The present study was conducted to assess the current status of iodine-deficiency disorders (IDD) in the National Capital Region of Delhi (NCR Delhi) and evaluate the implementation and impact of the National Iodine Deficiency Disorders Control Programme (NIDDCP).

Cross-sectional study.

School-going children (n 1230) in the age group of 6–12 years were enrolled from thirty primary schools in the Municipal Corporation of Delhi. Thirty schools were selected using the probability-proportional-to-size cluster sampling methodology. In each identified school forty-one children were surveyed. Urine and salt samples were collected and studied for iodine concentration. A total of sixty salt samples from retail level were also collected.

Schoolchildren aged 6–12 years.

The median urinary iodine excretion (UIE) was found to be 198·4 μg/l. The percentage of children with UIE levels of <20·0, 20·0–49·9, 50·0–99·9 and ≥100·0 μg/l was 1·9, 4·3, 9·5 and 84·2 %, respectively. The proportion of households consuming adequately iodized salt (salt with iodine levels of at least 15 ppm at consumption level) was 88·8 %. The assessment of iodine content of salt revealed that only 6·1 % of the families were consuming salt with iodine content less than 7 ppm. At retail level 88·3 % of salt samples had >15 ppm iodine.

Significant progress has been achieved towards elimination of IDD from NCR Delhi. There is a need for further strengthening of the system to monitor the quality of iodized salt provided to the beneficiaries under the universal salt iodization programme and so eliminate IDD from NCR Delhi.

The proportion of the Latin American population aged >60 years is expected to double during the next few decades. Metabolic syndrome (MetS) is associated with high morbidity and mortality worldwide. However, little is known about MetS in Latin America in general, and in Ecuador in particular. The present study aimed to examine the prevalence of MetS and its association with blood micronutrient, homocysteine (Hcy) and C-reactive protein (CRP) concentrations in the elderly living in a low-income urban area.

We performed a cross-sectional study. MetS, using the International Diabetes Federation definition, dietary intake and plasma micronutrient, CRP and Hcy concentrations were assessed.

A total of 352 elderly (≥65 years) Ecuadorians.

Quito, Ecuador.

MetS was prevalent (40 %) – considerably more so among women (81 %) than men (19 %; χ2 = 32·6, P < 0·0001). Further, 53 % of those without MetS exhibited two or more of its components. Micronutrient deficiencies were prevalent, including those of vitamin C, zinc, vitamin B12 and folate. Vitamin C and E concentrations were inversely (OR = 0·78, 95 % CI 0·71, 0·86; OR = 0·16, 95 % CI 0·03, 0·81, respectively) and CRP (OR = 1·79, 95 % CI 1·04, 3·06) was positively associated with MetS.

The coexistence of MetS with micronutrient deficiencies suggests that elderly Ecuadorians suffer from the double burden of diseases that are increasingly being observed in less developed countries. More research is needed to determine the causal factors, but results presented suggest that these older adults would benefit from interventions to reduce the risk factors for MetS, in particular higher consumption of micronutrient-rich foods.

To determine whether frequent vitamin C supplement use is associated with healthier behaviours, and a history of cancer and other illnesses in UK women.

The present cross-sectional analysis examines the odds of taking supplements containing vitamin C as recorded in 4 d food diaries, based on lifestyle characteristics and morbidity history self-reported by questionnaire.

A large national UK cohort study.

A total of 12 453 women aged between 37 and 79 years.

Women frequently taking supplements containing vitamin C, compared to those who did not, had healthier behaviours, including higher consumption of fruit and vegetables. Frequent high-dose vitamin C users (≥1000 mg) had a higher socio-economic status, visited alternative practitioners more often than family or private doctors, and were more likely to be ex-smokers and to drink little or no alcohol. Women who self-reported having had cancer (OR = 1·33, 95 % CI 1·00, 1·76) or specifically breast cancer (OR = 1·70, 95 % CI 1·14, 2·55), or reported a family history of cancer (OR = 1·16, 95 % CI 0·95, 1·41) or breast cancer (OR = 1·26, 95 % CI 1·01, 1·58) had increased odds of being frequent high-dose users after adjusting for sociodemographic and health behaviours. Women with personal or family histories of some cardiovascular or intestinal disorders were more likely to take supplements containing vitamin C, though not necessarily at high doses.

High-dose vitamin C intake by UK women was associated with healthier behaviours and a history of breast cancer, total cancer and other illnesses. Consequences of high-dose vitamin C supplement intake are not clear at the population level.

Evidence of the effects of soft drinks consumption on BMI and lifestyle in adult populations is mixed and quite limited. The aim of the present study was to determine the association of soft drinks consumption with BMI and lifestyle in a representative Mediterranean population.

Two independent, population-based, cross-sectional (2000 and 2005) studies. Dietary intake was assessed using a validated FFQ. Weight and height were measured.

Girona, Spain.

Random sample of the 35- to 74-year-old population (3910 men and 4285 women).

Less than half (41·7 %) of the population consumed soft drinks; the mean consumption was 36·2 ml/d. The prevalence of sedentary lifestyle increased with the frequency of soft drinks consumption (P = 0·025). Daily soft drinks consumption significantly increased the risk of low adherence to the Mediterranean diet (OR = 0·57, 95 % CI 0·44, 0·74 v. top tertile of Mediterranean diet score). Multiple linear regression analyses, controlled for potential confounders, revealed that an increment in soft drinks consumption of 100 ml was associated with a 0·21 kg/m2 increase in BMI (P = 0·001). Only implausibly low reports of energy consumption showed a null association between soft drinks consumption and BMI.

Soft drinks consumption was not embedded in a healthy diet context and was positively associated with BMI and sedentary lifestyle in this Mediterranean population.

To analyse changes and predictors of change in self-reported food intake among Brazilian families that benefitted from conditional cash transfer (CCT) implemented in the Programa Bolsa Família of the Brazilian Federal Government.

A cross-sectional survey.

The study was conducted from September to October 2007 in a nationwide representative household sample of families included in the CCT. Socio-economic variables, perception of food consumption and food insecurity were evaluated via questionnaire, which was completed during face-to-face interviews.

Five thousand households were selected from the CCT registry.

Families reported increased consumption of all food groups analysed, mainly cereals, processed foods, meat, milk and dairy, beans and sugar. The degree of dependence on income from the CCT was positively associated with increased self-reported intake of food items such as sugar and soft drinks. A Poisson regression revealed that the fourth quartile of CCT dependence demonstrated a twofold increase in the self-reported intake of soft drinks (relative risk (RR) = 2·3, 95 % CI 1·8, 2·9) and sugar (RR = 2·5, 95 % CI 2·1, 3·1) compared with the first quartile of CCT dependence.

Greater purchasing power of poor families increases unhealthy food choices; thus public policies should emphasise the availability of healthy food.

Research has suggested the abandonment of the traditional Mediterranean diet (MD) by youngsters for a more Westernized regime. The present study aimed (i) to delineate differences in the consumption of traditional Cretan dishes and key nutrients in the MD between two contiguous generations of women and (ii) define how these dietary changes contribute to the morbidity of the younger generation.

Cross-sectional.

The island of Crete, Greece.

Eighty pairs of mothers and daughters, all living in their own households, were recruited from Crete. Information regarding the consumption of traditional Cretan dishes and two previous-day recalls were collected. The health status of the participants was also recorded. Simple correspondence analysis (SCA) was used to assess associations between differences in the food intake of daughters compared with their mothers and the prevalence of disease.

The younger women showed increased intakes of rusks and meat dishes and decreased consumption of green vegetables, pulses and wine compared with their mothers. When nutrients were accounted for, only sugar consumption of the younger women surpassed the intake reported by their mothers. SCA associated hypercholesterolaemia in the daughters with increased cheese and meat intakes; allergies and respiratory problems were associated with lower cheese, fish and oil intakes; being overweight was associated with higher baked goods, oils, desserts, fish and alcohol intakes; and Fe-deficiency anaemia was associated with lower consumption of green vegetables.

Results showed that, although a trend towards a more Westernized diet was noted in the younger women, the differences between the two generations appear to be small. Therefore, in Crete, the MD is still the primary diet regime.

To demonstrate test–retest reliability (reproducibility) of a new self-administered lifetime diet questionnaire, with a focus on foods relevant to cognitive health in older age.

The reproducibility of dietary recall over four or five life periods was assessed by administering the questionnaire at two time points to an older cohort. The period between questionnaire administrations was 7 weeks. Polychoric correlations measured the association between recall at time 1 and time 2 and the weighted κ statistic measured the level of recall agreement for food groups across the two administrations of the questionnaire.

Adelaide, South Australia.

Fifty-two cognitively healthy, older-age, community-dwelling adults completed the Lifetime Diet Questionnaire; mean age 81·8 (sd 4·4) years, range 70–90 years.

The questionnaire showed very good reproducibility in this sample with a mean polychoric correlation coefficient of 0·81 between administration at time 1 and time 2, and an average weighted κ of 0·49 for the level of recall agreement between food groups.

The demonstrated reliability of this lifetime diet questionnaire makes it a useful tool to assess potential relationships between long-term dietary intake and later-age cognitive outcomes.

To compare the prevalence rates of obesity based on BMI/anthropometric measures, using WHO standard and ethnicity-specific criteria, the National Cholesterol Education Program–Adult Treatment Panel III (NCEP-ATPIII) and the International Diabetes Federation (IDF) definitions, among a migrant South Asian Indian population.

Cross-sectional study conducted in October 2007.

A total of 213 participants of South Asian descent over the age of 18 years. Measures included a questionnaire with basic demographic information and self-reported histories of diabetes, coronary artery disease and/or hypercholesterolaemia. Height, weight, waist and hip circumference and blood pressure measurements were obtained.

Houston and surrounding suburbs.

WHO-modified (WHO-mod) BMI and IDF waist circumference (WC) criteria independently identified higher numbers of overweight/obese participants; however, when the WHO-mod BMI or IDF WC criteria were applied, nearly 75 % of participants were categorized as overweight/obese – a proven risk factor for the future development of metabolic syndrome.

Obesity is likely under-diagnosed using the standard WHO and NCEP-ATPIII guidelines. Stressing the use of modified criteria more universally to classify obesity among South Asian Indians may be optimal to identify obesity and help appropriately risk stratify for intervention to prevent chronic diseases.

To develop a ‘fruit self-efficacy’ (FSE) instrument and a ‘vegetable self-efficacy’ (VSE) instrument for secondary-school students in the Netherlands and to test the reliability and validity of these instruments.

Methodological research.

Seven secondary schools in the Netherlands.

Students (11–19 years of age) completed the two instruments in the classroom (n 466). Out of the original subject group, 106 students completed the instruments a second time.

The relevance of the twenty-two items of the two developed instruments was evaluated on two occasions by four experts. This procedure resulted in seventeen items for both instruments. Further analysis was carried out on the basis of the secondary-school students’ answers. Factor analysis identified two unidimensional instruments. Cronbach's α was 0·94 for the FSE instrument and 0·95 for the VSE instrument. The intra-class correlation coefficient between the test and the retest for both instruments varied between 0·33 and 0·84 (P < 0·05), depending on how the tests were taken (during class or on the student's own initiative), and the order in which the tests were completed (started or finished with a different instrument used for similar research). The correlation between FSE and fruit consumption was 0·41 (P < 0·01) and between VSE and vegetable consumption was 0·32 (P < 0·01).

The two instruments are sufficiently reliable and valid to assess the FSE and VSE of secondary-school students in the Netherlands. Further research, in which the predominant ethnic minorities in the Netherlands are sufficiently represented, is required to confirm this conclusion.

To adapt and test the relative validity of an instrument measuring the usual food intake of 6–10-year-old children.

An FFQ encompassing the preceding 6 months was adapted and compared with the average of three 24 h dietary recalls.

Private and public schools in Porto Alegre, capital city of Rio Grande do Sul, the southernmost state in Brazil, with 1·5 million inhabitants.

Children aged 6–10 years attending grades 1–4 in private and public schools in Porto Alegre.

Ninety-one children were studied. The FFQ overestimated all nutrients. Correlations with the values obtained by 24 h dietary recalls were mostly above 0·50. The deattenuated correlations increased for all nutrients. The κ coefficients for the adjusted nutrients varied from 0·12 (weak) to 0·34 (reasonable). Graphically, the FFQ was shown to underestimate some of the parameters and to overestimate others, with a wide CI for all nutrients.

The FFQ does not have the required relative validity to classify the intake levels of schoolchildren, and further investigation is required to understand the sources of error.

To develop a diet quality index (DQI) that assesses adherence to the Swedish nutrition recommendations (SNR) and the Swedish dietary guidelines (SDG).

A cross-sectional study within the Malmö Diet and Cancer (MDC) cohort. A diet history method collected dietary data, a structured questionnaire lifestyle and socio-economic information, and anthropometric data were collected by direct measurements. The index (DQI-SNR) included six components: SFA, PUFA, fish and shellfish, dietary fibre, fruit and vegetables, and sucrose.

Malmö, Sweden.

Men (n 4525) and women (n 8491) of the MDC cohort enrolled from September 1994 to October 1996.

For participants with high DQI-SNR scores, nutrient and food intakes were close to recommendations. However, most of the study population exceeded the recommended intake for SFA (98 %) and few reached recommended intakes for dietary fibre (24 %), fruit and vegetables (32 %), vitamin D (18 %) and folate (2 %). A high DQI-SNR score was positively associated with age, physical activity, not smoking, past food habit change, education and socio-economic status. Individuals with high scores were more likely to have a diabetes diagnosis or experienced a cardiovascular event.

Results suggest that the DQI-SNR is a useful tool for assessing adherence to the SNR 2005 and the SDG in the MDC cohort. No index has previously been developed with the aim of evaluating adherence to the current dietary recommendations in Sweden. Further validation of the DQI-SNR, and evaluation of its utility, is needed.

To determine the association between long-term leisure-time physical activity/inactivity and eating behaviours in twin pairs discordant for physical activity for 30 years.

Co-twin control design with cross-sectional data collection using questionnaire on eating habits and 5 d food diary. Differences in eating behaviours between physically active and inactive co-twins were analysed with pairwise tests.

Finland.

Sixteen same-sex twin pairs (seven monozygotic and nine dizygotic, mean age 60 years) discordant for physical activity, selected from the Finnish Twin Cohort on the basis of physical activity discordance for 30 years, blinded to their possible differences in eating behaviours.

The eating habits questionnaire revealed that physically active co-twins more frequently reported that it is easy to eat according to need, whereas overeating and/or restrictive eating was more common among the inactive co-twins (P = 0·035). Avoiding calories was more common among the active than inactive co-twins (P = 0·034). Based on food diaries the physically active co-twins had daily energy intake on average 15·5 kJ/kg higher than their inactive co-twins (P = 0·030). The active co-twins also had a higher intake of vitamin C (P = 0·004), total water (P = 0·044), legumes and nuts (P = 0·015) and sweets (P = 0·036), as well as a lower energy-adjusted intake of meat (P = 0·013).

The physically active persons seem to eat more but not necessarily healthier food. However, habitual physical activity may help in eating according to need and in reaching and maintaining a healthy body composition. Therefore, it is necessary to incorporate both dietary and physical activity advice into health counselling.

Growing concern about ideal body image among adolescent girls in developing countries has led them to follow dietary modifications. In general, the ideal body image is perceived as a ‘thin body’ and now tagged with the concept of being physically fit. The present study evaluates the prevalence of weight concerns, and subsequent eating behaviour modifications among a group of adolescent girls in Sikkim.

Pre-tested FFQ and dietary behaviour questionnaire were canvassed through direct interviews. Anthropometric measurements were taken following standard techniques. In the present study, dieting stands for skipping meals or avoiding certain food items.

Sikkim, India.

A total of 577 girls were selected from several blocks of all four districts of Sikkim.

The results of the study show that concern with weight reduction is growing among adolescent girls, particularly among urban girls of affluent families. Girls from families with a higher economic status are about two times more likely to report dissatisfaction with their body weight (OR = 1·96; P ≤ 0·05) and these girls are five times more likely to report the need for dieting.

It is evident that weight concern and dissatisfaction over body weight are growing among adolescents. It can be safely argued that eating disorder, once a problem of the Western world, is now slowly creeping in among adolescents of the developing world as a consequence of rapid lifestyle changes over the past few decades.

The Nordic countries have published joint dietary recommendations, the Nordic Nutrition Recommendations (NNR), since 1980. We evaluated adherence to the NNR as a measure of a healthy diet and its potential association with self-reported upper respiratory tract infection (URTI).

A prospective, population-based study with a follow-up period of 4 months. Dietary intake was assessed using a semi-quantitative FFQ with ninety-six items, along with other lifestyle factors, at baseline. URTI was assessed every three weeks. A Poisson regression model was used to control for age, sex and other confounding factors.

A middle-sized county in northern Sweden.

Swedish men and women (n 1509) aged 20–60 years.

The NNR include recommendations on macronutrient proportions, physical activity and intake of micronutrients, sodium, fibre and alcohol. We found that overall adherence to the NNR was moderately good. In addition, we found that high adherence to the NNR (>5·5 adherence points) was not associated with a lower risk of URTI (incidence rate ratio (IRR) 0·89, 95 % CI 0·73, 1·08) compared with low adherence (<4·5 adherence points). When investigating individual components of the NNR, only high physical activity was associated with lower URTI risk (IRR = 0·82, 95 % CI 0·69, 0·97) whereas none of the dietary components were associated with risk of URTI.

Overall adherence to the NNR was moderately good. Overall adherence to the NNR was not associated with URTI risk in our study. However, when investigating individual components of the NNR, we found that high physical activity was associated with lower URTI risk.

To identify predictors of increasing waist circumference (WC) over a 5-year period in a contemporary population of Australian adults.

Longitudinal national cohort of adults participating in the Australian Diabetes, Obesity and Lifestyle Study (AusDiab).

Australian adults in 2000 and 2005.

A total of 2521 men and 2726 women aged ≥25 years at baseline who participated in AusDiab and provided anthropometric measurements at baseline (1999–2000) and follow-up (2005).

A ≥5 % increase of baseline WC occurred in 27 % of men and 38 % of women over the 5-year period. In the multivariate analysis of the total population, there was a higher risk of ≥5 % gain in baseline WC in women, younger people, people with a lower baseline WC, people who never married compared with married/de facto, current smokers compared with never smokers, people with a poorer diet quality and people with a low energy intake. However, there was no significant association with many expected predictors of waist gain such as physical activity. There were some associations between other lifestyle factors and change of WC by sex, age, level of education and across WC categories, but the associations differed across these groups.

A ≥5 % increase of baseline WC occurred in a significant proportion of men and women over the 5-year period. Of the behavioural factors, poor diet quality was the key predictor of the ≥5 % increase of baseline WC in this cohort. The findings highlight the need to understand better the causal role of lifestyle in regard to increasing WC over time.

Older people are vulnerable to zinc deficiency, which may impact upon their mood. This randomised, placebo-controlled, double-blind intervention study aimed to investigate the effect of oral zinc gluconate supplementation (15 mg/d; 30 mg/d; and placebo) on subjective mood (affect) in older Europeans.

Healthy volunteers (n 387) aged 55–87 years were recruited.

Volunteers in Rome (Italy; n 108) and Grenoble (France; n 91) were aged 70–87 years and those in Coleraine (Northern Ireland; n 93) and Clermont-Ferrand (France; n 95) were aged 55–70 years.

Mood was measured using the Positive and Negative Affect Scale on four occasions per day over 4 d at baseline, 3 and 6 months post-intervention.

Mixed ANOVA indicated that neither positive nor negative affect altered in response to zinc (15 mg/d or 30 mg/d) compared to placebo in either the 55–70 years or the ≥70 years age group.

These results suggest that zinc does not benefit mood in healthy older people.

To identify major meal and snack eating patterns, and examine their relationships with sleep duration.

The analyses included 27 983 participants in a prospective cohort study of women aged 35 to 74 years in the USA or Puerto Rico.

The principal component analysis of eight meal and snack frequency items at different times across the day yielded two major eating patterns: (i) eating during conventional eating hours (defined as times from breakfast to dinner); and (ii) dominance of snacks over meals. Comparing the identified eating patterns among women with varying sleep duration (<5, 5–5·9, 6–6·9, 7–7·9, 8–8·9, 9–9·9 and ≥10 h daily), the tendency for eating during conventional eating hours decreased with decreasing sleep duration: adjusted mean score of −0·54 (95 % CI –0·68, –0·41) in women sleeping for <5 h daily v. 0·08 (95 % CI 0·06, 0·11) among those with 7–7·9 h of sleep daily. The extent of snack dominance over meals increased in women with shorter sleep. Women with long (≥10 h) sleep duration had eating patterns similar to those with short (<6 h) sleep duration. Lower tendency for eating during conventional eating hours and greater snack dominance over meals were also related to higher intakes of fat and sweets for energy and lower intakes of fruits and vegetables.

Disrupted eating patterns and diet of poor nutritional quality may exacerbate the development of obesity and metabolic diseases in habitual short and very long sleepers.

Both stunting and overweight are present in children across China. Seemingly paradoxical, these two conditions can also coexist in the same child. The aim was to examine the associations between dietary food/nutrient intake and plasma lipid profiles related to stunting and overweight status.

The 2002 China National Nutrition and Health Survey was a family-based nationally representative cross-sectional study.

Thirty-one provinces, autonomous regions and municipalities.

The study included 13 770 children aged 2–17 years. The sample size for the four exposure groups was 10 814 for children of normal height and weight, 2128 for stunted, 729 for overweight and 99 for stunted overweight.

Compared with children of normal height and weight, stunted and stunted overweight children consumed more high-energy-dense foods with a lower dietary diversity score, less protein, polyunsaturated fat and Fe, and a higher molar ratio of phytate to Ca. On the contrary, overweight children tended to consume significantly less carbohydrates and more protein and fat. Overall, stunted overweight children consumed lower amounts of vegetables, fruit, white meat (poultry and fish) and more milk. The OR for prevalent dyslipidaemia were 1·32 (95 % CI 1·13, 1·53), 1·76 (95 % CI 1·48, 2·09) and 2·59 (95 % CI 1·65, 4·07) among stunted, overweight and stunted overweight children, respectively, compared with children of normal height and weight. In addition, being overweight was significantly associated with high glucose concentrations, whereas stunting was significantly associated with having anaemia.

Limited dietary diversity and intake of high-energy-dense foods were notably observed among stunted overweight children. Furthermore, being stunted and/or overweight was associated with an increased likelihood of unhealthy lipid profiles.

To assess energy and nutrient intakes and physical activity of adolescents in urban Cameroon according to sex and socio-economic status (SES).

Cross-sectional study with adolescents randomly selected from schools in low-, middle- and high-SES areas. Weight and height were measured and information about food intake and physical activity was obtained through repeated individual 24 h recalls. Under- and over-reporting of energy intake and inadequacy of nutrient intake were assessed.

Yaoundé, Cameroon.

Boys and girls aged 12–16 years (n 227).

Boys had a lower BMI and reported higher energy expenditures and physical activity levels (PAL) than girls. Under-reporting of energy intake was large among boys and girls regardless of PAL; boys under-reported more than girls. Among those with low PAL, over-reporting of energy intake was common. Over 50 % of boys and girls had protein below the recommendations. The intake of fat varied; 26 % of the adolescents were below and 25 % were above the recommendations. Inadequate intakes of vitamin B1, vitamin B3 and Fe were more common among girls, while boys more often had inadequate intake of vitamin A. Adolescents with low SES were more likely to be below the recommendations for fat and vitamins B2, B3, B6 and B12 than those with high SES.

A high proportion of boys and girls reported inadequate intakes. However under- and over-reporting were also very common. Boys under-reported energy intake more than girls and inadequate nutrient intake was more frequently reported by adolescents with low SES than by those with high SES.