To review existing methods and illustrate the use of a new, simple method for identifying inaccurate reports of dietary energy intake (rEI).

Comparison of rEI with energy requirements estimated by using total energy expenditure predicted (pTEE) from age, weight, height and sex using a previously published equation. Propagation of error calculations was performed and cut-offs for excluding rEI at plus or minus two standard deviations (±2 SD) and ±1 SD for the agreement between rEI and pTEE were established.

Dietary survey in a US national cohort: the Continuing Survey of Food Intakes by Individuals (CSFII), 1994–96.

Men and non-pregnant, non-lactating women aged 21–45 years in the CSFII who provided two multiple-pass 24-hour recalls, height and weight(n = 3755).

Average rEI was 77% of pTEE in men, and 64% of pTEE in women. Calculated cut-offs were rEI <40% or >160% of pTEE (±2 SD) and <70% or >130% of pTEE (±1 SD), respectively. Use of only the ±1 SD cut-offs, not the ±2 SD cut-offs, resulted in a relationship between rEI and body weight similar to what was expected (based on an independently calculated relationship between rEI and measured TEE). Exclusion of rEI outside either the ±2 SD (11% of subjects) or ±1 SD (57% of subjects) cut-offs did not affect mean reported macronutrient intakes, but did markedly affect relationships between dietary composition and body mass index.

When examining relationships between diet and health, use of ±1 SD cut-offs may be preferable to ±2 SD cut-offs for excluding inaccurate dietary reports.

To investigate the effect of television food advertising on children’s food intake, specifically whether childhood obesity is related to a greater susceptibility to food promotion.

The study was a within-subject, counterbalanced design. The children were tested on two occasions separated by two weeks. One condition involved the children viewing food advertisements followed by a cartoon, in the other condition the children viewed non-food adverts followed by the same cartoon. Following the cartoon, their food intake and choice was assessed in a standard paradigm.

The study was conducted in Liverpool, UK.

Fifty-nine children (32 male, 27 female) aged 9–11 years were recruited from a UK school to participate in the study. Thirty-three children were normal-weight (NW), 15 overweight (OW) and 11 obese (OB).

Exposure to food adverts produced substantial and significant increases in energy intake in all children (P < 0·001). The increase in intake was largest in the obese children (P = 0·04). All children increased their consumption of high-fat and/or sweet energy-dense snacks in response to the adverts (P < 0·001). In the food advert condition, total intake and the intake of these specific snack items correlated with the children’s modified age- and gender-specific body mass index score.

These data suggest that obese and overweight children are indeed more responsive to food promotion, which specifically stimulates the intake of energy-dense snacks.

Diet is an important determinant of health outcomes, but physicians have few ways to identify persons with suboptimal diets. The purposes of this study were to examine the reproducibility of a short dietary assessment questionnaire (PrimeScreen) and to compare its results with those of a longer food frequency questionnaire and with plasma levels of selected nutrients.

Each subject completed two PrimeScreen questionnaires at an interval of 2 weeks and one full length, 131-item, semiquantitative food frequency questionnaire (SFFQ), and had a sample of blood drawn. We compared the PrimeScreen with two reference standards, the SFFQ and plasma levels of selected nutrients.

A large managed care organization in New England.

A total of 160 men and women, aged 19–65 years, participated.

For foods and food groups, the mean correlation coefficient (r) was 0.70 for reproducibility and 0.61 for comparability with the SFFQ. For nutrients, the mean r was 0.74 for reproducibility and 0.60 for comparability with the SFFQ. No substantial differences were evident by sex, race, body mass index, occupation or education. Correlation coefficients for the comparison of vitamin E, β-carotene and lutein/zeaxanthin intakes from the PrimeScreen with plasma levels were 0.33, 0.43 and 0.43, respectively. These values were similar to those comparing the SFFQ with plasma levels. The median time to complete PrimeScreen was 5 min; 87% of participants required fewer than 10 min.

A quick way to assess quality of diet among adults, PrimeScreen has adequate reproducibility and its results compare well with a longer food frequency questionnaire and biomarkers.

To examine whether involvement in food preparation tracks over time, between adolescence (15–18 years), emerging adulthood (19–23 years) and the mid-to-late twenties (24–28 years), as well as 10-year longitudinal associations between home food preparation, dietary quality and meal patterning.

Population-based, longitudinal cohort study.

Participants were originally sampled from Minnesota public secondary schools (USA).

Participants enrolled in Project EAT (Eating Among Teens and Young Adults)-I, EAT-II and EAT-III (n 1321).

Most participants in their mid-to-late twenties reported an enjoyment of cooking (73 % of males, 80 % of females); however, few prepared meals including vegetables most days of the week (24 % of males, 41 % of females). Participants in their mid-to-late twenties who enjoyed cooking were more likely to have engaged in food preparation as adolescents and emerging adults (P < 0·01); those who frequently prepared meals including vegetables were more likely to have engaged in food preparation as emerging adults (P < 0·001), but not as adolescents. Emerging adult food preparation predicted better dietary quality five years later in the mid-to-late twenties, including higher intakes of fruit, vegetables and dark green/orange vegetables, and less sugar-sweetened beverage and fast-food consumption. Associations between adolescent food preparation and later dietary quality yielded few significant results.

Food preparation behaviours appeared to track over time and engagement in food preparation during emerging adulthood, but not adolescence, was associated with healthier dietary intake during the mid-to-late twenties. Intervention studies are needed to understand whether promoting healthy food preparation results in improvements in eating patterns during the transition to adulthood.

To review the available data on risk factors for cardiovascular disease (CVD), the influence of urbanisation of Africans on these risk factors, and to examine why stroke emerges as a higher risk than ischaemic heart disease (IHD) in the health transition of black South Africans.

A review of published data on mortality from and risk factors of CVD in South Africans.

South Africa.

South African population groups and communities.

The available data on the contribution of stroke and IHD to CVD mortality in South Africa are briefly reviewed, followed by a comparison of published data on the prevalence and/or levels of CVD risk factors in the different South African population groups. The impact of urbanisation of black South Africans on these risk factors is assessed by comparing rural and urban Africans who participated in the Transition and Health during Urbanisation of South Africans (THUSA) study.

Results and conclusions: The mortality rates from CVD confirmed that stroke is a major public health problem amongst black South Africans, possibly because of an increase in hypertension, obesity, smoking habit and hyperfibrinogenaemia during various stages of urbanisation. The available data further suggest that black South Africans may be protected against IHD because of favourable serum lipid profiles (low cholesterol and high ratios of high-density lipoprotein cholesterol) and low homocysteine values. However, increases in total fat and animal protein intake of affluent black South Africans, who can afford Western diets, are associated with increases in body mass indices of men and women and in total serum cholesterol. These exposures may increase IHD risk in the future.

A tax on sugar-sweetened beverages (SSB) has been proposed to address population weight gain but the effect across socio-economic position (SEP) is unclear. The current study aimed to clarify the differential impact(s) of SSB taxes on beverage purchases and consumption, weight outcomes and the amount paid in SSB taxes according to SEP.

Databases (OVID and EMBASE) and grey literature were systematically searched in June 2015 to identify studies that examined effects of an SSB price increase on beverage purchases or consumption, weight outcomes or the amount paid in tax across SEP, within high-income countries.

Of the eleven included articles, three study types were identified: (i) those that examined the association between variation in SSB taxes and SSB consumption and/or body weight (n 3); (ii) price elasticity estimation of SSB demand (n 1); and (iii) modelling of hypothetical SSB taxes by combining price elasticity estimates with population SEP-specific beverage consumption, energy intake or body weight (n 7). Few studies statistically tested differences in outcomes between SEP groups. Nevertheless, of the seven studies that reported on changes in weight outcomes for the total population following an increase in SSB price, all reported either similar reductions in weight across SEP groups or greater reductions for lower compared with higher SEP groups. All studies that examined the average household amount paid in tax (n 5) reported that an SSB tax would be regressive, but with small differences between higher- and lower-income households (0·10–1·0 % and 0·03 %–0·60 % of annual household income paid in SSB tax for low- and high-income households, respectively).

Based on the available evidence, a tax on SSB will deliver similar population weight benefits across socio-economic strata or greater benefits for lower SEP groups. An SSB tax is shown to be consistently financially regressive, but to a small degree.

To evaluate the association of ultra-processed food (UPF) consumption with gains in weight and waist circumference, and incident overweight/obesity, in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort.

We applied FFQ at baseline and categorized energy intake by degree of processing using the NOVA classification. Height, weight and waist circumference were measured at baseline and after a mean 3·8-year follow-up. We assessed associations, through Poisson regression with robust variance, of UPF consumption with large weight gain (1·68 kg/year) and large waist gain (2·42 cm/year), both being defined as ≥90th percentile in the cohort, and with incident overweight/obesity.

Brazil.

Civil servants of Brazilian public academic institutions in six cities (n 11 827), aged 35–74 years at baseline (2008–2010).

UPF provided a mean 24·6 (sd 9·6) % of ingested energy. After adjustment for smoking, physical activity, adiposity and other factors, fourth (>30·8 %) v. first (<17·8 %) quartile of UPF consumption was associated (relative risk (95 % CI)) with 27 and 33 % greater risk of large weight and waist gains (1·27 (1·07, 1·50) and 1·33 (1·12, 1·58)), respectively. Similarly, those in the fourth consumption quartile presented 20 % greater risk (1·20 (1·03, 1·40)) of incident overweight/obesity and 2 % greater risk (1·02; (0·85, 1·21)) of incident obesity. Approximately 15 % of cases of large weight and waist gains and of incident overweight/obesity could be attributed to consumption of >17·8 % of energy as UPF.

Greater UPF consumption predicts large gains in overall and central adiposity and may contribute to the inexorable rise in obesity seen worldwide.

To critique current practice in, and provide recommendations for, mediating variable analyses (MVA) of nutrition and physical activity behaviour change.

Theory-based behavioural nutrition and physical activity interventions aim at changing mediating variables that are hypothesized to be responsible for changes in the outcome of interest. MVA are useful because they help to identify the most promising theoretical approaches, mediators and intervention components for behaviour change. However, the current literature suggests that MVA are often inappropriately conducted, poorly understood and inadequately presented. Main problems encountered in the published literature are explained and suggestions for overcoming weaknesses of current practice are proposed.

The use of the most appropriate, currently available methods of MVA, and a correct, comprehensive presentation and interpretation of their findings, is of paramount importance for understanding how obesity can be treated and prevented.

To present the Mediterranean diet as an example of a sustainable diet, in which nutrition, biodiversity, local food production, culture and sustainability are strongly interconnected.

Review of notions and activities contributing towards the acknowledgement of the Mediterranean diet as a sustainable diet.

The Mediterranean region and its populations.

Mediterranean populations.

The acknowledgement of the Mediterranean diet as a sustainable diet needs the development of new cross-cutting intersectoral case studies to demonstrate further the synergies among nutrition, biodiversity and sustainability as expressed by the Mediterranean diet for the benefit of present and future generations.

To investigate the impact of school garden-enhanced nutrition education (NE) on children’s fruit and vegetable consumption, vegetable preferences, fruit and vegetable knowledge and quality of school life.

Quasi-experimental 10-week intervention with nutrition education and garden (NE&G), NE only and control groups. Fruit and vegetable knowledge, vegetable preferences (willingness to taste and taste ratings), fruit and vegetable consumption (24 h recall × 2) and quality of school life (QoSL) were measured at baseline and 4-month follow-up.

Two primary schools in the Hunter Region, New South Wales, Australia.

A total of 127 students in Grades 5 and 6 (11–12 years old; 54 % boys).

Relative to controls, significant between-group differences were found for NE&G and NE students for overall willingness to taste vegetables (P < 0·001) and overall taste ratings of vegetables (P < 0·001). A treatment effect was found for the NE&G group for: ability to identify vegetables (P < 0·001); willingness to taste capsicum (P = 0·04), broccoli (P = 0·01), tomato (P < 0·001) and pea (P = 0·02); and student preference to eat broccoli (P < 0·001) and pea (P < 0·001) as a snack. No group-by-time differences were found for vegetable intake (P = 0·22), fruit intake (P = 0·23) or QoSL (P = 0·98).

School gardens can impact positively on primary-school students’ willingness to taste vegetables and their vegetable taste ratings, but given the complexity of dietary behaviour change, more comprehensive strategies are required to increase vegetable intake.

A school-based nutrition information programme was initiated in 1992 in two towns in northern France (Fleurbaix and Laventie, FL) and was followed by a number of community-based interventions. We took the opportunity to measure the outcomes in terms of childhood obesity and overweight over the next 12 years.

Repeated, cross-sectional, school-based survey. For the school years beginning in 1992, 2000, 2002, 2003 and 2004, the height and weight of all 5- to 12-year-old children attending school were measured in FL. In 2004, the same assessments were made in two comparison towns with similar socio-economic characteristics but no intervention.

Fleurbaix and Laventie (intervention towns), Bois-Grenier and Violaines (comparison towns), northern France.

In 2002, 2003 and 2004, respectively 515, 592 and 633 children were measured in FL (participation rate of 95–98 % of all eligible individuals); in the comparison towns, 349 children were measured in the 2004 school year (98 % of the towns’ school population).

After an initial increase, trends in mean BMI and prevalence of overweight started to reverse. Compared with 2002, the age-adjusted OR for overweight in FL was significantly lower in 2003 and 2004 (but for girls only). In the 2004 school year, the overweight prevalence was significantly lower in FL (8·8 %) than in the comparison towns (17·8 %, P < 0·0001).

These data suggest that, over a long period of time, interventions targeting a variety of population groups can have synergistic effects on overweight prevalence. This gives hope that it is possible to reverse trends towards increasing overweight by actions at the community level.

To examine the association between breakfast skipping and type of breakfast consumed with overweight/obesity, abdominal obesity, other cardiometabolic risk factors and the metabolic syndrome (MetS).

Cross-sectional. Three breakfast groups were identified, breakfast skippers (BS), ready-to-eat-cereal (RTEC) consumers and other breakfast (OB) consumers, using a 24 h dietary recall. Risk factors were compared between the breakfast groups using covariate-adjusted statistical procedures.

The 1999–2006 National Health and Nutrition Examination Survey, USA.

Young adults (20–39 years of age).

Among these young adults (n 5316), 23·8 % were BS, 16·5 % were RTEC consumers and 59·7 % were OB consumers. Relative to the BS, the RTEC consumers were 31 %, 39 %, 37 %, 28 %, 23 %, 40 % and 42 % less likely to be overweight/obese or have abdominal obesity, elevated blood pressure, elevated serum total cholesterol, elevated serum LDL-cholesterol, reduced serum HDL-cholesterol or elevated serum insulin, respectively. Relative to the OB consumers, the BS were 1·24, 1·26 and 1·44 times more likely to have elevated serum total cholesterol, elevated serum LDL-cholesterol or reduced serum HDL-cholesterol, respectively. Relative to the OB consumers, the RTEC consumers were 22 %, 31 % and 24 % less likely to be overweight/obese or have abdominal obesity or elevated blood pressure, respectively. No difference was seen in the prevalence of the MetS by breakfast skipping or type of breakfast consumed.

Results suggest that consumption of breakfast, especially that included an RTEC, was associated with an improved cardiometabolic risk profile in US young adults. Additional studies are needed to determine the nature of these relationships.

A low socio-economic status (SES) is related to less healthy dietary habits, but the reasons for this remain unclear. We examined whether the absolute or relative importance of various food choice motives contributed to SES disparities in vegetable/fruit and energy-dense food intake.

We analysed cross-sectional data from the FINRISK Study 2007 by means of structural equation modelling and used a shortened version of the Food Choice Questionnaire to assess the absolute importance of health, pleasure, convenience, price, familiarity and ethicality motives. We calculated the relative importance of each motive by dividing the participant's rating of it by his/her mean score on all motives. Dietary intake was measured with an FFQ.

A population-based survey in Finland.

Men (n 1691) and women (n 2059) aged 25–64 years.

Higher education and income were related to a greater vegetable/fruit intake (β = 0·12, P < 0·001), while education was associated negatively with the consumption of energy-dense foods (β = −0·09, P < 0·001). Socio-economically disadvantaged individuals considered price and/or familiarity more important in their food choices in both absolute and relative terms. A higher income was related to a greater relative importance of health considerations. Relative motives were more strongly associated with vegetable/fruit and energy-dense food consumption than absolute motives and the relative importance of price, familiarity and health partly mediated the effects of the SES indicators on the consumption of these food items.

Individual priorities in food choice motives, rather than the absolute importance of single motives, play a role in producing SES disparities in diet.

Previous research on nutrition labelling has mainly used subjective measures. This study examines the effectiveness of two types of nutrition label using two objective measures: eye movements and healthiness ratings.

Eye movements were recorded while participants made healthiness ratings for two types of nutrition label: standard and standard plus the Food Standards Agency's ‘traffic light’ concept.

University of Derby, UK.

A total of 92 participants (mean age 31.5 years) were paid for their participation. None of the participants worked in the areas of food or nutrition.

For the standard nutrition label, participant eye movements lacked focus and their healthiness ratings lacked accuracy. The traffic light system helped to guide the attention of the consumer to the important nutrients and improved the accuracy of the healthiness ratings of nutrition labels.

Consumers have a lack of knowledge regarding how to interpret nutrition information for standard labels. The traffic light concept helps to ameliorate this problem by indicating important nutrients to which to pay attention.

Since inadequate food consumption patterns during adolescence are not only linked with the occurrence of obesity in youth but also with the subsequent risk of developing diseases in adulthood, the establishment and maintenance of a healthy diet early in life is of great public health importance. Therefore, the aim of the present study was to describe and evaluate the food consumption of a well-characterized sample of European adolescents against food-based dietary guidelines for the first time.

The HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study is a cross-sectional study, whose main objective was to obtain comparable data on a variety of nutritional and health-related parameters in adolescents aged 12·5–17·5 years.

Ten cities in Europe.

The initial sample consisted of more than 3000 European adolescents. Among these, 1593 adolescents (54 % female) had sufficient and plausible dietary data on energy and food intakes from two 24 h recalls using the HELENA-DIAT software.

Food intake of adolescents in Europe is not optimal compared with the two food-based dietary guidelines, Optimized Mixed Diet and Food Guide Pyramid, examined in this study. Adolescents eat half of the recommended amount of fruit and vegetables and less than two-thirds of the recommended amount of milk (and milk products), but consume much more meat (and meat products), fats and sweets than recommended. However, median total energy intake may be estimated to be nearly in line with the recommendations.

The results urge the need to improve the dietary habits of adolescents in order to maintain health in later life.

To determine whether an educational programme aimed at discouraging students from drinking sugar-sweetened beverages could prevent excessive weight gain.

Forty-seven classes in twenty-two schools were randomised as intervention or control.

Participants were 1140, 9–12-year-old fourth graders (435 in the intervention group and 608 in the control group). Sugar-sweetened beverages and juice intake were measured through one 24 h recall at baseline and another at the end of the trial. The main outcome was the change in BMI (BMI = weight (kg)/height (m2)), measured at the beginning and at the end of the school year. Intention-to-treat analysis was performed taking into account the cluster (classes) effect.

A statistically significant decrease in the daily consumption of carbonated drinks in the intervention compared to control (mean difference = −56 ml; 95 % CI −119, −7 ml) was followed by a non-significant overall reduction in BMI, P = 0·33. However, among those students overweight at baseline, the intervention group showed greater BMI reduction (−0·4 kg/m2 compared with −0·2 kg/m2 in the control group (P = 0·11)), and this difference was statistically significant among girls (P = 0·009). Fruit juice consumption was slightly increased in the intervention group (P = 0·08), but not among girls.

Decreasing sugar-sweetened beverages intake significantly reduced BMI among overweight children, and mainly among girls. Efforts to reduce energy intake through liquids need to emphasise overall sweetened beverages and addition of sugar on juices.

To study differences in the role of price and value in food choice between low-income and higher-income consumers and to study the perception of consumers about pricing strategies that are of relevance during grocery shopping.

A cross-sectional study was conducted using structured, written questionnaires. Food choice motives as well as price perceptions and opinion on pricing strategies were measured.

The study was carried out in point-of-purchase settings, i.e. supermarkets, fast-food restaurants and sports canteens.

Adults (n 159) visiting a point-of-purchase setting were included.

Price is an important factor in food choice, especially for low-income consumers. Low-income consumers were significantly more conscious of value and price than higher-income consumers. The most attractive strategies, according to the consumers, were discounting healthy food more often and applying a lower VAT (Value Added Tax) rate on healthy food. Low-income consumers differ in their preferences for pricing strategies.

Since price is more important for low-income consumers we recommend mainly focusing on their preferences and needs.

An absence of food literacy measurement tools makes it challenging for nutrition practitioners to assess the impact of food literacy on healthy diets and to evaluate the outcomes of food literacy interventions. The objective of the present scoping review was to identify the attributes of food literacy.

A scoping review of peer-reviewed and grey literature was conducted and attributes of food literacy identified. Subjects included in the search were high-risk groups. Eligible articles were limited to research from Canada, USA, the UK, Australia and New Zealand.

The search identified nineteen peer-reviewed and thirty grey literature sources. Fifteen identified food literacy attributes were organized into five categories. Food and Nutrition Knowledge informs decisions about intake and distinguishing between ‘healthy’ and ‘unhealthy’ foods. Food Skills focuses on techniques of food purchasing, preparation, handling and storage. Self-Efficacy and Confidence represent one’s capacity to perform successfully in specific situations. Ecologic refers to beyond self and the interaction of macro- and microsystems with food decisions and behaviours. Food Decisions reflects the application of knowledge, information and skills to make food choices. These interdependent attributes are depicted in a proposed conceptual model.

The lack of evaluated tools inhibits the ability to assess and monitor food literacy; tailor, target and evaluate programmes; identify gaps in programming; engage in advocacy; and allocate resources. The present scoping review provides the foundation for the development of a food literacy measurement tool to address these gaps.