To elicit predictors of variation in likelihood to purchase foods rich in long-chain omega-3 fatty acids.

Responses from a community sample (n = 220) were elicited using a computer-administered questionnaire based on an adaptation of Protection Motivation Theory including measures of perceived risk and vulnerability to coronary heart disease (CHD). Other measures included health status, body mass index (BMI), perceived risk/benefits of novel technologies and sociodemographics. Descriptions of model products were presented, including farmed fish fed fishmeal (FFFF); farmed fish fed genetically modified (GM) oilseed (FFFGM); bread, milk and supplements containing fish oil (SFO) or GM oilseed. It was hypothesised that perceived vulnerability to CHD would enhance acceptance of GM products (H1). Furthermore, information describing the benefits of LCO3FA, limitations to fish supply and potential alternatives was given to a treatment group (50%) and hypothesised to have a positive effect on the acceptance of GM products (H2).

No evidence was found to support H1 or H2. FFFF was most likely to be purchased (P < 0.01), followed by SFO and FFFGM. Multivariate regression analysis identified significant (P < 0.05) predictors (standardised β) for likelihood to purchase FFFF: self-efficacy 0.56; behaviour (product) efficacy 0.19; belief that fishmeal is unnatural −0.14 (R2 = 0.44) and for FFFGM: self-efficacy 0.65; perceived severity of CHD 0.15; BMI −0.13; significant other has/had arthritis 0.11; belief that GM oilseed is unnatural 0.11 (R2 = 0.49).

Self-efficacy (confidence to consume) was the most important predictor of likelihood to purchase all products.

Recent research indicates that n–3 fatty acids can inhibit cognitive decline, perhaps differentially by hypertensive status.

We tested these hypotheses in a prospective cohort study (the Atherosclerosis Risk in Communities). Dietary assessment using a food-frequency questionnaire and plasma fatty acid exposure by gas chromatography were completed in 1987–1989 (visit 1), while cognitive assessment with three screening tools – the Delayed Word Recall Test, the Digit Symbol Substitution Test of the Wechsler Adult Intelligence Scale–Revised and the Word Fluency Test (WFT) – was completed in 1990–1992 (visit 2) and 1996–1998 (visit 4). Regression calibration and simulation extrapolation were used to control for measurement error in dietary exposures.

Four US communities – Forsyth County (North Carolina), Jackson (Mississippi), suburbs of Minneapolis (Minnesota) and Washington County (Maryland).

Men and women aged 50–65 years at visit 1 with complete dietary data (n = 7814); white men and women in same age group in the Minnesota field centre with complete plasma fatty acid data (n = 2251).

Findings indicated that an increase of one standard deviation in dietary long-chain n–3 fatty acids (% of energy intake) and balancing long-chain n−3/n–6 decreased the risk of 6-year cognitive decline in verbal fluency with an odds ratio (95% confidence interval) of 0.79 (0.66–0.95) and 0.81 (0.68–0.96), respectively, among hypertensives. An interaction with hypertensive status was found for dietary long-chain n–3 fatty acids (g day−1) and WFT decline (likelihood ratio test, P = 0.06). This exposure in plasma cholesteryl esters was also protective against WFT decline, particularly among hypertensives (OR = 0.51, P < 0.05).

One implication from our study is that diets rich in fatty acids of marine origin should be considered for middle-aged hypertensive subjects. To this end, randomised clinical trials are needed.

To test the hypothesis that maternal food fortification with omega-3 fatty acids and multiple micronutrients increases birth weight and gestation duration, as primary outcomes.

Non-blinded, randomised controlled study.

Pregnant women received powdered milk during their health check-ups at 19 antenatal clinics and delivered at two maternity hospitals in Santiago, Chile.

Pregnant women were assigned to receive regular powdered milk (n = 477) or a milk product fortified with multiple micronutrients and omega-3 fatty acids (n = 495).

Intention-to-treat analysis showed that mean birth weight was higher in the intervention group than in controls (65.4 g difference, 95% confidence interval (CI) 5–126 g; P = 0.03) and the incidence of very preterm birth (<34 weeks) was lower (0.4% vs. 2.1%; P = 0.03). On-treatment analysis showed a mean birth weight difference of 118 g (95% CI 47–190 g; P = 0.001) and a relative fall in both the proportion of birth weight ≤3000 g (P = 0.015) and the incidence of pre-eclampsia (P = 0.015). Compliance with the experimental product was apparent from a haematological study of red-blood-cell folate at the end of pregnancy, which was performed in a sub-sample. In both types of analyses, positive differences were also present for mean gestation duration, birth length and head circumference. Nevertheless, the relatively small sample sizes allowed a statistical power of >0.80 just for mean birth weight and birth length in the on-treatment analysis; birth length in that analysis had a difference of 0.57 cm (95% CI 0.19–0.96 cm; P = 0.003).

The new intervention resulted in increased mean birth weight. Associations with gestation duration and most secondary outcomes need a larger sample size for confirmation.

To describe (1) the prevalence of overweight and obesity and their association with physical activity; (2) the effect of different cut-off points for body mass index (BMI) on weight status categorisation; and (3) associations of weight status with perceptions of body size, health and diet quality.

A cross-sectional study.

Secondary schools in Barbados.

A cohort of 400 schoolchildren, 11–16 years old, selected to study physical education practices.

Prevalence of overweight (15% boys; 17% girls) and obesity (7% boys; 12% girls) was high. Maternal obesity, as defined by the International Obesity Task Force (IOTF) BMI cut-off points, predicted weight status such that reporting an obese mother increased the odds of being overweight by 5.25 (95% confidence interval: 2.44, 11.31). Physical activity was inversely associated with weight status; however levels were low. Recreational physical activity was not associated with weight status in either category. Overweight subjects tended to misclassify themselves as normal weight and those who misclassified perceived themselves to be of similar health status to normal-weight subjects. The National Center for Health Statistics and IOTF BMI cut-off points produced different estimates of overweight and obesity.

Our findings suggest that inadequate physical activity and ignorance related to food and appropriate body size are promoting high levels of adiposity with a strong contribution from maternal obesity, which may be explained by perinatal and other intergenerational effects acting on both sexes. Prevalence studies and local proxy tools for adiposity assessment are needed.

To identify determinants of adolescents’ consumption of carbonated soft drinks (regular and diet), both of total consumption and of consumption at school.

Regular and diet soft drink consumption was measured by food frequency questions that were dichotomised. Several potential environmental and personal determinants of consumption were measured. A total of 2870 (participation rate: 85%) 9th and 10th graders, within 33 Norwegian schools, participated in the study. Multilevel logistic regression analyses were preformed for total soft drink consumption (twice a week or more vs. less) and for consumption at school (once a week or more vs. less).

A total of 63% and 27% of the participants reported to drink respectively regular and diet soft drinks twice a week or more, and 24% and 8%, respectively, reported to drink soft drinks once a week or more at school. Preferences, accessibility, modelling and attitudes were the strongest determinants of both regular and diet soft drink consumption. In addition, gender, educational plans and dieting were related to both total soft drink consumption and consumption at school. Pupils with longer distance from school to shop and those in schools with rules concerning soft drink consumption tended to have lower odds of drinking both regular and diet soft drinks at school.

This study shows that gender, educational plans, dieting, accessibility, modelling, attitudes and preferences all seem to be strong determinants of adolescents’ soft drink consumption. Parents and the home environment appear as great potential intervention targets.

To create, validate and assess the reliability of a checklist to measure calcium intake in children.

Calcium intakes from a checklist and parent-assisted 24-h dietary recall were compared. Checklist reliability was assessed separately.

After-school programmes in the United States.

Forty-two children (18 males, 24 females, age = 8.0 ± 0.9 years) participated in the validation analysis and 49 children (28 males, 21 females, age = 7.5 ± 0.9 years) in the reliability analysis.

No differences in mean calcium intakes were found by method or gender. The checklist correlated well with recall among girls (r = 0.65, P = 0.01) but not boys (r = −0.33, P = 0.19). Agreement over time was above 80% for most foods.

The calcium checklist is useful for assessing calcium intake among groups of 6–10-year-old children in settings that preclude parental assistance. More research is needed to improve accuracy among boys.

To validate a diet history questionnaire (DHQ) using a weighed food record (WFR) as the standard method in the estimation of food consumption and nutrient intake in a group of adults.

WFR: all foods consumed by subjects during 7 consecutive days were weighed and recorded by nutrition students. Two DHQ interviews were carried out on days 1 (first diet history questionnaire, DHQ1) and 28 (second diet history questionnaire, DHQ2).

Costa Rica.

Sixty adults: 30 men and 30 women; 30 living in urban and 30 in rural areas.

In comparison to the WFR, the DHQ1 gave statistically significant higher estimates of the mean intake of 19 nutrients for men and of three nutrients for women. The uncorrected correlation coefficients for nutrient intake according to both methods ranged from 0.40 to 0.83 for males and from 0.22 to 0.62 for females. Percentage of subjects classified in the same quartiles of nutrient intake according to each method ranged from 33.3% to 63.3% for males and from 23.3% to 53.3% for females. Misclassification in extreme quartiles ranged from 0% to 13.3% for both sexes. The mean food group consumption, according to the DHQ1, when compared with the WFR, gave statistically significant differences for three of the 18 food groups for men and for two groups in the case of women. The two applications of the DHQ gave similar results.

Validation of a DHQ using a WFR as the standard method gave results that compare favourably with those reported by other authors. This study found important differences in the response of men and women to the DHQ: among men, the estimates of mean nutrient intake from DHQ1 were significantly greater than those of the WFR, while in the case of women, the mean nutrient intake estimates from both methods were not significantly different. There was a higher degree of correlation between the DHQ1 and the WFR mean nutrient intakes among men than among women. The DHQ showed good reproducibility.

To quantify factors influencing iron supplementation compliance and haemoglobin (Hb) concentrations among pregnant women participating in an iron supplementation programme under routine field conditions.

Cross-sectional interviews and Hb measurements.

Albay and Sorsogon provinces, Bicol, Philippines.

Three hundred and forty-six pregnant women receiving iron supplements via the Philippine iron supplementation programme.

Women had a mean Hb concentration of 10.75 ± 1.43 g dl−1, and 56.4% were anaemic (Hb < 11.0 g dl−1). On average, the first prenatal visit occurred at nearly 4 months (3.80 ± 1.56). The ratio of visits to number of months pregnant was 0.51 ± 0.24. Self-reported consumption of pills received was 85% (0.85 ± 0.23), although pill counts suggested that consumption was 70% (0.70 ± 0.35). Using multiple regression, an earlier first prenatal visit and greater self-reported compliance were positively associated with Hb concentrations. Additionally, perceived health benefits from taking the supplements and higher health programme knowledge were positively associated with pill consumption, while experiencing side-effects and disliking the taste of the supplements were associated with lower pill consumption. A greater number of living children was negatively associated with the frequency of prenatal visits. The number of children was also directly negatively associated with Hb concentrations.

Compliance was positively related to Hb concentrations. Several factors associated with greater compliance were identified, including marital status, number of children, health programme knowledge, side-effects, perceived health benefits, and dislike of taste. Some of these factors may serve as avenues for interventions to increase compliance, and ultimately Hb concentrations.

To develop and validate a short food-frequency questionnaire to assess habitual dietary salt intake in South Africans and to allow classification of individuals according to intakes above or below the maximum recommended intake of 6 g salt day−1.

Cross-sectional validation study in 324 conveniently sampled men and women.

Repeated 24-hour urinary Na values and 24-hour dietary recalls were obtained on three occasions. Food items consumed by >5% of the sample and which contributed ≥50 mg Na serving−1 were included in the questionnaire in 42 categories. A scoring system was devised, based on Na content of one index food per category and frequency of consumption.

Positive correlations were found between Na content of 35 of the 42 food categories in the questionnaire and total Na intake, calculated from 24-hour recall data. Total Na content of the questionnaire was associated with Na estimations from 24-hour recall data (r = 0.750; P < 0.0001; n = 328) and urinary Na (r = 0.152; P = 0.0105; n = 284). Urinary Na was higher for subjects in tertile 3 than tertile 1 of questionnaire Na content (P < 0.05). Questionnaire Na content of <2400 and ≥2400 mg day−1 equated to a reference cut-off score of 48 and corresponded to mean (standard deviation) urinary Na values of 145 (68) and 176 (99) mmol day−1, respectively (P < 0.05). Sensitivity and specificity against urinary Na ≥100 and <100 mmol day−1 was 12.4% and 93.9%, respectively.

A 42-item food-frequency questionnaire has been shown to have content-, construct- and criterion-related validity, as well as internal consistency, with regard to categorising individuals according to their habitual salt intake; however, the devised scoring system needs to show improved sensitivity.

A nationwide study was performed in Cuba to assess vitamin A status and the intake of vitamin-A-providing foods in children aged 6–11 years.

The sample comprised 1191 schoolchildren from first to sixth grade, both sexes, from municipalities randomly selected from the five eastern provinces of Cuba in 2002 (first semester) and from the four western and four central provinces in 2003 (first semester). A food-frequency questionnaire was completed by 2038 mother-and-child pairs.

Mean (±standard deviation) plasma retinol concentrations were 1.77 ± 0.48 μmol l−1 in the western, 2.01 ± 0.56 μmol l−1 in the central and 1.40 ± 0.41 μmol l−1 in the eastern region. No child had plasma retinol concentration below 0.35 μmol l−1, indicative of a high risk of clinical deficiency. Subclinical deficiency, plasma retinol concentration of 0.35–0.7 μmol l−1, was seen in <2% of subjects in all three regions and was <5% even in the two provinces with the worst vitamin A status (Guantánamo, 4.6%; Las Tunas, 3.0%). Adequate status (>1.05 μmol l−1) was present in >90% of subjects in all western and central provinces, and in one of the eastern provinces (Holguín), whereas in the four remaining eastern provinces, adequate status was present in >75%. Only nine fruits and vegetables were consumed frequently (>3 times per week) by >50% of children. Thirty-seven per cent regularly consumed a supplement containing vitamin A.

Most Cuban children aged 6–11 years had adequate vitamin A status. Consumption of foods rich in vitamin and provitamin A, especially vegetables, was frequent but limited to a small variety of foods.

There are no data on optimal cut-off points to classify obesity among Omani Arabs. The existing cut-off points were obtained from studies of European populations.

To determine gender-specific optimal cut-off points for body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) associated with elevated prevalent cardiovascular disease (CVD) risk among Omani Arabs.

A community-based cross-sectional study.

The survey was conducted in the city of Nizwa in Oman in 2001.

The study contained a probabilistic random sample of 1421 adults aged ≥20 years. Prevalent CVD risk was defined as the presence of at least two of the following three risk factors: hyperglycaemia, hypertension and dyslipidaemia. Logistic regression and receiver-operating characteristic (ROC) curve analyses were used to determine optimal cut-off points for BMI, WC and WHR in relation to the area under the curve (AUC), sensitivity and specificity.

Over 87% of Omanis had at least one CVD risk factor (38% had hyperglycaemia, 19% hypertension and 34.5% had high total cholesterol). All three indices including BMI (AUC = 0.766), WC (AUC = 0.772) and WHR (AUC = 0.767) predicted prevalent CVD risk factors equally well. The optimal cut-off points for men and women respectively were 23.2 and 26.8 kg m−2 for BMI, 80.0 and 84.5 cm for WC, and 0.91 and 0.91 for WHR.

To identify Omani subjects of Arab ethnicity at high risk of CVD, cut-off points lower than currently recommended for BMI, WC and WHR are needed for men while higher cut-off points are suggested for women.