To assess the more prevalent beliefs about body weight and the factors involved in weight changes in the Spanish adult population.

A national survey was carried out according to an established protocol on Spanish subjects selected by a multistage procedure following a random route model, which was quota-controlled for several sociodemographic variables. This study was undertaken by the Spanish arm of a pan-European survey and was performed with a validated questionnaire. It contained questions to evaluate some aspects concerning the relationship between obesity, physical activity and health. We also estimated the proportion of self-reported overweight and obesity.

Spain.

The sample included 1000 subjects aged 15 years or older.

Eleven per cent of the sample were obese (body mass index, BMI > 30 kg m-2) and an additional 32% were overweight (BMI > 25 and < 30 kg m-2). Obesity prevalence was higher among older individuals, those with lower education and socioeconomic levels, and among housewives and retired or unemployed people. Most Spanish people believed that fat intake (51%) and the amount of food consumption (44%) were the major factors involved in weight gain, while physical activity was less mentioned (12%). The method most frequently used to lose weight was diet (9%). Individuals from central and southern regions payed more attention to genetics (20–27%) and physical activity (12–20%) as determinants of weight gain than people living in the north or northwest regions (15–17% and 8–9%, respectively). Normal weight people participated more often in some physical activity during their leisure time.

The Spanish population is not familiar with factors influencing weight gain. Health promotion strategies should emphasize the role of physical activity, especially among older individuals, retired or unemployed subjects, those from lower educational or socioeconomic levels and among people living in the north or northwest of Spain.

Diet validation research was conducted to compare the respondents' reporting of dietary intake in a food frequency questionnaire (FFQ) with intake reported in food recalls. Because the population received annual salary increments that could modify food intake, diet validation studies (DVSs) were conducted during two time intervals.

A 99-item FFQ was administered by an interviewer twice in a 1-year interval, and responses to each FFQ item were compared with 28 days of interviewer-administered food recalls that were collected in four 1-week intervals during each season of 1992/93. The second validation study in 1995/96 had a similar design to the earlier one.

A prospective cohort study of lung cancer among tin miners in China was initiated in 1992, with dietary and other risk factors updated annually.

Among a cohort of high risk tin miners for lung cancer, two different samples (n = 141 in 1992/93, and n = 113 in 1995/96) for each diet validation study were randomly selected from four mine units, that were representative of all worker units.

Miners reported a significantly higher average frequency of intake of foods in the food recalls than the FFQ, with few exceptions. Deattenuated Pearson correlation coefficients of the frequency of food intake between the FFQ and food recalls were in the range of –0.40 to 0.72 in both studies, with higher positive correlations for beverages and cereal staples than for animal protein sources, vegetables, fruits and legumes. The percentage of individuals with exact agreement in the extreme quartiles of intake in the food recalls and FFQ ranged from 0 to 100% in both studies.

Among Chinese miners, the range in correlations between the food recalls and the FFQ were due to: (i) market availability of foods during the food recall weeks compared to their annual reported intake in the FFQ; (ii) cultural perception of time; and (iii) differences in how the intake of mixed dishes and their multi-ingredient foods were reported in the recalls vs. the FFQ. The range in the percentage of agreement in the same quartiles and the changes in food intake over time may have implications for the analysis of the diet-disease relationship in this cohort.

This study sought to evaluate the benefit of utilizing a nutritionist review of a self-administered food frequency questionnaire (FFQ), to determine whether accuracy could be improved beyond that produced by the self-administered questionnaire alone.

Participants randomized into a dietary intervention trial completed both a FFQ and a 4-day food record (FR) at baseline before entry into the intervention. The FFQ was self-administered, photocopied and then reviewed by a nutritionist who used additional probes to help complete the questionnaire. Both the versions – before nutritionist review and after nutritionist review – were individually compared on specific nutrients to the FR by means, correlations and per cent agreement into quintiles.

Three hundred and twenty-four people, a subset of participants from the Polyp Prevention Trial – a randomized controlled trial examining the effect of a low-fat, high-fibre, high fruit and vegetable dietary pattern on the recurrence of adenomatous polyps – were recruited from clinical centres at the University of Utah, University of Buffalo, Memorial Sloan Kettering Cancer Center in New York and Kaiser Permanente Medical Program in Oakland.

Reviewing the FFQ increased correlations with the FR for every nutrient, and per cent agreement into quintiles for all nutrients except calcium. Energy was underestimated in both versions of the FFQ but to a lesser degree in the version with review.

One must further evaluate whether the increases seen with nutritionist review of the FFQ will enhance our ability to predict diet–disease relationships and whether it is cost-effective when participant burden and money spent utilizing trained personnel are considered.

To assess the ability of a food frequency questionnaire (FFQ1) and a food checklist (FCL) to determine energy and macronutrient intakes of adolescent girls in the general population.

Energy and macronutrient intakes determined by FFQ1 and the FCL were compared with those from a 7-day weighed dietary record (WDR). The reproducibility of FFQ1 was assessed by a comparison of intakes with those from a repeated questionnaire (FFQ2) completed a month later.

Southampton, UK.

Forty-seven 15-year-old girls completed FFQ1 and the WDR and FCL; and 61 girls completed FFQ1 and FFQ2.

The broad dietary patterns described by the three methods of assessment were similar, although absolute intakes differed. Energy and macronutrient intakes determined by FFQ1 were higher than those recorded in the WDR (all P < 0.001), but intakes assessed by the FCL and WDR were similar. Only FFQ1-assessed energy intakes appeared consistent with predicted energy requirements. With the exception of protein intake, there was reasonable agreement between FFQ1 and the WDR in their estimation of energy and macronutrient intake (range of correlation coefficients 0.28 for energy to 0.33 for carbohydrate). The poorer agreement between FFQ1 and the WDR in their estimates of protein intake arose principally from the misclassification of meat and fish intake, although there was no obvious explanation for this. Energy and macronutrient intakes were similar for FFQ1 and FFQ2.

Adolescent girls give reproducible answers in response to a self-administered FFQ, which yield useful information about their broad dietary patterns. The FFQ may be a more suitable dietary assessment method than prospective records for use in general population studies of girls of this age. We discuss suggestions for its improved performance.

A novel system for nutrient analysis has been developed and tested over 5 years. Its key features are a nutrient database of 600 commonly eaten foods (95% of foods eaten in 7-day surveys); a booklet identifying each food with a bar code, bar codes for gram weight and for portion sizes (small, medium, large) and a bar-code reader with dietary analysis software for PCs. In the present study the bar-code system has been evaluated by comparison with a commonly used manual entry nutrient analysis software for dietitians' use.

Cross-sectional.

Glasgow city district.

One hundred and sixty adults aged 18–65 years old.

Comparing mean intakes for macro- and micronutrients, using the Bland and Altman method1, the bias between the two methods was small, ranging from 0.93 to 1.03. The bar-code system took significantly less professional time in data entry and nutrient analysis than the widely used manual system (29 min per 7-day diary vs. 47 min per 7-day diary, P < 0.001).

It is suggested that the bar-code system offers greater speed with a saving of professional time needed for nutrient analysis of dietary surveys. This system is commended for maintaining accuracy while promoting economy.

To develop a method to make use of incomplete 24-hour urinary samples in nutritional epidemiology, especially when validating the dietary intake of nitrogen (protein), sodium and potassium.

Urinary data for men and women collected in three different studies were evaluated. The concentration of para-aminobenzoic acid (PABA) in one 24-hour urine sample per person was compared with the concentrations of nitrogen, sodium, potassium and creatinine.

Men and women living in Cambridge, UK and women living in the town of Varberg, Sweden.

In total, this study consists of data from 73 Swedish women (20–50 years of age), 165 UK women (50–65 years) and 75 UK men (55–88 years).

On average four out of 10 people in this study had a PABA recovery below 85%. The linear regression equations for urinary excretion of nitrogen, sodium and potassium in relation to PABA recovery were y = 2.3 + 0.088 * x (r = 0.99), y = 45 + 0.82 * x (r = 0.87) and y = 19 + 0.60 * x (r = 0.93), respectively.

The linear regression equations can be used for adjusting urinary nitrogen, sodium and potassium in urinary collections in cases where the PABA recovery is below 85%. Since it is common to obtain 24-hour urine collections with a PABA recovery below 85%, this method should increase the usefulness of biological markers of food intake in nutritional epidemiological studies and also increase the possibilities to study people that previously have been part of the drop-out group or the group with low motivation and cooperation. It is important to stress that we have not studied the relationship between PABA recovery and various urinary variables below the PABA recovery of 50%. Thus, in a case of PABA recovery below 50%, we do not recommend the use of this method to compensate for incomplete collections.

The case for exercise and health has primarily been made on its impact on diseases such coronary heart disease, obesity and diabetes. However, there is a very high cost attributed to mental disorders and illness and in the last 15 years there has been increasing research into the role of exercise a) in the treatment of mental health, and b) in improving mental well-being in the general population. There are now several hundred studies and over 30 narrative or meta-analytic reviews of research in this field. These have summarised the potential for exercise as a therapy for clinical or subclinical depression or anxiety, and the use of physical activity as a means of upgrading life quality through enhanced self-esteem, improved mood states, reduced state and trait anxiety, resilience to stress, or improved sleep. The purpose of this paper is to a) provide an updated view of this literature within the context of public health promotion and b) investigate evidence for physical activity and dietary interactions affecting mental well-being.

Narrative review and summary.

Sufficient evidence now exists for the effectiveness of exercise in the treatment of clinical depression. Additionally, exercise has a moderate reducing effect on state and trait anxiety and can improve physical self-perceptions and in some cases global self-esteem. Also there is now good evidence that aerobic and resistance exercise enhances mood states, and weaker evidence that exercise can improve cognitive function (primarily assessed by reaction time) in older adults. Conversely, there is little evidence to suggest that exercise addiction is identifiable in no more than a very small percentage of exercisers. Together, this body of research suggests that moderate regular exercise should be considered as a viable means of treating depression and anxiety and improving mental well-being in the general public.

Anthropometrical, biological and lifestyle parameters, and age 27 also bone mineral density (BMD) of the lumbar spine (L2–L4), were measured repeatedly. Adolescent dietary intake and physical activity was related to adult cardiovascular and bone health status indicators by MLR; longitudinal relationships between physical activity and dietary intake, and cardiovascular health status indicators were assessed by GEE-analysis.

Adolescent physical activity was not related to most of the indicators of adult cardiovascular health status, with the exception of a positive relationship with the waist-to-hip in females; in males ‘energetic’ adolescent physical activity contributed significantly to adult BMD; both in males and females, when taking the entire longitudinal period into account, peak strain physical activity was a relatively more important predictor of adult BMD than ‘energetic’ physical activity; calcium intake during adolescence was not a significant predictor of bone health status measured at age 27, both in males and females; a consistent significant positive longitudinal relationship was found between physical activity and serum HDL-cholesterol and significant negative longitudinal relationships were found with the subscapular skinfold and with body fat mass; a positive longitudinal relationship was found between serum total cholesterol (TC) and cholesterol intake, saturated fat (SFA) intake and the Keys-score; a negative longitudinal relationship was found between TC and polyunsaturated fat and total energy intake; for HDL a positive longitudinal relationship was found with SFA intake; low tracking was found for physical (in-) activity and dietary intake variables.

To assess the possible associations between physical activity, diet, social state and overweight in children.

Crossectional study on 1468 children aged between 5 and 7 years old in Kiel, northwest Germany.

Assessment of physical activity and social factors by a questionnaire, food frequency record, body composition analysis by anthropometrics and bioelectrical impedance analysis.

23% of our children were overweight or obese. Low levels of physical activity (as assessed by TV viewing time) were associated with increased body mass index and a higher prevalence of overweight. TV-viewing of more than 1 h per day was associated with a high consumption fast food, sweets, chips and pizza whereas fruits and vegetables were less frequently consumed. Overweight, inactivity and unhealthy eating habits were seen more frequently in families with a low social status.

In 5 to 7 years old children, overweight is associated with physical inactivity, unhealthy eating habits and a low social status. Primary prevention efforts should be directed to low income families.

To examine the effects of a health and nutrition intervention, implemented in primary schools of Crete, on health knowledge, nutrient intakes and physical activity of the intervention population.

The intervention group consisted of 24 schools while the control group consisted of 16 schools. The overall duration of the intervention was six years, while the topics of the intervention primarily focused on children' dietary habits, physical activity and fitness.

After the completion of the intervention period, the changes observed in health knowledge, nutrient intakes and physical activity were in favour of the intervention group pupils.

The encouraging findings of the study indicate the potential of the programme in health promotion and disease prevention without involving substantial new school resources and time.