewer weight-loss products than other clusters; conversely, article content had a greater prevalence of weight-loss messages.

The cyclical nature of magazine content – indulgence and excess encouraged at Christmas, restraint recommended post-New Year and severe dieting advocated in the summer months – endorses yo-yo dieting behaviour and may not be conducive to public health.

To investigate: (i) the percentage of the New Zealand (NZ) population reporting fast food/takeaway food and restaurant/café food per day; (ii) examine demographic factors associated with their use; (iii) quantify their contribution to energy intake; and (iv) describe the specific types of foods reported from both sources.

Twenty-four hour diet recalls from the cross-sectional 2008/09 NZ Adult Nutrition Survey were used to identify fast-food and restaurant-food consumers.

NZ households.

Adults aged 15 years and older (n 4721).

Overall 28 % reported consuming at least one fast food and 14 % a restaurant food within the 24 h diet recall. Fast-food consumption was not associated with level of education or an area-based measure of socio-economic status, but a higher education was positively associated with restaurant-food consumption. Individual factors such as ethnicity, household size, age, sex and marital status were found to be important influences on the use of fast food and restaurant food. Fast-food consumption was more prevalent among participants living in urban areas, young adults (19–30 years) and Māori compared with NZ European and Others. The most frequently reported fast foods were bread-based dishes, potatoes (including fries) and non-alcoholic beverages.

Given the high reported consumption of fast food by young adults, health promotion initiatives both to improve the nutritional quality of fast-food menus and to encourage healthier food choices would likely make a large impact on the overall diet quality of this group.

To evaluate the association between waist-to-height ratio (WHtR) and specific biomarkers of inflammation, CVD risk and endothelial dysfunction in prepubertal obese children.

Prospective, multicentre case–control study matched by age and sex.

Children were recruited between May 2007 and May 2010 from primary-care centres and schools in three cities in Spain (Cordoba, Santiago de Compostela and Zaragoza).

Four hundred and forty-six (223 normal weight and 223 obese) Caucasian prepubertal children aged 6–12 years.

WHtR was higher in the obese than in the normal-weight children. Blood pressure, waist circumference, weight, height, insulin, plasma lipids, leptin, resistin, abnormal neutrophil and monocyte counts, C-reactive protein, IL-6, IL-8, TNF-α, myeloperoxidase, soluble intercellular adhesion molecule-1, selectin and plasminogen activator inhibitor-1 levels were higher in the obese than in the normal-weight group. Adiponectin and HDL-cholesterol were lower and glucose and metalloproteinase-9 showed no differences. Resistin, TNF-α and active plasminogen activator inhibitor-1 were associated with WHtR, a sensitive indicator of central obesity.

Our results lead to the hypothesis that changes in biomarker levels of insulin resistance, inflammation and CVD risk before puberty might induce metabolic consequences of obesity in obese children before reaching adulthood.