To investigate the short- and long-term effectiveness and the predictors of weight loss in a mobile phone weight-loss programme among healthy overweight adults.

One hundred and twenty-five healthy, overweight (BMI = 26–36 kg/m2), 25–44-year-old, screened volunteers were randomized to an experimental group (n 62) to use a mobile phone-operated weight-loss programme or to a control group (n 63) with no intervention. Via text messaging, the programme instructed a staggered reduction of food intake and daily weight reporting with immediate tailored feedback. Assessments were at 0, 3, 6, 9 and 12 months for the experimental group; at 0 and 12 months for the control group. Main outcome variables were changes in body weight and waist circumference.

By 12 months the experimental group had lost significantly more weight than the control group (4·5 (sd 5·0) v. 1·1 (sd 5·8) kg; F(1,80) = 8·0, P = 0·006) and had a greater reduction in waist circumference (6·3 (sd 5·3) v. 2·4 (sd 5·4) cm; F(1,80) = 55·2, P = 0·0001). Early weight loss, self-efficacy, contact frequency, attitudes towards the medium, changes in work and family life and changes made in dietary habits were the strongest predictors of weight loss.

This mobile phone weight-loss programme was effective in short- and long-term weight loss. As a minimum-advice, maximal-contact programme, it offers ideas for future weight-loss programmes.

Obesity prevalence among Chilean children is 19·4 %. The present study aimed to assess the effectiveness of a school-based obesity prevention programme.

Non-randomized controlled study. The intervention included activities in nutrition and physical activity, fully applied the first year and partially in the second one. Primary outcomes were BMI Z-score (BMIZ) and obesity prevalence; secondary outcomes were waist circumference and triceps skinfold thickness. Time effects were assessed by changes in BMI-related variables by gender and period (ANOVA and Tukey test), while intervention effects were determined by comparing changes in (i) obesity prevalence by gender and period (PROC GENMOD) and (ii) BMIZ according gender, age and period (PROC MIXED).

Primary schools in the Chilean cities of Casablanca (intervention group) and Quillota (control group).

One thousand seven hundred and fifty-nine children from three schools (intervention group) and 671 from one school (control group).

Over the two years, obesity prevalence and BMIZ declined significantly in the intervention group; from 17·0 % to 12·3 % and 14·1 % to 10·3 % in boys and girls, respectively, and from 0·62 to 0·53 and 0·64 to 0·58, respectively. In the control group, obesity remained stable at about 21 % and 15 %, while BMIZ increased significantly in the second year. BMIZ declined in both genders and all age categories in the intervention group during the first year (significant only in younger boys). No changes occurred during the summer, while during the second year, BMIZ increased in boys and girls from both groups (significant only in the younger control boys). Obesity declined significantly only in boys during the first year.

Effectiveness was greater in the first school year and more evident in younger boys.

Betel-nut use is associated with metabolic syndrome and obesity. However, the association between betel-nut chewing and risk for chronic kidney disease (CKD) is unknown. The present study was conducted to determine the association between betel-nut chewing and CKD in men.

We retrospectively reviewed health-check records of 3264 men in a hospital-based cross-sectional screening programme from 2003 to 2006. CKD was defined as estimated glomerular filtration rate less than 60 ml/min/1·73 m2 calculated by the Modification of Diet in Renal Disease formula. Risk factors for CKD including diabetes, hypertension, BMI, smoking, alcohol consumption and age were also considered.

A total of 677 (20·7 %) men were found to have CKD and 427 (13·1 %) participants reported a history of betel-nut use. The prevalence (24·8 %) of CKD in betel-nut users was significantly higher than that (11·3 %) of participants without betel-nut use (P = 0·026). In multivariate logistic regression analysis with adjustments for age, hypertension, diabetes and hyperlipidaemia, betel-nut use was independently associated with CKD (P < 0·001). The adjusted odds ratio for betel-nut use was 2·572 (95 % CI 1·917, 3·451).

Betel-nut use is associated with CKD in men. The association between betel-nut use and CKD is independent of age, BMI, smoking, alcohol consumption, hypertension, diabetes and hyperlipidaemia.

The present study examines the relationships of household food security status with Fe deficiency (ID) and Fe-deficiency anaemia (IDA) among children less than 3 years of age, and associated factors that contribute to ID and IDA.

Cross-sectional study and chart review. The US Food Security Survey Module was administered to adult caregivers as part of the Children’s Sentinel Nutrition Assessment Project (C-SNAP). Haematological data were obtained from medical records.

A large metropolitan medical centre in Minneapolis, Minnesota, USA.

A multi-ethnic sample of 2853 low-income children aged <36 months who received care at the medical centre.

Among the caregivers, 23·3 % reported low household food security and 11·6 % reported very low household food security (VLFS). After controlling for background factors, children from households with VLFS were almost twice as likely to have IDA than were children from households with high or marginal food security (OR = 1·98, 95 % CI 1·11, 3·53); the corresponding associations for ID were not statistically significant.

The prevalence of IDA in early childhood is significantly larger in low-income infants and toddlers living in VLFS households. Asian, Hispanic and African-American children have elevated prevalences of ID and IDA. Breast-feeding may be associated with elevated ID and IDA, while participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) may be protective for ID.

The objectives of the present study were to (i) develop and validate a norm-referenced performance-rating scale to interpret a nutrition knowledge test developed for urban adolescents and (ii) develop a prototype for other researchers to follow when developing nutrition knowledge tests.

For norm development the nutrition knowledge test (questionnaire) was administered to a sample representative of the questionnaire target group, referred to as the norm group. These included 512 adolescents in grades 8 (n 158), 10 (n 149) and 12 (n 205) at three randomly selected schools in Soweto and Johannesburg. The performance scores (in percentages) obtained by the norm group were transformed to Z-scores which were categorised into stanines using established Z-score cut-off points. For validation purposes the questionnaire was completed by 148 volunteers: sixty university dietetics students, nineteen non-nutrition university students and sixty-nine primary-school teachers.

As required of an ideal norm group, the Z-scores formed a normal distribution (a bell-shaped curve). To facilitate interpretation of the results, the Z-score cut-off points for these categories were transformed back to performance scores (percentages) so that the performance of a testee could be interpreted directly from his/her performance in percentage. As is recommended, the nine stanine categories were reduced to five: very poor, fair/below average, good/average, very good/above average and excellent. The discriminatory validity of the norms was substantiated by showing that groups with known nutrition knowledge levels were rated appropriately and that the performance ratings of these groups differed significantly, with university dietetics students scoring 98·3 %, primary-school teachers 20·3 % and non-nutrition university students 31·6 %.

The norm-referenced performance-rating scale can be used with confidence to interpret the performance score achieved by a testee on the nutrition knowledge test developed for urban adolescents in South Africa. The methodology used in the study serves as a prototype for other researchers who are developing knowledge tests.

To study whether the dietary patterns of Finnish pregnant women are associated with their weight gain rate during pregnancy.

A validated 181-item FFQ was applied retrospectively to assess the diet during the eighth month of pregnancy, and maternal height and maternal weight at first and last antenatal visits were recalled. Information on sociodemographic characteristics, parity and smoking of the pregnant women was obtained by a structured questionnaire and from the Finnish Birth Registry. Principal components analysis was used to identify dietary patterns that described the diet of pregnant women based on their food consumption profile.

Finland.

Subjects consisted of 3360 women who had newly delivered in 1997–2002 and whose baby carried human leucocyte antigen-conferred susceptibility to type 1 diabetes in two university hospital regions, Oulu and Tampere, in Finland.

Out of seven dietary patterns identified, the ‘fast food’ pattern was positively associated (β = 0·010, se = 0·003, P = 0·004) and the ‘alcohol and butter’ pattern was inversely associated (β = –0·010, se = 0·003, P < 0·0001) with weight gain rate (kg/week) during pregnancy after adjusting for potential dietary, perinatal and sociodemographic confounding factors. Both of the dietary pattern associations demonstrated dose dependency.

Pregnant women should be guided to have a well-planned, balanced, healthy diet during pregnancy in order to avoid rapid gestational weight gain. The association between diet, health and maternal weight gain of the women who consumed alcohol during pregnancy should be studied further.

Anaemia currently affects 40–80 % of women in Africa. While risk factors for anaemia have been intensively studied, research has rarely compared risk factors between mild anaemia and moderate/severe anaemia. Also, the contribution of neighbourhood to the prevalence of anaemia has been rarely studied. The aim of the present study was to identify and compare individual and contextual factors associated with various levels of anaemia among women.

A multilevel analysis of data from the 2001 Mali Demographic and Health Survey (n 3763) was carried out. Outcomes variables were mild anaemia, moderate-to-severe anaemia and any anaemia. Multilevel regression analyses were performed for each outcome.

Mali, West Africa.

Women (n 3763) aged 15 to 49 years, including 512 pregnant women.

Among the eleven potential risk factors included in the models, two factors were associated with mild anaemia (BMI and education), three with any anaemia (pregnancy, BMI and education) and six with moderate-to-severe anaemia (pregnancy, BMI, education, wealth, childhood residency and region of residence). Clustering of anaemia within communities was 20 % for moderate-to-severe anaemia and 13 % for mild anaemia. Despite significant differences in the prevalence of anaemia across regions in Mali, no difference between regions in the risk of mild anaemia was found and only the region of Gao showed a significantly higher risk of moderate-to-severe anaemia.

The findings indicate that sociodemographic risk factors as well as clustering of anaemia varies with the severity of anaemia. Specific studies are needed to identify risk factors of mild anaemia as well as its consequences, as mild anaemia accounts for 20–40 % of total prevalence of anaemia in Africa.

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 analyse changes in the sensation of hunger and the sensation of well-being of young overweight/obese women following two hypoenergetic diets.

Fifty-seven women (BMI = 24–35 kg/m2) were randomly assigned to one of two hypoenergetic diets: diet V, in which the consumption of vegetables was increased; or diet C, in which the consumption of cereals (especially breakfast cereals) was increased. Dietetic and anthropometric data and an evaluation of the sensation of hunger and well-being were collected at the start and end of the study, 6 weeks later.

The diets led to a reduction in weight and BMI in both groups. The sensation of hunger at the end of meals was higher at the end of the study than at the start in both groups. At 6 weeks, the sensation of well-being after breakfast, morning snack and lunch, as well as the mean sensation of well-being after all meals, was greater in diet C. Compared with that recorded at the beginning of the study, the capacity to experience satiety at the end of meals also increased with diet C, as did the capacity to experience well-being at 6 weeks (for breakfast, lunch, dinner and for the mean for all meals). This capacity to experience well-being was also greater in diet C than in diet V with respect to the mid-morning snack and lunch.

The more positive results obtained with diet C may contribute to the increased weight loss seen in that group and their lower withdrawal rate.

To validate a two-item food security questionnaire (FSQ) for use in a clinical setting to screen HIV-1 infected patients for food insecurity.

The present study was a questionnaire-based survey of forty-nine subjects attending an HIV clinic. Subjects completed a two-item questionnaire and a six-item validated FSQ contemporaneously.

A strong correlation was found between the two-item and six-item FSQ (ρ = 0·895; 95 % CI 0·821, 0·940; P < 0·0001). Cronbach's α coefficient was found to be 0·94 and 0·90 for the two-item and six-item FSQ, respectively. The two-item FSQ yielded a sensitivity of 100 % (95 % CI 75, 100) and a specificity of 78 % (95 % CI 61, 90). The negative predictive value was found to be 100 % (95 % CI 88, 100).

The results of the present study suggest that the two-item FSQ is a valid, reliable and sensitive screening tool of food insecurity in people living with HIV in a clinical setting.

Glycaemic index (GI) reflects the postprandial glucose response of carbohydrate-containing foods. A diet with lower GI may improve glycaemic control in people with diabetes. The purpose of the present study was to evaluate the change in outcomes following a behavioural intervention which promoted lower-GI foods among adults with diabetes.

A pre-test–post-test control group design was used with participants randomly assigned to an immediate (experimental) or delayed (control) treatment group. The intervention included a 9-week, group-based intervention about carbohydrate and the glycaemic index. Dietary, anthropometric and metabolic measures were obtained pre/post-intervention in both groups and at 18-week follow-up for the immediate group.

The study was conducted in a rural community in the north-eastern USA.

Adults having type 2 diabetes mellitus for ≥1 year, aged 40–70 years and not requiring insulin therapy (n 109) were recruited.

Following the intervention, mean dietary GI (P < 0·001), percentage of energy from total fat (P < 0·01) and total dietary fibre (P < 0·01) improved in the immediate compared with the delayed group. Mean BMI (P < 0·0001), fasting plasma glucose (P = 0·03), postprandial glucose (P = 0·02), fructosamine (P = 0·02) and insulin sensitivity factor (P = 0·04) also improved in the immediate group compared with the delayed group. Mean waist circumference among males (P < 0·01) and body weight among males and females (P < 0·01) were significantly different between treatment groups.

Educating clients about carbohydrate and the glycaemic index can improve dietary intake and health outcomes among adults with type 2 diabetes.