To establish a laboratory iodization quality assurance system to support small-scale salt production facilities in India and to assess the level of agreement for the internal quality assurance (IQA) and external quality assurance (EQA) protocols.

Operational research. The IQA and EQA programme was established in the year 2008. Agreement between field laboratories and the reference laboratory for estimation of iodine content of salt from 2008 to 2011 was assessed. Agreement was assessed using the χ2 test, kappa statistics and the Bland–Altman plot.

Small-scale salt producers in the states of Andhra Pradesh, Gujarat, Rajasthan, Tamil Nadu, Odisha and Karnataka; ‘field laboratories’ supporting the small-scale salt producers; and the ‘reference laboratory’ of the Regional Office (South Asia) of the International Council for the Control of Iodine Deficiency Disorders.

Three hundred small-scale salt producers in the states of Andhra Pradesh, Gujarat, Rajasthan, Tamil Nadu, Odisha and Karnataka and seventeen ‘field laboratories’.

A total of 6573 salt samples for IQA and 347 salt samples for EQA were exchanged between field and reference laboratories during 2008–2012. Out of the total salt sample exchanges, 527 were from Andhra Pradesh and Odisha, 2343 from Gujarat, 2016 from Rajasthan and 1677 from Tamil Nadu and Karnataka. The overall between-laboratory agreement was for 61·6 % for IQA and 64·8 % for EQA. The mean difference between iodine content estimation of field laboratories and the reference laboratory was 0·3 ppm (sd 8·2 ppm) for IQA and –0·3 ppm (sd 3·5 ppm) for EQA.

Our study successfully documents implementation of a laboratory iodization quality assurance protocol in laboratories supporting small-scale salt production facilities in India.

To explore the influence of socio-economic position (SEP) on habitual dietary intake in Colombian cities.

We conducted a cross-sectional, population-based study in five Colombian cities. Dietary intake was assessed with a 157-item semi-quantitative FFQ previously developed for the Colombian population. Nutrient analysis was performed using national and international food composition tables. SEP was assessed with two indicators: a government-defined, asset-based, household-level index called socio-economic stratum (SES) and, among adults, highest educational level attained.

The five main urban centers of Colombia: Bogotá, Medellin, Barranquilla, Cali and Bucaramanga.

Probabilistic, multi-stage sample of 1865 participants (n 1491 for analyses on education).

For both sexes, increasing SES was associated with a lower consumption of energy (P-trend <0·001 in both sexes), carbohydrates (P-trend <0·001 in both sexes), Na (P-trend = 0·005 in males, <0·001 in females), SFA (P-trend <0·001 in both sexes) and among females, cholesterol (P-trend = 0·002). More educated men consumed significantly less energy and carbohydrates (P-trend = 0·036 and <0·001, respectively). Among men, intake of trans fats increased monotonically with educational level, being 21 % higher among college graduates relative to those with only elementary education (P-trend = 0·023). Among women, higher educational level was associated with higher MUFA intake (P-trend = 0·027).

SES and educational level are strong correlates of the usual diet of urban Colombians. Economically deprived and less educated segments of society display dietary habits that make them vulnerable to chronic diseases and should be the primary target of public health nutrition policies.

The current study assessed whether home-based data collection by trained data collectors can produce high-quality physical measurement data in young children.

The study assessed the quality of intra-examiner measurements of blood pressure, pulse rate and anthropometric dimensions using intra-examiner reliability and intra-examiner technical error of measurement (TEM).

Non-clinical, primarily private homes of National Children’s Study participants in twenty-two study locations across the USA.

Children in four age groups: 5–7 months (n 91), 11–16 months (n 393), 23–28 months (n 1410) and 35–40 months (n 800).

Absolute TEM ranged in value from 0·09 to 16·21, varying widely by age group and measure, as expected. Relative TEM spanned from 0·27 to 13·71 across age groups and physical measures. Reliabilities for anthropometric measurements by age group and measure ranged from 0·46 to >0·99 with most exceeding 0·90, suggesting that the large majority of anthropometric measures can be collected in a home-based setting on young children by trained data collectors. Reliabilities for blood pressure and pulse rate measurements by age group ranged from 0·21 to 0·74, implying these are less reliably measured with young children when taken in the data collection context described here.

Reliability estimates >0·95 for weight, length, height, and thigh, waist and head circumference, and >0·90 for triceps and subscapular skinfolds, indicate that these measures can be collected in the field by trained data collectors without compromising data quality. These estimates can be used for interim evaluations of data collector training and measurement protocols.

The aim of the present study was to investigate blood pressure (BP) levels and their relationship with different indices of body fat in a group of adolescents, in order to evaluate the prevalence of hypertension and plan preventive and corrective strategies.

Cross-sectional study in primary care.

All high schools in the Aosta Valley region, northern Italy.

Five hundred and thirty-two adolescents of both sexes, aged 15·4 (standard deviation 0·7) years. The following parameters were measured: body weight, body height, body mass index (BMI), four skinfold thicknesses, body fat mass, waist and hip circumferences and BP.

BMI data indicated a high prevalence of overweight subjects in both sexes, but higher in males, while the prevalence rate of obese adolescents was lower. Of the total, 11·8 % of subjects suffered from systolic hypertension, while 6·9 % suffered from diastolic hypertension. In linear correlation analysis, BMI and all adiposity indices, except waist:hip ratio, were found to be significantly associated (P ranging between 0·05 and 0·001) with both systolic BP and diastolic BP in both sexes, with r ranging between 0·152 and 0·359. Multiple regression analysis with the stepwise method showed BMI and body fat mass to have the strongest association (P < 0·001) with BP, with r ranging between 0·275 and 0·359.

Unless reversed, these conditions are worrying and predict the possible development of cardiovascular disease in adulthood. There is a pressing need to develop a comprehensive medical and nutrition plan, together with preventive and corrective strategies, in school programmes.

To estimate the impact of foetal nutritional status on cardiovascular risk among children with the Foetal Nutritional Status Index (FNSI), calculated by dividing the child's birth weight (BW, kg) by the mother's height (m2).

Cross-sectional survey analysis.

A sample of children from the US Third National Health and Nutrition Examination Survey.

A total of 3109 children who were 5–11 years of age and had data on BW and mother's height. Non-fasting blood samples were included.

Overall, the FNSI was positively associated with BW and negatively associated with mother's height (P < 0.0001). Within sex-specific quintiles of FNSI (third quintile as reference) adjusted for potential confounding variables, cardiovascular risk factors tended to be ‘higher’ in the lower quintiles for males while the opposite was true for females. Multivariate logistic regression analyses indicated that the odds for males in quintile 1 was 2.4 for having a low level of high-density lipoprotein cholesterol (P < 0.01) and 2.1 for having a cluster of cardiovascular risk factors (P = 0.01); for females, the odds of having a cluster of cardiovascular risk factors was approximately two times higher for those in the first and fifth quintiles, who also had a significantly higher prevalence of central obesity.

The FNSI may be a potential proxy indicator of foetal nutritional status and it may be used to test specific hypotheses of whether foetal nutrition restriction or overnutrition programmes future cardiovascular risk.

Cultural food security is crucial for cultural health and, for people from refugee backgrounds, supports the settlement journey. Cultural communities are vital in facilitating access to cultural foods; however, it is not understood how refugee-background communities sustain cultural food security in the Australian context. This study aimed to explore key roles in refugee-background communities to understand why they were important and how they facilitate cultural food security.

Interviews were conducted by community researchers, and data analysis was undertaken using best-practice framework for collaborative data analysis.

Greater Brisbane, Australia.

Six interviews were conducted between August and December 2022 with people from a refugee-background community, lived in Greater Brisbane and who fulfilled a key food role in the community that facilitated access to cultural foods.

Fostering improved cultural food security supported settlement by creating connections across geographical locations and cultures and generated a sense of belonging that supported the settlement journey. Communities utilised communication methods that prioritised the knowledge, wisdom and experience of community members. It also provided community members with influence over their foodways. Community leaders had an ethos that reflected collectivist values, where community needs were important for their own health and well-being.

Communities are inherently structured and communicate in a way that allows collective agency over foodways. This agency promotes cultural food security and is suggestive of increased food sovereignty. Researchers and public health workers should work with communities and recognise community strengths. Food security interventions should target cultural food security and autonomy.

(i) Describe the development of a multipurpose Cardio-Med survey tool (CMST) comprising a semi-quantitative FFQ designed to measure dietary intake in multicultural patients with or at high risk of CVD and (ii) report pilot evaluation of test–retest reliability and validity of the FFQ in measuring energy and nutrient intakes.

The CMST was developed to identify CVD risk factors and assess diet quality over 1 year using an FFQ. Design of the ninety-three-item FFQ involved developing food portion photographs, and a list of foods appropriate for the Australian multicultural population allowing the capture of adherence to a Mediterranean diet pattern. The FFQ was administered twice, 2 weeks apart to assess test–retest reliability, whilst validity was assessed by comparison of the FFQ with a 3-d food record (3DFR).

The Northern Hospital and St Vincent’s Hospital, Melbourne, Australia.

Thirty-eight participants aged 34–81 years with CVD or at high risk.

Test–retest reliability of the FFQ was good: intraclass correlation coefficient (ICC) ranged from 0·52 (Na) to 0·88 (alcohol) (mean 0·79), with energy and 70 % of measured nutrients being above 0·75. Validity was moderate: ICC ranged from 0·08 (Na) to 0·94 (alcohol) (mean 0·59), with energy and 85 % of measured nutrients being above 0·5. Bland–Altman plots demonstrated good levels of agreement between the FFQ and 3DFR for carbohydrates, protein, alcohol, vitamin D and Na.

The CMST FFQ demonstrated good test–retest reliability and moderate validity for measuring dietary energy and nutrients in a multicultural Australian cardiology population.

To examine whether targeted determinants mediated the effects of the HEalth In Adolescents (HEIA) intervention on fruit and vegetable (FV) consumption and explore if these mediating effects were moderated by sex, parental education or weight status.

Cluster-randomised controlled trial.

The HEIA study (2007–2009) was a Norwegian 20-month multi-component school-based intervention to promote healthy weight development. FV consumption and targeted determinants were self-reported at baseline, mid-way (8 months) and post-intervention (20 months).

Adolescents (11–13-year-old) in twenty-five control schools (n 746) and twelve intervention schools (n 375).

At post-intervention, more adolescents in the intervention group compared with the control group had knowledge of the FV recommendations (OR: 1·4, 95 % CI 1·1, 1·9) and reported a decreased availability of vegetables at home (β: –0·1, 95 % CI –0·2, 0·0). Availability/accessibility of FV at home, availability of vegetables at dinner, taste preferences for different types of FV and knowledge of the FV recommendations were positively associated with the consumption of FV. However, none of the post-intervention determinants significantly mediated the intervention effects on FV consumption. Although no moderating influences by sex, parental education or weights status were observed on the mediating effects, exploratory analyses revealed significant moderations in the b-paths.

Since none of the targeted determinants could explain the increase in FV consumption, it remains unclear why the intervention was effective. Reporting on a wide range of mediators and moderators in school-based interventions is needed to reveal the pathways through which intervention effects are achieved.

Childhood obesity is on the rise in South Africa (SA), and child-directed marketing (CDM) is one of the contributing factors to children’s unhealthy food choices. This study assessed CDM on packaged breakfast cereals available in SA supermarkets and their nutritional quality.

Photographic images were examined in a descriptive quantitative study. A codebook of definitions of CDM was developed for this purpose. REDCap, an online research database, was used for data capturing, and SPSS was used for data analyses including cross-tabulations and one-way ANOVA.

The current study was set in the Western Cape province of SA.

Photographic images of all packaged breakfast cereals sold in major retailers in the Western Cape province of SA in 2019 were studied.

CDM strategies were classified as direct (to the child) or indirect (through the parent). A total of 222 breakfast cereals were studied, of which 96·9 % had a nutritional or health claim, 95·0 % had illustrations, 75·2 % had product and consumption appeals, 10·8 % had characters, 10·8 % consisted of different appeals, 8·6 % alluded to fantasy and 7·7 % had role models. In breakfast cereals with direct CDM, the protein and fibre content was significantly lower than in breakfast cereals without direct CDM. This study found a significantly higher total carbohydrate and total sugar content in breakfast cereals with direct CDM than those without direct CDM.

CDM was highly prevalent in breakfast cereals sold in SA. Regulations to curb the marketing of packaged foods high in nutrients of concern is recommended.

To determine the prevalences of overweight and obesity in children aged 4 to 12 years, using the standard definitions proposed by the International Obesity Taskforce.

Population prevalence cross-sectional survey involving measurement of height and weight. Data collection took place in 1998.

Schools in Gibraltar.

In total 2994 children, aged 4–12 years, attending these schools (1540 boys, 1454 girls).

Prevalence of overweight in boys was 19.7%, while obesity prevalence was 10.8%. For the girls, overweight prevalence was 21.4%, while obesity prevalence was 10.6%. There were no significant differences in the proportions of overweight or obesity between boys and girls.

This was the first time that the prevalences of overweight and obesity have been estimated in children from Gibraltar. These data provide further information on prevalence rates of overweight and obesity, using defined cut-offs for comparison with data from other countries.

This study aimed to estimate the prevalence of vegetarians, vegans and other dietary patterns that exclude some animal-source foods in New Zealand adults. We also examined socio-demographic and lifestyle correlates of these dietary patterns.

The New Zealand Health Survey is a representative rolling cross-sectional survey of New Zealanders; data from the 2018/19 and 2019/20 waves were used for this analysis. Participants were asked if they completely excluded red meat, poultry, fish/shellfish, eggs or dairy products from their diet.

New Zealand.

Adults, aged ≥ 15 years (n 23 292).

The prevalence of red-meat excluders (2·89 %), pescatarians (1·40 %), vegetarians (2·04 %) and vegans (0·74 %) was low. After adjustment for socio-demographic and lifestyle factors, women (OR = 1·54, 95 % CI: 1·22, 1·95), Asian people (OR = 2·56, 95 % CI: 1·96, 4·45), people with tertiary education (OR = 1·71, 95 % CI: 1·18, 2·48) and physically active people (OR = 1·36, 95 % CI: 1·04, 1·76) were more likely to be vegetarian/vegan. Those aged ≥ 75 years (OR = 0·28, 95 % CI: 0·14, 0·53) and current smokers (OR = 0·42, 95 % CI: 0·23, 0·76) were less likely to be vegetarian/vegan. Similar associations were seen between socio-demographic and lifestyle factors and the odds of being a red-meat excluder/pescatarian.

Approximately 93 % of New Zealand adults eat red meat and a very small number exclude all animal products from their diets. The Eating and Activity Guidelines for New Zealand adults recommend a plant-based diet with moderate amounts of animal-source foods. A comprehensive national nutrition survey would provide detailed information on the amount of red meat and other animal-source foods that the New Zealand population currently consumes.

To determine if limb lengths, as markers of early life environment, are associated with the risk of diabetes in China.

We performed a cohort analysis using data from the China Health and Retirement Longitudinal Study (CHARLS), and multivariable-adjusted Cox proportional hazard regression models were used to examine the associations between baseline limb lengths and subsequent risk of diabetes.

The CHARLS, 2011–2018.

The study confined the eligible subject to 10 711 adults aged over 45 years from the CHARLS.

During a mean follow-up period of 6·13 years, 1358 cases of incident diabetes were detected. When controlling for potential covariates, upper arm length was inversely related to diabetes (hazard ratio (HR) 0·95, 95 % CI (0·91, 0·99), P = 0·028), and for every 1-cm difference in knee height, the risk of diabetes decreased by about 4 % (HR 0·96, 95 % CI (0·93, 0·99), P = 0·023). The association between upper arm length and diabetes was only significant among females while the association between knee height and diabetes was only significant among males. In analyses stratified by BMI, significant associations between upper arm length/knee height and diabetes only existed among those who were underweight (HR 0·91, 95 % CI (0·83, 1·00), P = 0·049, HR 0·92, 95 % CI (0·86, 0·99), P = 0·031).

Inverse associations were observed between upper arm length, knee height and the risk for diabetes development in a large Asian population, suggesting early life environment, especially infant nutritional status, may play an important role in the determination of future diabetes risk.

The aim of the study is (1) to assess the extent to which omnivores are willing to stop or reduce their consumption of red and processed meat in response to evidence-based information regarding the possible reduction of cancer mortality and incidence achieved by dietary modification; (2) to identify socio-demographic categories associated with higher willingness to change meat consumption and (3) to understand the motives facilitating and hindering such a change.

During an initial computer-assisted web interview, respondents were presented with scenarios containing the estimates of the absolute risk reduction in overall cancer incidence and mortality tailored to their declared level of red and processed meat consumption. Respondents were asked whether they would stop or reduce their average meat consumption based on the information provided. Their dietary choices were assessed at 6-month follow-up. Additionally, we conducted semi-structured interviews to better understand the rationale for dietary practices and the perception of health information.

The study was conducted among students and staff of three universities in Krakow, Poland.

Most of the 513 respondents were unwilling to change their consumption habits. We found gender to be a significant predictor of the willingness. Finally, we identified four themes reflecting key motives that determined meat consumption preferences: the importance of taste and texture, health consciousness, the habitual nature of cooking and persistence of omnivorous habits.

When faced with health information about the uncertain reduction in the risk of cancer mortality and incidence, the vast majority of study participants were unwilling to introduce changes in their consumption habits.

Recent research supports the importance of PUFA intake in children, particularly of EPA and DHA; however, few verified methods to assess whether PUFA intake is adequate are available.

We assessed the correlation between serum PUFA and lipid concentrations with seafood and PUFA intake measured using a brief-type self-administered diet history questionnaire for Japanese preschool children (BDHQ3y).

Single centre birth cohort in Japan.

A total of 152 36-month-old Japanese children.

Average dietary intake of daily seafood, EPA and DHA was 13·83 (sd 10·36) g, 49·4 (sd 43·5) mg and 98·3 (sd 64·6) mg, respectively. Significant weak-to-moderate correlations were observed between dietary intake and serum EPA (Spearman rho = 0·41, P < 0·001; Pearson r = 0·44, P < 0·001); DHA (Spearman rho = 0·40, P < 0·001; Pearson r = 0·42, P < 0·001) and AA (arachidonic acid) (Spearman rho = 0·33, P < 0·001; Pearson r = 0·32, P < 0·001), whereas no significant correlation was observed for dihomo-γ-linolenic acid (DGLA) (Spearman rho = 0·06, P = 0·484; Pearson r = 0·07, P = 0·387). Correlations between seafood intake and serum EPA and DHA were also moderate (0·39–0·43). A negative correlation between serum TAGs and serum EPA, as well as positive correlations between serum cholesterol (total cholesterol, LDL and HDL) with serum EPA and DHA were observed, whereas no significant correlations between seafood intake and serum lipid profiles. Based on this model, we estimated 61–98 g/week of seafood intake is required to meet current EPA/DHA intake recommendations by the WHO (100–150 mg/d).

For children of 2–4 years of age, weekly intake of 61–98 g of seafood is required to meet WHO recommendations of EPA/DHA intake.