To develop a targeted FFQ (TFFQ) and evaluate its effectiveness for ranking minority women by their intake of multiple nutrients important to a healthy pregnancy.

In Stage 1, food groups derived from 24 h recall dietary data were entered into a stepwise multiple regression model to identify ‘discriminating’ foods for the TFFQ; in Stage 2, the TFFQ and a 24 h recall were administered to pregnant women. The TFFQ data were used to create a Habitual Multi-Nutrient Intake Scale (H-MNIS) for ranking the women. The effectiveness of the ranking was tested against women’s reported nutrient intakes on the 24 h recall.

Southern Israel.

In Stage 1, 519 Bedouin Arab adults; in Stage 2, 404 pregnant Bedouin women.

Of the ninety-three food groups included in the regression analysis, twenty-eight explained >80 % of the between-person variability in the intake of the target nutrients. Whole-wheat bread was a main discriminator for protein, Fe, Zn, Ca and folate. Fish, poultry and canned tuna explained ≥88 % of the between-person variation in DHA and EPA intakes. The mean daily intakes of pregnant Bedouin women from the 24 h recall data differed significantly across H-MNIS quartiles (P < 0·01) for all but three target nutrients (folate, EPA, DHA); and the P for trend was significant (P < 0·02) for all but EPA.

The TFFQ and H-MNIS represent rapid assessment tools for studying maternal nutrition on a multi-nutrient basis, and effectively ranked pregnant Bedouin women into exposure groups by their intake of the target nutrients.

To determine the reproducibility and validity of a short FFQ (SFFQ) for Australian rural children aged 10 to 12 years, particularly Aboriginal and Torres Strait Islander children.

In this cross-sectional study participants completed the SFFQ on two occasions and three 24 h recalls. Concurrent validity was established by comparing results of the first SFFQ against food recalls; reproducibility was established by comparing the two SFFQ.

The north coast of New South Wales in the Australian summer of late 2005.

Two hundred and forty-one children (ninety-two Aboriginal and Torres Strait Islander children and 100 boys) completed two SFFQ and were included in the reproducibility study; of these, 205 participants with a mean age of 10·8 (sd 0·7) years took part in the validity study.

The SFFQ showed moderate to good reproducibility among all children with kappa coefficients for repeated measures between 0·41 and 0·80. Eighteen of twenty-three questions demonstrated good validity against the mean of the 24 h recalls, with statistically significant increasing trends (P ≤ 0·05) for mean daily weight and/or frequency as survey response categories increased. A similar number of short questions showed good validity for Aboriginal and Torres Strait Islander children as for their non-Indigenous counterparts.

Many short questions in this SFFQ are able to discriminate between different categories of food intake and provide information on relative intake within the given population. They can be used to monitor and/or evaluate population-wide health programmes, including those with rural Aboriginal and Torres Strait Islander children.

To examine the risk of CHD in relation to alcohol intake from three different instruments.

In the European Prospective Investigation into Cancer in Norfolk study, weekly alcohol intake was estimated from a single question in a mail-in health and lifestyle questionnaire (HLQ), a semi-quantitative FFQ, and a 7 d diet diary (7DD). Information on smoking status, physical activity, disease history, social class and medication use was reported in the HLQ. Height, weight, blood pressure and blood lipids were measured at a health check-up. The average length of follow-up was 11 years. The association between alcohol intake and incident fatal and non-fatal CHD in a nested case–control sample was calculated using logistic regression.

Norfolk, England.

A total of 2151 cases of incident fatal and non-fatal CHD and 5354 controls.

The Spearman correlation values between the 7DD, FFQ and HLQ alcohol estimates ranged from r = 0·70 to 0·82 (P < 0·0001 for all r values). Alcohol intake from all instruments was inversely associated with the risk of CHD in age- and multivariate-adjusted models. The relationships between the risk of CHD and alcohol intake from the 7DD, HLQ or FFQ were not significantly different from each other (P >0·10). A marginal difference between men and women was detected for the risk of CHD in relation to HLQ alcohol intake (P = 0·065).

In conclusion, while the instruments were not uniform in their assessment of alcohol intake levels, the 7DD, HLQ and FFQ yielded similar inverse associations between alcohol intake and risk of CHD.

To validate an FFQ designed to estimate energy intake in children against doubly labelled water (DLW). To investigate how quality control and standard beverage portion sizes affect the validity of the FFQ.

Thirty healthy children, aged 4–6 years, participated. Total energy expenditure (EE) was measured by the DLW method during an observation period of 15 d. At the end of this period parents filled out an FFQ designed to assess the child’s habitual energy intake (EI) of the preceding four weeks.

Validation study in The Netherlands.

Thirty healthy children (fifteen boys and fifteen girls), aged 4–6 years.

Mean EI (6117 (sd 1025) kJ/d) did not differ significantly from mean EE (6286 (sd 971) kJ/d; P = 0·15); the mean EI:EE ratio was 0·98. The Pearson correlation coefficient between EI and EE was 0·62. The Bland–Altman plot showed no systematic bias and a constant bias close to zero. Less intensive quality control of the FFQ maintained the mean EI:EE ratio and decreased the correlation slightly. Using standard instead of individually measured beverage portion sizes decreased the mean EI:EE ratio, but maintained the correlation.

It can be concluded that the developed FFQ is a valid instrument to estimate mean energy intake in a group of 4- to 6-year-old children and performs reasonably well to rank the subjects with respect to energy intake. It is therefore a useful instrument to estimate energy intake in children in surveys and epidemiological studies in The Netherlands.

To test the effect of image size and presence of size cues on the accuracy of portion size estimation by children.

Children were randomly assigned to seeing images with or without food size cues (utensils and checked tablecloth) and were presented with sixteen food models (foods commonly eaten by children) in varying portion sizes, one at a time. They estimated each food model’s portion size by selecting a digital food image. The same food images were presented in two ways: (i) as small, graduated portion size images all on one screen or (ii) by scrolling across large, graduated portion size images, one per sequential screen.

Laboratory-based with computer and food models.

Volunteer multi-ethnic sample of 120 children, equally distributed by gender and ages (8 to 13 years) in 2008–2009.

Average percentage of correctly classified foods was 60·3 %. There were no differences in accuracy by any design factor or demographic characteristic. Multiple small pictures on the screen at once took half the time to estimate portion size compared with scrolling through large pictures. Larger pictures had more overestimation of size.

Multiple images of successively larger portion sizes of a food on one computer screen facilitated quicker portion size responses with no decrease in accuracy. This is the method of choice for portion size estimation on a computer.

To assess the validity of a 148-item quantitative FFQ (QFFQ) that was developed for the Barbados National Cancer Study (BNCS) to determine dietary intake over 12 months and examine the dietary risk factors.

A cross-sectional validation study of the QFFQ against 4 d food diaries. Spearman’s rank correlations (ρ), intra-class correlation coefficients (ICC) and weighted κ were computed as measures of concordance, adjusting for daily variations in the food diaries. Cross-classification tables and Bland–Altman plots were created for further assessment.

BNCS is a case–control study of environmental risk factors for breast and prostate cancer in a predominantly African-origin population in Barbados.

Fifty-four individuals (21 years and older) were recruited among controls in the BNCS who were frequency-matched on sex and age group to breast and prostate cancer cases.

Similar mean daily energy intake was derived from the food diary (8201 kJ (1960 kcal)) and QFFQ (7774 kJ (1858 kcal)). Rho for energy and macronutrients ranged from 0·66 (energy) to 0·17 (dietary fibre). The percentage of energy from carbohydrates and protein showed the highest and lowest ICC among macronutrients (0·63 and 0·27, respectively). The highest weighted κ was observed for energy (0·45). When the nutrient intake was divided into quartiles, approximately 34 % of the observations were in the same quartile.

This investigation supports the validity of the QFFQ as a method for assessing long-term dietary intake except for dietary fibre, folate, vitamins A, E and B12. The instrument will be a useful tool in the analysis of diet–cancer associations in the BNCS.

To examine the reliability and convergent validity of physical activity (PA) and inactivity estimates obtained with the past-week Modifiable Activity Questionnaire (PWMAQ).

The PWMAQ, an interviewer-administered questionnaire, was administered twice, one week apart, during visits 3 and 4 of six total visits. Intra-class correlation coefficients (ICC) between administrations of the PWMAQ were used to assess the reliability of summary estimates. Spearman rank-order correlation coefficients (ρ) were used to examine the associations of PWMAQ summary estimates with temporally matched and averaged accelerometer data in all participants and then stratified by whether the data were reflective of usual PA.

Data were obtained from the Evaluation of Physical Activity Measures in Middle-Aged Women (PAW) study.

Sixty-six women, mean age 52·6 (sd 5·4) years.

The reliability of the PWMAQ physical inactivity estimate suggested substantial agreement over one week (ICC = 0·77, 95 % CI 0·57, 0·82; P < 0·0001). With the exception of light-intensity PA, the PWMAQ leisure PA estimate was significantly associated with averaged accelerometer data (ρ = 0·33–0·76; P < 0·05). For both temporally matched and averaged accelerometer data, correlation coefficients were higher between the PWMAQ estimate and moderate-walk- to vigorous-intensity PA in those who indicated that reported activity was reflective of usual PA; however, the association with moderate-lifestyle-intensity PA was higher in those reporting that data were not reflective.

The PWMAQ is a reliable and valid measure of leisure PA levels in middle-aged women and supports subsequent studies evaluating this questionnaire in other population subgroups.

To investigate the reliability and the validity of the long format, Chinese version of the International Physical Activity Questionnaire (IPAQ-LC).

Cross-sectional study, examining the reliability and validity of the IPAQ-LC compared with a physical activity log (PA-log) and objective accelerometry.

Self-reported physical activity (PA) in Hong Kong adults.

A total of eighty-three Chinese adults (forty-seven males, thirty-six females) were asked to wear an ActiTrainer accelerometer (MTI-ActiGraph, Fort Walton Beach, FL, USA) for >10 h over 7 d, to complete a PA-log at the end of each day and to complete the IPAQ-LC on day 8. On a sub-sample of twenty-eight adults the IPAQ-LC was also administered on day 11 to assess its reliability.

The IPAQ-LC had good test–retest reliability for grouped activities, with intra-class correlation coefficients ranging from 0·74 to 0·97 for vigorous, moderate, walking and total PA, with between-test effect sizes that were small (<0·49). The Spearman correlation coefficients were statistically significant for vigorous PA (r = 0·28), moderate + walking PA (r = 0·27), as well as overall PA (r = 0·35), when compared with the accelerometry-based criterion measures, but none of the IPAQ activity categories correlated significantly with the PA-log. In absolute units, only the IPAQ light and overall PA did not differ significantly from the accelerometry measures, yet overall PA was able to faithfully discriminate between quartiles of PA (P = 0·019) when compared to accelerometry.

The IPAQ-LC demonstrated adequate reliability and showed sufficient evidence of validity in assessing overall levels of habitual PA to be used on Hong Kong adults.

The growing interest in maintaining good health status through optimal nutrition has boosted the launch of a number of functional foods on the market. The objective of the present study was to theoretically evaluate the nutritional relevance of incorporating selected enriched foods in the diet.

A 28 d dietary plan, designed to be balanced under the recommended macronutrients criteria, was used as a basal diet. Some conventional foods were exchanged with foods enriched in fibre, calcium, iodine, vitamins A, D, E or n-3 fatty acids.

Nutritional composition of basal and modified diets was derived and compared to the Spanish recommended intakes (RI).

The basal diet covered the recommendations for fibre and calcium with mean intake of 28 g and 1241 mg, respectively. The current intake of salt, if iodized, or bread elaborated with this salt, allowed reaching the daily intake of iodine every day, with a mean supply of 216 μg/d and 278 μg/d, respectively. The deficient supply of vitamin E in the basal diet (mean = 8 mg/d) was covered by including enriched margarine and dairy products (mean = 15 mg/d). The low n-3 fatty acids intake in the basal diet (1·1 g/d) increased up to 1·9 g/d after the use of enriched margarine, butter and biscuits and soya drink instead of milk.

In order to improve the accomplishment of the RI iodine, vitamin E and n-3 fatty acids, interesting strategies dealing with the incorporation of enriched foods in the diet were successfully initiated.

Supplements are an important source of micronutrient intake, which, unless taken into account, can misclassify individuals with regard to levels of nutrient exposure. A label-based vitamin and mineral supplements (ViMiS) database was developed to contain manufacturers’ information and to enter supplement use by participants in the European Prospective Investigation into Cancer and Nutrition in Norfolk (EPIC-Norfolk). The ViMiS database contains information on all ingredients, broken down into nutrient information in order to be combined with nutrient intake derived from food consumption.

Development of the ViMiS database and cross-sectional analysis of supplement use in a population-based study.

Men and women aged 40–79 years from the general population participating in the EPIC-Norfolk study between 1993 and 1997, with data available from 7 d diet diaries (7dDD).

A subset of 19 330 participants with available 7dDD and known supplement status.

To date, the ViMiS database includes 2066 supplements, which altogether contain 16 586 ingredients, with a median of eleven nutrient/ingredients per supplement. Forty per cent of the cohort took a supplement, of which cod liver oil was the most common (24·5 %).

The ViMiS database provides a flexible tool for estimating total nutrient intake. The high prevalence of supplement use in the general population indicates that supplement use needs to be taken into account when examining the relationship of intake of particular nutrients to health outcomes.

To examine (i) situational characteristics of young adults’ eating occasions, including away-from-home eating, social influences and multi-tasking, and (ii) how these characteristics are associated with specific foods/beverages consumed.

Participants logged numerous characteristics of eating occasions (n 1237) in real time over 7 d.

Minneapolis/St. Paul metropolitan area (Minnesota, USA).

Forty-eight participants, aged 18–23 years.

Half of all eating occasions (46 %) occurred alone, 26 % occurred while watching television and 36 % involved other multi-tasking. Most participants (63 %) did not think about their food choices in advance of eating occasions. Eating that occurred in the absence of television viewing and/or other multi-tasking was less likely to include sweetened beverages and more likely to include items like water, fruit, vegetables, cereal, grains and entrées. Eating occasions occurring alone, and/or those occurring at home, were more likely to include snack foods that required little preparation (e.g. cookies, baked goods) and less likely to include more traditional meal items (e.g. fruits, vegetables, entrée items).

Overall, a large proportion of young adults’ eating occasions occurred alone, while engaging in other activities and with little advanced planning. Although many young adults’ eating occasions consist of a wide range of highly processed, energy-dense, convenience products, more traditional meal settings (i.e. eating at home with others in the absence of multi-tasking) may result in more structured mealtimes and better food choices, such as more fruits and vegetables. Effective behavioural strategies promoting positive eating patterns, including home meal preparation, are urgently needed among young adults.

Dietary fish is the main source of methylmercury (MeHg) for man, and fish consumption has been used as a measure of MeHg exposure. However, other dietary sources of exposure exist and MeHg metabolism may also be modified by nutritional factors. The aim of the present study was to examine the association between blood MeHg concentration and consumption of different foods in a Finnish population with high fish consumption.

Blood samples, a detailed FFQ and additional frequency data on fish consumption were collected. MeHg was analysed from whole blood by the isotope dilution method with high-resolution MS. The consumption of different foods was calculated by MeHg quartiles and tested for linear trend.

Finnish southern and south-western coast of the Baltic Sea.

Two hundred and ninety-nine professional fishermen, their spouses and other family members.

Mean (range) blood MeHg concentration was 4·6 (0·21–22) μg/l among men and 2·8 (<0·15–20) μg/l among women. Fish had the strongest positive association with MeHg (P for linear trend <0·001 among both men and women). Among men, positive associations were also observed for fruit vegetables, wheat and wine. Among women, positive associations were observed for root vegetables, legumes, potato and game, but adjustment for fish consumption attenuated these trends.

The study shows that, besides fish, MeHg may have other dietary sources that should be taken into account in risk assessment studies. Due to the observed high blood MeHg concentration, a thorough exposure assessment among the general Finnish population is recommended.

To critically examine child-oriented packaged food products sold in Canada for their sodium content, and to assess them light of intake recommendations, the current policy context and suggested targets.

Baby/toddler foods (n 186) and child-oriented packaged foods (n 354) were coded for various attributes (including sodium). Summary statistics were created for sodium, then the children’s food products were compared with the UK Food Standards Agency (FSA) ‘targets’ for sodium in packaged foods. Also assessed were the products’ per-serving sodium levels were assessed in light of the US Institute of Medicine’s dietary reference intakes and Canada’s Food Guide.

Calgary, Alberta, Canada.

None.

Twenty per cent of products could be classified as having high sodium levels. Certain sub-categories of food (i.e. toddler entrées, children’s packaged lunches, soups and canned pastas) were problematic. Significantly, when scaled in according to Schedule M or viewed in light of the serving sizes on the Nutrition Facts table, the sodium level in various dry goods products generally fell within, and below, the Adequate Intake (AI)/Tolerable Upper Intake Level (UL) band for sodium. When scaled in accordance with the UK FSA targets, however, none of the (same) products met the targets.

In light of AI/UL thresholds based on age and per-serving cut-offs, packaged foodstuffs for youngsters fare relatively well, with the exception of some problematic areas. ‘Stealth sodium’ and ‘subtle sodium’ are important considerations; so is use of the FSA’s scaling method to evaluate sodium content, because it is highly sensitive to the difference between the reference amount and the actual real-world serving size for the product being considered.

A systematic literature review was conducted to determine whether sweetened beverage intake increases the risk for obesity, and the extent to which it has contributed to recent increases in energy intake and adiposity in the USA.

The search included studies published between 1970 and 2010 that examined secular trends, mechanisms, observational associations and intervention outcomes. Observational and intervention studies were abstracted and systematically evaluated for quality.

Trends in obesity prevalence in the USA and studies from industrialized (developed) countries were included.

Studies were included for all ages, genders, ethnic and socio-economic groups for which data were available.

Obesity rates and sweetened beverage intake have increased in tandem in the USA. Studies consistently show that higher intake of sweetened beverages is associated with higher energy intake. Energy in liquid form is not well compensated for by reductions in the intake of other sources of energy. Well-designed observational studies consistently show a significant positive relationship between sweetened beverage intake and adiposity. More importantly, several well-conducted randomized controlled trials have shown statistically significant changes in adiposity as a result of corresponding changes in sweetened beverage intake.

All lines of evidence consistently support the conclusion that the consumption of sweetened beverages has contributed to the obesity epidemic. It is estimated that sweetened beverages account for at least one-fifth of the weight gained between 1977 and 2007 in the US population. Actions that are successful in reducing sweetened beverage consumption are likely to have a measurable impact on obesity.

To identify the information that adult consumers use on food labels, the difficulties they experience when using food labels and their reasons for not always using food labels. The relationship between their understanding of the information on the food label and their ability to make informed food choices was also investigated by means of their being required to perform labelling tasks.

A cross-sectional and descriptive research approach was followed. Data were collected by means of the administration of questionnaires.

Selected supermarkets in Potchefstroom and Klerksdorp in the North West Province, South Africa.

Questionnaires were administered to 174 consumers of African descent and Caucasians, ≥18 years of age, who were involved in purchasing household food products.

The information that is mostly used on food labels includes the expiry date, the list of ingredients and nutritional information, such as fat and cholesterol content. The difficulties associated with food labels were indicated mainly as being the font size of the print, whereas the reasons for not reading food labels were related to product attributes (‘taste and price are more important than is the nutritional content of the food product’), demographic characteristics (‘lack of education and nutritional knowledge’) and situational factors (‘experiencing time constraints’).

Results from the present study indicated that the expiry date was the most important information on a food label used by consumers. Scores from the labelling tasks showed that the respondents did not always understand how to use the information on food labels in order to make informed food choices. Barriers to consumer understanding and the use of food labels are highlighted. Improvements on current food labels in South Africa are suggested. Guidelines for consumer education regarding the use of food labels are also provided.

Foods prepared outside of the home have been linked to less-than-ideal nutrient profiles for health. We examine whether the locations where meals are prepared and consumed are associated with socio-economic predictors among women.

A cross-sectional study using self-reported data. We examined multiple locations where meals are prepared and consumed: (i) at home; (ii) fast food eaten at home; (iii) fast food eaten at the restaurant; (iv) total fast food; (v) non-fast-food restaurant meals eaten at home; (vi) non-fast-food restaurant meals eaten at the restaurant; and (vii) all non-fast-food restaurant meals. Multilevel logistic regression was used to determine whether frequent consumption of meals from these sources varied by level of education, occupation, household income and area-level disadvantage.

Metropolitan Melbourne, Australia.

A total of 1328 women from forty-five neighbourhoods randomly sampled for the SocioEconomic Status and Activity in Women study.

Those with higher educational qualifications or who were not in the workforce (compared with those in professional employment) were more likely to report frequent consumption of meals prepared and consumed at home. High individual- and area-level socio-economic characteristics were associated with a lower likelihood of frequent consumption of fast food and a higher likelihood of frequent consumption of meals from non-fast-food sources. The strength and significance of relationships varied by place of consumption.

The source of meal preparation and consumption varied by socio-economic predictors. This has implications for policy makers who need to continue to campaign to make healthy alternatives available in out-of-home food sources.

To estimate the extent of under- and over-reporting, to examine associations with misreporting and sociodemographic and lifestyle characteristics and mental health status and to identify differential reporting in micro- and macronutrient intake and quality of diet.

A health and lifestyle questionnaire and a semi-quantitative FFQ were completed as part of the 2007 Survey of Lifestyle, Attitudes and Nutrition. Energy intake (EI) and intake of micro- and macronutrients were determined by applying locally adapted conversion software. A dietary score was constructed to identify healthier diets. Accuracy of reported EI was estimated using the Goldberg method. ANOVA, χ2 tests and logistic regression were used to examine associations.

Residential households in Ireland.

A nationally representative sample of 7521 adults aged 18 years or older.

Overall, 33·2 % of participants were under-reporters while 11·9 % were over-reporters. After adjustment, there was an increased odds of under-reporting among obese men (OR = 2·01, 95 % CI 1·46, 2·77) and women (OR = 1·68, 95 % CI 1·23, 2·30) compared to participants with a healthy BMI. Older age, low socio-economic status and overweight/obesity reduced the odds of over-reporting. Among under-reporters, the percentage of EI from fat was lower and overall diet was healthier compared to accurate and over-reporters. The reported usage of salt, fried food consumption and snacking varied significantly by levels of misreporting.

Patterns in differential reporting were evident across sociodemographic, lifestyle and mental health factors and diet quality. Consideration should be given to how misreporting affects nutrient analysis to ensure sound nutritional policy.

The present study aimed to scrutinize the food nutrition labelling practice in China before the Chinese Food Nutrition Labeling Regulation (CFNLR) era.

Nutrition information of pre-packaged foods collected from a supermarket between December 2007 and January 2008 was analysed and compared with findings from a survey conducted in Beijing.

Information collected from a supermarket in Shanghai.

A total of 850 pre-packaged foods.

In the Shanghai survey, the overall labelling rate was 30·9 %, similar to that found in the Beijing study (29·7 %). While only 20·5 % of the snacks in Shanghai had nutrition labelling, the percentage of food items labelled with SFA (8·6 %), trans fatty acid (4·7 %) or fibre (12·1 %) was very low. Of those food items with nutrition labels, a considerable proportion (7–15 %) did not label energy, fat, carbohydrate or protein. Food products manufactured by Taiwan and Hong Kong companies had a lower labelling rate (13·6 %) than those manufactured by domestic (31·6 %) or international manufacturers (33·8 %).

The very low food nutrition labelling rate among products sold in large chain supermarkets in major cities of China before CFNLR emphasizes the need for such critical regulations to be implemented in order to reinforce industrial compliance with accurate nutrition labelling.

European governments have yet to introduce mandatory folic acid fortification of foods for neural tube defect prevention because of uncertainty about the long-term safety of high intake of folic acid. Novel folate-enriched eggs have been proposed as offering a practical way of increasing intake of natural folates, which do not have the same safety concerns as synthetic folic acid. Our objective was to estimate the potential increase in folate supply that could occur in European Union (EU) countries if normal eggs were replaced by folate-enriched eggs.

FAOSTAT data on daily per capita availability of eggs were linked to mean folate concentrations of un-enriched and folate-enriched eggs from three representative feeding trials from the recent literature.

Data were collated in Microsoft Excel.

The study used food balance sheets for Europe for 1961–2003 and for twenty-six individual EU countries for 2003.

There has been little variation in egg supply in Europe over the past 40 years, with eggs providing only about 1·3–1·6 % of total energy. In 2003, the average per capita egg supply across twenty-six EU countries was 32·8 g/d, equivalent to a little over half an egg. Even if the folate concentrations of all eggs across the EU were increased two- to threefold, per capita folate supply would increase only by about 25 μg/d.

At current enrichment levels, the availability of novel folate-enriched eggs will have little impact on folate supply in EU countries. In the absence of mandatory fortification, additional natural folate sources are needed urgently.