Fe is an essential element for erythropoiesis and Hb synthesis. High Hb levels affect the blood’s viscosity and are associated with cardiovascular dysfunction. The aim of the present study was to examine relationships of Hb and cardiometabolic abnormalities with the risk of alanine aminotransferase (ALT) elevation in adolescents.

A population-based, cross-sectional study.

National Nutrition and Health Survey in Taiwan (2010–2011, adolescents).

Healthy adolescents aged 13–18 years.

In total, 1941 adolescents (963 boys and 978 girls) were entered in the study. The mean age was 15·3 (sd 0·1) years (boys, 15·3 (sd 0·1) years; girls, 15·2 (sd 0·1) years). ALT tertile cut-off points for boys were 11 and 16 U/l, and for girls were 9 and 12 U/l. Girls without dyslipidaemia and presenting in the highest quartile (Q1) of Hb (>13·6 g/dl) were 1·89 and 3·76 times more likely to have raised serum ALT (9 and >12 U/l, respectively) than the reference (lowest quartile of Hb (Q1), <12·4 g/dl). Moreover, for those girls with dyslipidaemia, serum ALT seemed to increase with an increase in Hb levels. Specifically, girls with dyslipidaemia and Hb levels of 12·4, 13·1 and 13·6 g/dl were, respectively, 2·86, 3·53 and 5·64 times more likely to have elevated serum ALT levels (>12 U/l) than the reference (Q1 of Hb, <12·4 g/dl). The only effect found in boys was for those who had dyslipidaemia and presenting in Q4 of Hb (>15·4 g/dl), who were 7·40 times more likely to have elevated serum ALT of >16 U/l than the reference (Q1 of Hb, <14·1 g/dl).

Our findings suggest that an increased Hb level is a predictor of elevated serum ALT in adolescent girls with dyslipidaemia. Our study also highlights the importance of further research to establish cut-off points for Hb and its utility in diagnosing and preventing the onset of dyslipidaemia in adolescents.

To elucidate the factors influencing food intake and preferences for potential nutritional supplements to treat mild and moderate malnutrition among adult people living with HIV (PLHIV).

Qualitative research using in-depth interviews with a triangulation of participants and an iterative approach to data collection.

The study was conducted in a health clinic of rural Chilomoni, a southern town of Blantyre district, Malawi.

Male and female participants, aged 18–49 years (n 24), affected by HIV; health surveillance assistants of Chilomoni clinic (n 8).

Six themes emerged from the in-depth interviews: (i) PLHIV perceived having a poor-quality diet; (ii) health challenges determine the preferences of PLHIV for food; (iii) liquid–thick, soft textures and subtle natural colours and flavours are preferred; (iv) preferred organoleptic characteristics of nutritional supplements resemble those of local foods; (v) food insecurity may contribute to intra-household sharing of nutritional supplements; and (vi) health surveillance assistants and family members influence PLHIV’s dietary behaviours. No differences by sex were found. The emergent themes were corroborated by health surveillance assistants through participant triangulation.

In this setting, a thickened liquid supplement, slightly sweet and sour, may be well accepted. A combination of quantitative and qualitative methods for data collection should follow to further develop the nutritional supplement and to fine tune the organoleptic characteristics of the product to the taste and requirements of PLHIV. Results of the present study provide a first approach to elucidate the factors influencing food intake and preferences for potential nutritional supplements among adult PLHIV.

To examine temporal trends and determinants of discretionary salt use in the USA.

Multiple logistic regression was used to assess temporal trends in discretionary salt use at the table and during home cooking/preparation, adjusting for demographic characteristics, using data from the National Health and Nutrition Examination Survey 2003–2012. Prevalence and determinants of discretionary salt use in 2009–2012 were also examined.

Participants answered salt use questions after completing a 24 h dietary recall in a mobile examination centre.

Nationally representative sample of non-institutionalized US children and adults, aged ≥2 years.

From 2003 to 2012, the proportion of the population who reported using salt ‘very often’ declined; from 18 % to 12 % for use at the table (P<0·01) and from 42 % to 37 % during home cooking (P<0·02). While one-third of the population reported never adding salt at the table, most used it during home cooking/preparation (93 %). Use of discretionary salt was least commonly reported among young children and older adults and demographic and health subgroups at risk of CVD.

While most people reported using salt during home cooking/preparation, a minority reported use at the table. Reported ‘very often’ discretionary salt use has declined. That discretionary salt use is less common among those at risk of CVD suggests awareness of messages to limit Na intake.

To investigate the reciprocal relationship between unhealthy eating behaviours and depressive symptoms from childhood to adolescence.

Unhealthy eating behaviours were measured by the frequencies of eating foods with excess salt, sugar or fat in the past week. Depressive symptoms in the past two weeks were measured using a seven-item scale. Hierarchical linear growth models were used to analyse longitudinal associations between unhealthy eating behaviours and depressive symptoms. Time-fixed variables (sex, parents’ education level and household monthly income) and time-varying variables (parents’ marital status, family activities, body weight, vegetable or fruit consumption, exercising and smoking) were controlled for.

The Child and Adolescent Behaviors in Long-Term Evolution study, which commenced in 2001 and has annual follow-up.

Students (n 2630) followed from 2nd grade (8 years old in 2002) to 11th grade.

The frequency of unhealthy eating behaviours in the previous year and the difference between the frequency in the previous and successive year were positively associated with the initiation and growth rate of depressive symptoms. Depressive symptoms in the previous year and the difference in depressive symptoms between the previous and successive year were positively associated with the initial state and growth rate of unhealthy eating behaviours.

Our results suggest a reciprocal relationship between depressive symptoms and unhealthy eating behaviours. This relationship should be considered when developing programmes targeting depressive symptoms and unhealthy diet in children and adolescents.

Undernutrition is prevalent among pregnant women in Cambodia. The provision of fortified dietary supplements is one strategy to help pregnant women meet their nutritional needs. Corn Soya Blend Plus (CSBP) is a widely used prenatal dietary supplement in areas with high rates of undernutrition and food insecurity. However, little is known about its acceptability during pregnancy. The present study aimed to identify factors that affected the acceptability and consumption of CSBP supplements among pregnant women.

Women completed a structured interview designed to provide information on facilitators of and barriers to utilization. In addition, six focus groups were conducted with a subset of women (n 70) to further explore attitudes, perceptions and experiences related to CSBP use.

Two districts in Kampong Chhnang Province, Cambodia.

Pregnant women (n 288) participating in a cluster-randomized trial of CSBP.

The acceptability of CSBP was influenced by sensory attributes, family support, peer influences, and attitudes related to diet, nutritional status and weight gain in pregnancy. Attaining adequate nutrition was considered less important than other concerns during pregnancy, particularly anxiety related to the costs of delivery and postpartum care. Acceptance was lower among new mothers due to fears of weight gain. Health benefits were common reasons for continued use and minor side-effects, such as nausea, were not major barriers to consumption.

CSBP was generally well accepted in this population. However, organoleptic factors and perceptions regarding nutrition and weight gain in pregnancy, particularly for first-time mothers, were barriers to increasing acceptance among Cambodian women.

Vitamin D plays a major role in Ca and bone metabolism, and its extraskeletal functions are being appraised. Although inadequate vitamin D concentrations have been reported in populations worldwide, too little is known about vitamin D status and its determinants among children in developing countries. We aimed to determine vitamin D status and its determinants in Nepalese children of pre-school age.

A community-based, cross-sectional study.

Rural Nepal at latitude 27·39°N.

Healthy children (n 280) aged 12–60 months, selected randomly from the records of a vitamin A supplementation programme. Blood samples were collected using the dried blood spot technique and analysed for serum 25-hydroxyvitamin D (s-25(OH)D) concentration using liquid chromatography–tandem mass spectrometry. Ca intake and background variables were assessed with a structured questionnaire.

Hypovitaminosis D, defined as s-25(OH)D concentration less than 50 nmol/l, was found in 91·1 % of the children. S-25(OH)D concentration was not related to gender, socio-economic indicators, sun exposure or nutritional status. Currently breast-fed children had higher s-25(OH)D concentrations (36·4 (sd 13·2) nmol/l) than those who were not (28·6 (sd 9·8) nmol/l, P<0·001). Adjustment for sociodemographic factors did not alter the results.

There is widespread vitamin D deficiency among pre-school children in a rural area of Nepal. In our sample, sociodemographic factors did not affect the vitamin D status of children, but prolonged breast-feeding was associated with higher s-25(OH)D concentrations. Further research is required to investigate the health consequences of poor vitamin D status for this population.

To examine and quantify the potential dose–response relationship between red and processed meat consumption and risk of all-cause, cardiovascular and cancer mortality.

We searched MEDLINE, Embase, ISI Web of Knowledge, CINHAL, Scopus, the Cochrane library and reference lists of retrieved articles up to 30 November 2014 without language restrictions. We retrieved prospective cohort studies that reported risk estimates for all-cause, cardiovascular and cancer mortality by red and/or processed meat intake levels. The dose–response relationships were estimated using data from red and processed meat intake categories in each study. Random-effects models were used to calculate pooled relative risks and 95 % confidence intervals and to incorporate between-study variations.

Nine articles with seventeen prospective cohorts were eligible in this meta-analysis, including a total of 150 328 deaths. There was evidence of a non-linear association between processed meat consumption and risk of all-cause and cardiovascular mortality, but not for cancer mortality. For processed meat, the pooled relative risk with an increase of one serving per day was 1·15 (95 % CI 1·11, 1·19) for all-cause mortality (five studies; P<0·001 for linear trend), 1·15 (95 % CI 1·07, 1·24) for cardiovascular mortality (six studies; P<0·001) and 1·08 (95 % CI 1·06, 1·11) for cancer mortality (five studies; P<0·001). Similar associations were found with total meat intake. The association between unprocessed red meat consumption and mortality risk was found in the US populations, but not in European or Asian populations.

The present meta-analysis indicates that higher consumption of total red meat and processed meat is associated with an increased risk of total, cardiovascular and cancer mortality.

The objective of the present study was to examine the relationship between plasma alkyresorcinol (AR) concentrations, which are biomarkers of whole-grain intake, and atherosclerotic progression over 3 years in postmenopausal women with coronary artery disease.

Plasma AR concentrations were measured by a validated GC–MS method in fasting plasma samples. Atherosclerosis progression was assessed using change in mean minimal coronary artery diameter (MCAD) and percentage diameter stenosis (%ST), based on mean proximal vessel diameter across up to ten coronary segments. Dietary intake was estimated using a 126-item interviewer-administered FFQ.

A prospective study of postmenopausal women participating in the Estrogen Replacement and Atherosclerosis trial.

For the analysis of plasma AR concentrations and atherosclerotic progression, plasma samples and follow-up data on angiography were available for 182 women.

Mean whole-grain intake was 9·6 (se 0·6) servings per week. After multivariate adjustment, no significant associations were observed between plasma AR concentrations and change in mean MCAD or progression of %ST. Plasma AR concentrations were significantly correlated with dietary whole grains (r=0·35, P<0·001), cereal fibre (r=0·33, P<0·001), bran (r=0·15, P=0·05), total fibre (r=0·22, P=0·003) and legume fibre (r=0·15, P=0·04), but not refined grains, fruit fibre or vegetable fibre.

Plasma AR concentrations were not significantly associated with coronary artery progression over a 3-year period in postmenopausal women with coronary artery disease. A moderate association was observed between plasma AR concentrations and dietary whole grains and cereal fibre, suggesting it may be a useful biomarker in observational studies.

To describe adolescents’ eating patterns of traditional, global/non-local and mixed foods, and the factors that may influence food consumption, access and preferences, in a globalizing city.

A representative sample of school-going adolescents completed a cross-sectional survey including an FFQ designed to identify traditional and global foods. Student’s t test and ordinal logistic regression were used to examine weekly food intake, including differences between boys and girls and between adolescents attending private and public schools.

Vijayapura city, Karnataka State, India.

Adolescents (n 399) aged 13–16 years.

Compared with dietary guidelines, adolescents consumed fruit, green leafy vegetables, non-green leafy vegetables and dairy less frequently than recommended and consumed energy-dense foods more frequently than recommended. Traditional but expensive foods (fruits, dairy, homemade sweets and added fat) were more frequently consumed by private-school students, generally from wealthier, more connected families, than by public-school students; the latter more frequently consumed both traditional (tea, coffee, eggs) and mixed foods (snack and street foods; P≤0·05). Girls reported more frequent consumption of global/non-local packaged and ready-to-eat foods, non-green leafy vegetables and added fat than boys (P≤0·05). Boys reported more frequent consumption of eggs and street foods than girls (P≤0·05).

Adolescents’ eating patterns in a globalizing city reflect a combination of global/non-local and traditional foods, access and preferences. As global foods continue to appear in low- and middle-income countries, understanding dietary patterns and preferences can inform efforts to promote diversity and healthfulness of foods.

Conflicting results on the association between fruit consumption and cancer risk have been reported. Little is known about the cancer preventive effects of different fruit types. The present meta-analysis investigates whether an association exists between apple intake and cancer risk.

Relevant observational studies were identified by literature search (PubMed, Web of Science and Embase). A random-effect model was used to estimate the cancer risk in different anatomical sites. Between-study heterogeneity and publication bias were assessed using adequate statistical tests.

Twenty case–control (three on lung, five on colorectal, five on breast, two on oesophageal, three on oral cavity, two on prostate and one each on pancreas, bladder, larynx, ovary, kidney and brain cancer) and twenty-one cohort (seven on lung, two on colorectal, three on breast and one each on oesophageal, pancreas, bladder, kidney, endometrial, head–neck, urothelial and stomach cancer) studies met the inclusion criteria. Comparing the highest v. lowest level of apple consumption, the reduction of lung cancer risk was statistically highly significant in both case–control (OR=0·75; 95% CI 0·63, 0·88; P=0·001, I2=0 %) and cohort studies (relative risk=0·89; 95% CI 0·84, 0·94; P<0·001, I2=53 %). Instead, in the case of colorectal (OR=0·66; 95% CI 0·54, 0·81; P<0·001, I2=55%), breast (OR=0·79; 95% CI 0·73, 0·87; P<0·001, I2=1 %) and overall digestive tract (OR=0·50; 95% CI 0·36, 0·69; P<0·001, I2=90 %) cancers a significant preventive effect of apples was found only in case–control studies while prospective studies indicated no effect. No evidence of publication bias could be detected for colorectal, oral cavity, oesophageal and breast cancer. However, some confounding effects may be present and related to the consumption of other fruit which have not been considered as adjusting factors.

The present meta-analysis indicates that consumption of apples is associated with a reduced risk of cancer in different anatomical sites.

Consumers may choose soya foods as healthful alternatives to animal products, but concern has arisen that eating large amounts of soya may adversely affect thyroid function. The present study aimed to examine the association between soya food consumption and serum thyroid-stimulating hormone (TSH) concentrations in North American churchgoers belonging to the Seventh-day Adventist denomination that encourages vegetarianism.

Participants completed six repeated 24 h dietary recalls within a 6-month period. Soya protein and soya isoflavone intakes were estimated, and their relationships to TSH concentrations measured at the end of 6 months were calculated using logistic regression analyses.

Calibration sub-study of the Adventist Health Study-2.

Women (n 548) and men (n 295) who were not taking thyroid medications.

In men, age and urinary iodine concentrations were associated with high serum TSH concentrations (>5 mIU/l), while among women White ethnicity was associated with high TSH. In multivariate models adjusted for age, ethnicity and urinary iodine, soya isoflavone and protein intakes were not associated with high TSH in men. In women higher soya isoflavone consumption was associated with higher TSH, with an adjusted odds ratio (highest v. lowest quintile) of 4·17 (95 % CI 1·73, 10·06). Likewise, women with high consumption of soya protein (midpoint of highest quintile, 11 g/d) v. low consumption (midpoint of lowest quintile, 0 g/d) carried increased odds of high TSH (OR=2·69; 95 % CI 1·34, 5·30).

In women high consumption of soya was associated with elevated TSH concentrations. No associations between soya intake and TSH were found in men.

To investigate the potential influence of dietary Se intake on mortality among Chinese populations.

We prospectively evaluated all-cause, CVD and cancer mortality risks associated with dietary Se intake in participants of the Shanghai Women’s Health Study (SWHS) and the Shanghai Men’s Health study (SMHS). Dietary Se intake was assessed by validated FFQ during in-person interviews. Cox proportional hazards models were used to calculate hazard ratios (HR) and 95 % CI.

Urban city in China.

Chinese adults (n 133 957).

During an average follow-up of 13·90 years in the SWHS and 8·37 years in the SMHS, 5749 women and 4217 men died. The mean estimated dietary Se intake was 45·48 μg/d for women and 51·34 μg/d for men, respectively. Dietary Se intake was inversely associated with all-cause mortality and CVD mortality in both women and men, with respective HR for the highest compared with the lowest quintile being 0·79 (95 % CI 0·71, 0·88; Ptrend<0·0001) and 0·80 (95 % CI 0·66, 0·98; Ptrend=0·0268) for women, and 0·79 (95 % CI 0·70, 0·89; Ptrend=0·0001) and 0·66 (95 % CI 0·54, 0·82; Ptrend=0·0002) for men. No significant associations were observed for cancer mortality in both women and men. Results were similar in subgroup and sensitivity analyses.

Dietary Se intake was inversely associated with all-cause and cardiovascular mortality in both sexes, but not cancer mortality.

To examine the association of 24 h urinary Na excretion and Na:K with obesity in Chinese adults.

Population-based cross-sectional study using a four-stage stratified sampling strategy.

Shandong Province, China.

Chinese adults (n 1906) aged 18–69 years who provided complete 24 h urine samples.

Odds of obesity increased significantly across increasing quartiles of urinary Na excretion (1·00, 1·54, 1·69 and 2·52, respectively, for overweight; 1·00, 1·20, 1·50, and 2·03, respectively, for obesity; 1·00, 1·44, 1·85 and 2·53, respectively, for abdominal obesity (assessed by waist circumference); and 1·00, 1·28, 1·44 and 1·75, respectively, for abdominal obesity (assessed by waist-to-height ratio); P for linear trend <0·001 for all). In addition, odds of abdominal obesity, but not odds of overweight and obesity, increased significantly with successive Na:K quartiles. Additionally, for each increment in urinary Na excretion of 100 mmol, odds of overweight, obesity, abdominal obesity (by waist circumference) and abdominal obesity (by waist-to-height ratio) increased significantly by 46 %, 39 %, 55 % and 33 %, respectively. Similarly, with a 1 sd increase in Na:K, odds of abdominal obesity (by waist circumference) and abdominal obesity (by waist-to-height ratio) increased significantly by 12 % and 15 %, respectively.

These findings suggest that 24 h urinary Na excretion and Na:K might be important risk factors for obesity in Chinese adults.

To elucidate the association between the intake of soft drinks and periodontal disease (PD) among Taiwanese middle-aged adults.

The cross-sectional design was employed to assess a dose–response relationship between the intake of soft drinks and PD after controlling for relevant confounding factors, with adjusted odds ratios obtained from a multivariate logistic regression model.

Keelung Community-based Integrated Screening (KCIS) programme, Keelung, Taiwan.

Participants (n 10 213) aged 35–44 years who had undergone oral checks for PD between 2005 and 2009.

A dose–response relationship between the intake of soft drinks and elevated risk for PD defined by community periodontal index ≥3 (the current status of PD) was noted (P=0·02 by trend test). Compared with infrequent intake of soft drinks (≤2 times/week), the adjusted OR increased from 1·05 (95 % CI 0·92, 1·20) for the frequency of 3–4 times/week to 1·17 (95 % CI 1·03, 1·34) for the frequency of ≥5 times/week. A similar trend (P<0·01) was also observed for PD defined by loss of attachment ≥1 (representing the long-term cumulative gum damage due to PD).

A dose–response relationship between the intake frequency of soft drinks and PD was observed in Taiwanese middle-aged adults. Such evidence could be used in health promotion to support reductions in soft drink intake.

Epidemiological studies have examined associations between dietary patterns and the risk of type 2 diabetes. However, information on dietary patterns and the risk of type 2 diabetes in Chinese populations is scarce. The aim of the present study was to identify dietary patterns and examine their association with incident hyperglycaemia in Nanjing, China.

A community-based prospective cohort study. Dietary assessment was carried out using a validated eighty-seven-item FFQ. Dietary patterns were identified by exploratory factor analysis. Participants were categorized into tertiles of dietary factor score for each dietary pattern. The relationship between dietary patterns and hyperglycaemia risk was analysed using multivariable linear and Cox regression.

Seven communities from two urban districts in Nanjing, China.

A total of 2900 of Chinese local residents aged 30 years or above, free of hyperglycaemia and other serious diseases, who participated in the baseline survey from June to September 2007 were followed up 3 years later from June to September 2010 for the development of hyperglycaemia. Fasting blood samples were collected at both baseline and 3-year follow-up surveys. Hyperglycaemia was defined as fasting plasma glucose concentration of ≥6·1 mmol/l or already taking oral hyperglycaemia agents for treatment of type 2 diabetes.

Five major dietary patterns were identified: (i) the ‘condiments’ pattern; (ii) the ‘animal and plant protein’ pattern; (iii) the ‘healthy traditional’ pattern; (iv) the ‘fruits, eggs and juice’ pattern; and (v) the ‘alcohol, milk and tea’ pattern. A total of 2093 (72·2 %) individuals completed the follow-up survey and the 3-year cumulative incidence of hyperglycaemia was 7·5 % (158/2093). A 1-unit increase in the score for the ‘healthy traditional’ pattern was associated with a decrease of 0·054 mmol/l in fasting plasma glucose (P=0·017), while a 1-unit increase in the ‘fruits, eggs and juice’ pattern score was associated with an increase of 0·050 mmol/l in fasting plasma glucose (P=0·023) by multivariable linear regression. For men, tertile 3 of the ‘fruits, eggs and juice’ pattern was associated with an 88 % greater risk (hazard ratio=1·88; 95 % CI 1·04, 3·54) of hyperglycaemia than tertile 1 of this pattern. Being in tertile 3 of the ‘alcohol, milk and tea’ pattern was associated with a 35 % greater risk (hazard ratio=1·35; 95 % CI 1·04, 2·16) relative to tertile 1 in women, while for the ‘'healthy traditional’ pattern tertile 3 was associated with a 41 % lower risk (hazard ratio=0·59; 95 % CI 0·35, 0·99) compared with tertile 1. The ‘condiments’ and the ‘animal and plant protein’ patterns were not independently associated with hyperglycaemia.

Our findings suggest that modifying dietary patterns could reduce hyperglycaemia incidence in the mainland Chinese adult population.

Over 300 million people rely on desalinated seawater and the numbers are growing. Desalination removes iodine from water and could increase the risk of iodine-deficiency disorders (IDD). The present study assessed the relationship between iodine intake and thyroid function in an area reliant on desalination.

A case–control study was performed between March 2012 and March 2014. Thyroid function was rigorously assessed by clinical examination, ultrasound and blood tests, including serum thyroglobulin (Tg) and autoimmune antibodies. Iodine intake and the contribution made by unfiltered tap water were estimated by FFQ. The contribution of drinking-water to iodine intake was modelled using three iodine concentrations: likely, worst-case and best-case scenario.

The setting for the study was a hospital located on the southern Israeli Mediterranean coast.

Adult volunteers (n 102), 21–80 years old, prospectively recruited.

After screening, seventy-four participants met the inclusion criteria. Thirty-seven were euthyroid controls. Among those with thyroid dysfunction, twenty-nine were classified with non-autoimmune thyroid disease (NATD) after excluding eight cases with autoimmunity. Seventy per cent of all participants had iodine intake below the Estimated Average Requirement (EAR) of 95 µg/d. Participants with NATD were significantly more likely to have probable IDD with intake below the EAR (OR=5·2; 95 % CI 1·8, 15·2) and abnormal serum Tg>40 ng/ml (OR=5·8; 95 % CI 1·6, 20·8).

Evidence of prevalent probable IDD in a population reliant on desalinated seawater supports the urgent need to probe the impact of desalinated water on thyroid health in Israel and elsewhere.

We estimated the prevalence of food insecurity among people who inject drugs (PWID) in Los Angeles and San Francisco and explored correlates of food insecurity.

A cross-sectional study that measured 30 d food insecurity using the US Adult Food Security Survey ten-item Module developed by the US Department of Agriculture. Food insecurity was defined as including low and very low food security.

Two cities in the state of California, USA.

Male and female active PWID (n 777).

Among participants, 58 % reported food insecurity and 41 % reported very low food security. Food-insecure PWID were more likely to report being homeless (prevalence ratio (PR)=1·20; 95 % CI 1·05, 1·37), chest pain in the past 12 months (PR=1·19; CI 1·06, 1·35), acquiring syringes from someone who goes to a syringe exchange programme (PR=1·27; 95 % CI 1·13, 1·43) and feeling at risk for arrest for possession of drug paraphernalia (PR=1·30; 95 % CI 1·15, 1·46).

Current food insecurity was common among PWID in these two cities, yet few factors were independently associated with food insecurity. These data suggest that broad strategies to improve food access for this high-risk population are urgently needed.

‘DASH for Asthma’ (n 90) was a 6-month randomized controlled trial that demonstrated potential benefits of a DASH (Dietary Approaches to Stop Hypertension) behavioural intervention for improving diet quality and asthma control by comparing intervention to usual care in adults with uncontrolled asthma. The present study examined acceptability and feasibility of the intervention from the perspective of intervention participants and lifestyle coaches.

Grounded in Social Cognitive Theory, the 3-month intensive stage, including three individual and eight group sessions, focused on diet modifications and behavioural self-regulation. The 3-month maintenance stage contained telephone consultations. Participants and lifestyle coaches completed surveys including 5-point Likert scales and open-ended questions. We analysed data using descriptive and inductive content analyses.

Forty-six intervention participants (survey response rate was 65–72 %) and two lifestyle coaches.

Participants and lifestyle coaches were highly satisfied (all mean ratings >4) with individual and group sessions. Participants identified mastery of knowledge and skills (awareness, goal setting, self-monitoring, problem solving), social learning (class members sharing experiences and ideas) and good coaching skills (reflective listening, empathy, motivational counselling) as important contributors to self-efficacy and programme satisfaction. Participants also valued personalized feedback received in individual sessions. Lifestyle coaches viewed participant engagement as a facilitator to effective sessions. Finally, participants and lifestyle coaches identified food tasting as beneficial for observational learning and facilitation of participant engagement. High class attendance and self-monitoring rate also reflected the high engagement among participants.

The DASH behavioural intervention was feasible and highly acceptable to participants with uncontrolled asthma and lifestyle coaches.

To examine breast-feeding and complementary feeding practices during the first 6 months of life among Norwegian infants of Somali and Iraqi family origin.

A cross-sectional survey was performed during March 2013–February 2014. Data were collected using a semi-quantitative FFQ adapted from the second Norwegian national dietary survey among infants in 2006–2007.

Somali-born and Iraqi-born mothers living in eastern Norway were invited to participate.

One hundred and seven mothers/infants of Somali origin and eighty mothers/infants of Iraqi origin participated.

Breast-feeding was almost universally initiated after birth. Only 7 % of Norwegian-Somali and 10 % of Norwegian-Iraqi infants were exclusively breast-fed at 4 months of age. By 1 month of age, water had been introduced to 30 % of Norwegian-Somali and 26 % of Norwegian-Iraqi infants, and infant formula to 44 % and 34 %, respectively. Fifty-four per cent of Norwegian-Somali and 68 % of Norwegian-Iraqi infants had been introduced to solid or semi-solid foods at 4 months of age. Breast-feeding at 6 months of age was more common among Norwegian-Somali infants (79 %) compared with Norwegian-Iraqi infants (58 %; P=0·001). Multivariate analyses indicated no significant factors associated with exclusive breast-feeding at 3·5 months of age. Factors positively associated with breast-feeding at 6 months were country of origin (Somalia) and parity (>2).

Breast-feeding initiation was common among Iraqi-born and Somali-born mothers, but the exclusive breast-feeding period was shorter than recommended in both groups. The study suggests that there is a need for new culture-specific approaches to support exclusive breast-feeding and complementary feeding practices among foreign-born mothers living in Norway.