To develop a worked example of product reformulation of a very popular ‘junk food’ to meet nutritional guidelines for public health in a ready meal.

Indicative survey of popular Margherita pizzas, followed by product reformulation, applying dietary guidelines to generate a single-item pizza meal containing 30 % daily amounts of energy and all nutrients. An iterative process was used; first to optimize nutrient balance by adjusting the proportions of bread base, tomato-based sauce and mozzarella topping, then adding ingredients to provide specific nutrients and consumer tasting.

Urban areas of contrasting socio-economic status.

Untrained unselected adults (n 49) and children (n 63), assessing pizza at tasting stations.

Most commercial pizzas provide insufficient information to assess all nutrients and traditional Margherita pizza ingredients provide insufficient Fe, Zn, iodine, and vitamins C and B12. Energy content of the portions currently sold as standard range from 837 to 2351 kJ (200 to 562 kcal), and most exceed 30 % Guideline Daily Amounts for saturated fat and Na when a 2510 kJ (600 kcal) notional meal is considered. The ‘nutritionally balanced pizza’ provides the required energy for a single-item meal (2510 kJ/600 kcal), with all nutrients within recommended ranges: Na (473 mg, ∼45 % below recommended level), saturated fat (<11 % energy) and dietary fibre (13·7 g). Most adults (77 %) and children (81 %) rated it ‘as good as’ or ‘better than’ their usual choice.

Nutritional guidelines to reduce chronic diseases can be applied to reformulate ‘junk food’ ready meals, to improve public health through a health-by-stealth approach without requiring change in eating habits.

To study consumer knowledge and use of food labels.

A cross-sectional study employing both quantitative and qualitative methods. Intercept interviews were conducted with 1832 consumers at supermarket sites selected using a stratified random sampling procedure. This information was triangulated with twenty-one focus group discussions.

New Delhi and Hyderabad, two metro-cities from north and south India.

Adolescent (10–19 years), adult (20–59 years) and elderly (≥60 years) consumers.

While the national urban literacy rate is 84 %, about 99 % of the study participants were educated. About 45 % reported that they buy pre-packaged foods once weekly and about a fifth buy them every day. Taste, quality, convenience and ease of use are the main reasons for buying pre-packaged foods. Although 90 % of consumers across the age groups read food labels, the majority (81 %) looked only for the manufacturing date or expiry/best before date. Of those who read labels, only a third checked nutrition information and ingredients. Nutrient information on labels was not often read because most consumers either lacked nutrition knowledge or found the information too technical to understand. About 60 % read quality symbols. A positive association was found between education level and checking various aspects of food labels. Women and girls concerned about ‘fat’ and ‘sugar’ intake read the nutrition facts panel.

The intention of promoting healthy food choices through use of food labels is not being completely met. Since a majority of people found it difficult to comprehend nutrition information, there is a need to take up educational activities and/or introduce new forms of labelling.

To examine the opinions of stakeholders on strategies to improve dietary quality of Supplemental Nutrition Assistance Program (SNAP) participants.

Participants answered a thirty-eight-item web-based survey assessing opinions and perceptions of SNAP and programme policy changes.

USA.

Survey of 522 individuals with stakeholder interest in SNAP, conducted in October through December 2011.

The top three barriers to improving dietary quality identified were: (i) unhealthy foods marketed in low-income communities; (ii) the high cost of healthy foods; and (iii) lifestyle challenges faced by low-income individuals. Many respondents (70 %) also disagreed that current SNAP benefit levels were adequate to maintain a healthy diet. Stakeholders believed that vouchers, coupons or monetary incentives for purchasing healthful foods might have the greatest potential for improving the diets of SNAP participants. Many respondents (78 %) agreed that sodas should not be eligible for purchases with SNAP benefits. More than half (55 %) believed retailers could easily implement such restrictions. A majority of respondents (58 %) agreed that stores should stock a minimum quantity of healthful foods in order to be certified as a SNAP retailer, and most respondents (83 %) believed that the US Department of Agriculture should collect data on the foods purchased with SNAP benefits.

Results suggest that there is broad stakeholder support for policies that align SNAP purchase eligibility with national public health goals of reducing food insecurity, improving nutrition and preventing obesity.

There is a recognised need to strengthen capacity in the nutrition in emergencies sector and for greater clarity on the role of emergency nutritionists and the skills they require. Competency frameworks are an important tool for human resource development and have been developed for several other humanitarian sectors. We therefore developed a technical competency framework for practitioners in nutrition in emergencies.

Existing competency frameworks were reviewed and interviews conducted to explore methods used in developing competency frameworks for other sectors. Competencies were identified through interviews with field experts, feedback from course trainees, academic course content and job specifications. Competencies were then categorised and behavioural indicators developed for each. The draft framework was then reviewed by members of the Global Nutrition Cluster and modified in an iterative process.

Global.

Not applicable.

A wide range of competencies were identified as essential for nutritionists working in emergencies, covering technical skills and general core competencies. The proposed framework contains twenty competency areas with 161 behavioural indicators categorised into three levels, corresponding to the requirements of progressively more senior roles. Many of the competencies are common across development and emergency nutrition.

The proposed technical competency framework should prove to be a valuable tool in creating standards within the sector and promoting effective capacity strengthening and professionalisation. Continued research is needed to validate the framework, optimise methods for assessment, develop approaches to integrate it within the sector and measure its impact on performance.

To evaluate the impact of a worksite intervention to prevent weight gain among adult workers.

A controlled community trial was performed by dividing the workers into two groups: intervention group (IG) and control group (CG). The theoretical framework applied was Intervention Mapping Protocol and the intervention was implemented through interactive software for weight self-monitoring. To evaluate the impact of the intervention, the differences in weight, BMI and waist circumference between the IG and CG were assessed before and 6 months after the intervention by regression models. Additionally, the sustainability of the intervention was evaluated at 12 months after the intervention.

São Paulo, Brazil.

Four companies; 281 workers for the analysis of effectiveness and 427 for the analysis of sustainability.

The intervention resulted in significant reductions in weight, BMI and waist circumference in the IG compared with the CG. The impact of the intervention on IG individuals’ body weight was −0·73 kg, while the weight of CG individuals increased. IG individuals with adequate initial weights did not show significant variations, while those who were overweight demonstrated a significant reduction in body weight. The intervention resulted in a reduction of 0·26 kg/m2 in BMI and 0·99 cm in waist circumference, and the sustainability analysis after 12 months showed a continued reduction in body weight (−0·72 kg).

The behavioural intervention was effective, resulting in weight maintenance among participants with adequate initial weight and in significant reductions among those who were overweight. More research on longer-term weight maintenance is needed.

The main objective was to assess the relationship of breakfast skipping, television (TV) viewing at breakfast and breakfast without TV with weight status among parents of 10–12-year-olds in eight European countries.

A cross-sectional survey assessed breakfast eating and TV viewing at breakfast by three frequency questions and parents were categorized into: (i) breakfast skippers; (ii) breakfast with TV (TV watchers at breakfast); and (iii) breakfast without TV (breakfast eaters who do not watch TV during breakfast). Self-reported weight and height were used to categorize weight status as underweight, normal weight, overweight and obese. Multinomial logistic regression analyses were conducted with weight status as the dependent variable and breakfast habits as predictors, adjusting for sex, ethnicity and level of education.

The survey was conducted in 2010 in 199 primary schools across eight European countries participating in the ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) cross-sectional study.

Parents (n 6512) of 10–12-year-olds responded to the questionnaire.

In the total study sample, with breakfast without TV as the reference group and adjusting for sex, ethnicity and level of education, the OR of being respectively overweight or obese (compared with normal weight) was 1·2 (95 % CI 1·0, 1·4) or 1·8 (95 % CI 1·5, 2·3) for breakfast skippers. The OR of being respectively underweight or obese was 0·5 (95 % CI 0·2, 0·9) or 1·4 (95 % CI 1·1, 1·8) for breakfast with TV.

Breakfast skippers were significantly more likely to be overweight and obese, and those eating breakfast while watching TV were significantly more likely to be obese and less likely to be underweight.

In contrast to non-vegetarians, vegetarians consume more legumes and meat analogues as sources of protein to substitute for meat intake. The present study aimed to assess the association between foods with high protein content (legumes, meat, meat analogues) by dietary pattern (vegetarians, non-vegetarians) and hip fracture incidence, adjusted for selected lifestyle factors.

A prospective cohort of Adventist Health Study-2 (AHS-2) enrollees who completed a comprehensive lifestyle and dietary questionnaire between 2002 and 2007.

Every two years after enrolment, a short questionnaire on hospitalizations and selected disease outcomes including hip fractures was sent to these members.

Respondents (n 33 208) to a baseline and a follow-up questionnaire.

In a multivariable model, legumes intake of once daily or more reduced the risk of hip fracture by 64 % (hazard ratio = 0·36, 95 % CI 0·21, 0·61) compared with those with legumes intake of less than once weekly. Similarly, meat intake of four or more times weekly was associated with a 40 % reduced risk of hip fracture (hazard ratio = 0·60, 95 % CI 0·41, 0·87) compared with those whose meat intake was less than once weekly. Furthermore, consumption of meat analogues once daily or more was associated with a 49 % reduced risk of hip fracture (hazard ratio = 0·51, 95 % CI 0·27, 0·98) compared with an intake of less than once weekly.

Hip fracture incidence was inversely associated with legumes intake and, to a lesser extent, meat intake, after accounting for other food groups and important covariates. Similarly, a high intake of meat analogues was associated with a significantly reduced risk of hip fracture.

Iodine deficiency has recently been found in UK young and pregnant women, which is of concern given the importance of adequate iodine intake in pregnancy for fetal brain development. The WHO recommends that iodine deficiency in a population should be corrected through salt iodisation but there is a lack of UK data on iodised-salt availability, a situation that the present study aimed to address.

Availability of iodised salt for household use was determined by a shelf survey in five supermarket chains in each of sixteen UK areas (in Southern England, Wales and Northern Ireland) encompassing a total of seventy-seven supermarkets. All branches of a sixth supermarket chain that had 2·3 % of the market share sold exclusively iodised salt. Weighted iodised-salt availability was calculated taking the market share of supermarkets into account.

The UK.

Not applicable.

Iodised salt was available in thirty-two of the seventy-seven supermarkets (41·6 %). After accounting for market share and including all six UK supermarket chains, the weighted availability of iodised salt was 21·5 %. The iodine concentration of the major UK brand of iodised salt is low, at 11·5 mg/kg.

In contrast to other countries, iodised household table salt is unlikely to contribute meaningful amounts to UK iodine intake as (i) availability is low, (ii) table salt is only a small percentage of total UK salt intake and (iii) UK public-health campaigns have encouraged reduced salt consumption. As iodine intake in the UK is dependent entirely on food choices, regular monitoring of iodine status is essential.

To assess the effectiveness of facility-based care for children with severe acute malnutrition (SAM) in malnutrition treatment centres (MTC).

Early detection and treatment of SAM using locally adapted protocols; assessment of programme outcomes, including survival, default, discharge and recovery rates.

All forty-eight MTC in Jharkhand, India.

Children (n 3595) with SAM admitted to MTC (1 July 2009–30 June 2011).

Of children admitted, 55·0 % were girls, 77·7 % were 6–23 months old and 68·6 % belonged to scheduled tribes or castes; 34·4 % had oedema or medical complications. Of the 3418 programme exits, the proportion of children who died was 0·6 % (n 20), the proportion of children who defaulted was 18·4 % (n 628) and the proportion of children discharged was 81·0 % (n 2770). Children's average weight gain was 9·6 (sd 8·4) g/kg body weight per d and their average length of stay was 16·0 (sd 5·7) d. Among the 2770 children who were discharged from the programme, 39·4 % (n 1090) gained 15 % or more of their initial weight while 60·6 % (n 1680) gained less than 15 % of their initial weight.

MTC provide live-saving care for children with SAM as demonstrated by high survival rates. However, the protocols and therapeutic foods currently used need to improve to ensure the recovery of all discharged children. MTC should be reserved for children with complicated SAM; children with uncomplicated SAM should be admitted to a community-based programme for the management of SAM, at a lesser risk to children and a lesser cost to families and the health system.

To study the association between dinner eating location and the nutritional quality of the specific dinner meal and the whole-day dietary intake and to compare the diets of those consuming ≥25 % of energy out of home and at school/work (SOH; substantial out-of-home eaters) with those consuming <25 % of energy out (NSOH; non-substantial out-of-home eaters).

Cross-sectional dietary survey using two non-consecutive 24 h recalls. Recorded eating locations were at home, other private households, work/school, restaurant/cafeteria/fast-food outlet and travel/meeting.

Nationwide, Norway (2010–2011).

Adults aged 18–70 years (n 1746).

Dinners at restaurants and other private households were higher in energy than home dinners (P < 0·01). Restaurant dinners contained less fibre (g/MJ; P < 0·01) and had a higher percentage of alcohol consumers (P < 0·05), while dinners at other private households had a higher percentage of energy from sugar (P < 0·001) and a higher percentage of consumers of sugar-sweetened beverages (P < 0·05) than home dinners. Most differences between dinners consumed at different eating locations were also observed in dietary intakes for the whole day. SOH-eaters had a higher energy intake (P < 0·01), a higher percentage of energy from sugar (P < 0·01) and a lower fibre intake (P < 0·01) than NSOH-eaters. The percentages of consumers of alcohol and sugar-sweetened beverages were higher (P < 0·01) among SOH-eaters.

Dinner eating location was significantly associated with the nutritional quality of the diet, both for the specific dinner meal and for whole-day intake. Our data generally point to healthier dinners being consumed at home. SOH-eaters had a less favourable dietary intake than NSOH-eaters.

To articulate a healthy and sustainable (H&S) diet; outline key health and environmental sustainability principles that can be applied in the selection of foods for inclusion in such a diet; and describe a methodology with which to assess the availability and affordability of a H&S food basket.

We synthesized publically available evidence on the environmental impact of different foods from academic, government, industry and non-government sources and constructed a hypothetical H&S equivalent of the typical Australian diet. Based on this, we constructed a weekly H&S food basket for a household of two adults and two children.

Australia.

Australian populations.

The H&S diet is based on three overarching principles: (i) any food that is consumed above a person's energy requirement represents an avoidable environmental burden in the form of greenhouse gas emissions, use of natural resources and pressure on biodiversity; (ii) reducing the consumption of discretionary food choices, which are energy-dense and highly processed and packaged, reduces both the risk of dietary imbalances and the use of environmental resources; and (iii) a diet comprising less animal- and more plant-derived foods delivers both health and ecological benefits.

We have focused on the articulation of a H&S diet not to facilitate ‘policy drift’ to focus on individual dietary choice, but rather to provide evidence to extend dietary guideline recommendations so as to integrate environmental considerations within the scope of food and health policy advice in Australia and elsewhere.

The objectives of the present study were to assess the nutritional status, identify factors for malnutrition risk and evaluate barriers to adequate nutrition among recipients of the Public Assistance (PA) scheme for socio-economically disadvantaged Singaporeans.

Using a cross-sectional study design, we assessed PA recipients’ malnutrition risk using the DETERMINE Nutritional Health checklist and the full Mini-Nutritional Assessment (MNA), as well as their nutritional knowledge, co-morbidity burden, depression risk, instrumental and basic activities of daily living (IADL and BADL), and awareness and utilization of available food services. In-depth interviews were also conducted on malnourished individuals (MNA score < 17) to understand barriers to adequate nutrition.

Homes of community-living older adults and nursing homes of institutionalized older adults.

All PA recipients aged ≥55 years in Central Singapore District.

Four hundred and sixty-five of 511 (91·0 %) eligible PA recipients participated in the study. The prevalence of malnutrition in the study population was 2·8 %. However, 50·3 % were at risk of malnutrition. Among community-dwelling respondents, the risk of malnutrition was independently associated with age >75 years, currently unmarried, BADL impairment, depression risk and BMI < 19·0 kg/m2. Qualitative analysis revealed that financial, social and physical barriers and lack of knowledge were the main contributors to poor nutritional status. Only half were aware of subsidized food services and education increased interest in utilizing food services. Among nursing home respondents, those who were BADL impaired were more likely to be at risk of malnutrition.

Among PA recipients, the prevalence of malnutrition is low but the risk of malnutrition is high. Education on adequate nutrition and food services are recommended.

To assess current salt † reduction policies in countries of the WHO European Region against the backdrop of varying levels of human development adjusted for income, education and health (longevity) inequalities.

Population-based, cross-sectional study, with data gathered through systematic review of relevant databases and supplementary information provided by WHO Nutrition Counterparts.

Member States of the WHO European Region.

Inequality-adjusted Human Development Index scores were analysed against assessed levels of development and implementation of national nutrition policies and initiatives targeting population-level salt reduction.

Within the WHO European Region, Inequality-adjusted Human Development Index values among countries with no existing salt reduction initiatives (mean 0·643 (se 0·022)) were significantly lower than among those with either partially implemented/planned salt initiatives (mean 0·766 (se 0·017), P < 0·001) or fully implemented salt initiatives (mean 0·780 (se 0·021), P < 0·001).

Where salt reduction strategies are implemented as an integral part of national policy, outcomes have been promising. However, low- and middle-income countries may face severe resource constraints that keep them from emulating more comprehensive strategies pursued in high-income countries. Care must be taken to ensure that gaps are not inadvertently widened by monitoring differential policy impacts of salt policies, particularly regarding trade flows.

Neural tube defects are among the most common birth defects worldwide. Folic acid intake from one month before to three months after conception reduces the likelihood of neural tube defects by at least 50 %. Since 1995, several campaigns have been organised in the Netherlands which resulted in 51 % of pregnant women using folic acid supplements during the entire recommended period in the northern part of the Netherlands in 2005. Our research question was to gain insight into the current prevalence and factors associated with inadequate pregnancy-related use of folic acid supplements.

Data from the DELIVER study were used, which is a population-based cohort study.

Twenty midwifery practices across the Netherlands in 2009 and 2010.

In total 5975 pregnant women completed a questionnaire covering items on sociodemographic and lifestyle factors, including folic acid intake.

Of our study population, 55·5 % (3318/5975) used folic acid supplements before conception. Several sociodemographic and lifestyle factors were associated with no preconception use of folic acid, of which non-Western ethnicity and not having a partner had the largest effect size.

In the Netherlands, the folic acid intake before conception is suboptimal and has not improved over recent years. Fortification of staple foods with folic acid should be reconsidered as it would provide a more effective means of ensuring an adequate intake, especially for those groups of women who are unlikely to plan their pregnancies or to receive or respond to health promotion messages.

To evaluate the quality of policies concerning the diagnosis, treatment and prevention of anaemia in children and adolescents; to determine to what extent these are evidence-based; and to use this analysis to inform the policy-making process.

Children and adolescents in sub-Saharan Africa.

Almost 50 % of children and adolescents in sub-Saharan Africa are anaemic, which has profound effects on their intellectual and physical development and their chance of survival. Evidence-based policies are essential to reduce anaemia but because it is caused by an array of interdependent factors, developing policies is challenging.

Forty-six policy documents concerning the diagnosis, treatment and prevention of anaemia in children and adolescents were identified and analysed.

There was policy consensus on the usefulness of Fe supplements, the need to treat co-morbidities and the use of blood transfusions for severe anaemia. Information about diagnosis was scarce, and messages regarding the control of anaemia were mixed. Few of the policies were tailored for the African context and they were located on several websites hosted by different health programmes.

The weakest aspects of the policies and consequently the priorities for better policy making were: lack of adherence to WHO recommendations for guideline development; little involvement of African practitioners/policy makers in the guideline group and as peer reviewers; and lack of harmonisation, demonstrating the need to establish a single body responsible for developing/revising anaemia policies.

Nutrition information aims to reduce information asymmetries between manufacturers and consumers. To date, however, it remains unclear how nutrition information that is shown on the front of the packaging should be designed in order to increase both visual attention and the tendency to make healthful food choices. The present study aimed to address this gap in research.

An experimental laboratory study applying mobile eye-tracking technology manipulated the presence of two directive cues, i.e. health marks and traffic light colour-coding, as part of front-of-package nutrition information on actual food packages.

Participants wore mobile eye-tracking glasses during a simulated shopping trip. After the ostensible study had finished, they chose one snack (from an assortment of fifteen snacks) as a thank you for participation. All products were labelled with nutrition information according to the experimental condition.

Consumers (n 160) who were mainly responsible for grocery shopping in their household participated in the study.

The results showed that, in the absence of traffic light colouring, health marks reduced attention to the snack food packaging. This effect did not occur when the colouring was present. The combination of the two directive cues (v. presenting traffic light colours only) made consumers choose more healthful snacks, according to the nutrient profile.

Public policy makers may recommend retailers and manufacturers implement consistent front-of-pack nutrition labelling that contains both health marks and traffic light colouring as directive cues. The combination of the cues may increase the likelihood of healthful decision making.

To compare, in adolescents, two models of front-of-pack Guideline Daily Amounts (GDA) labels in terms of (i) friendliness and acceptance and (ii) the ability to choose a diet that closely follows the nutritional recommendations.

A randomized cross-over study was designed to compare two simplified front-of-pack GDA nutrition labels.

A Spanish secondary school.

Eighty-one healthy adolescents aged between 14 and 16 years were recruited. Participants were randomly exposed to two experimental non-real food-choice conditions using multiple-traffic-light or monochrome nutritional labels. Participants had to choose options from a closed menu for 5 d on the basis of the experimental front-of-pack labelling. For each meal, three food options with different nutritional compositions were given to the participants. The contents of total energy and fat, saturated fat, sugar and salt of the chosen options were calculated.

There were no significant differences in baseline sociodemographic and anthropometric characteristics between participants regardless of the experimental condition in which they started. There were no carry-over effects between the experimental sequences. It was observed that when participants used the multiple-traffic-light GDA system they chose significantly less total energy (mean –123·1 (sd 211·0) kJ (−29·4 (sd 50·4) kcal), P < 0·001), sugar (−4·5 (sd 4·6) g, P < 0·001), fat (−2·1 (sd 4·5) g, P = 0·006), saturated fat (−1·0 (sd 1·9) g, P = 0·002) and salt (−0·4 (sd 0·5) g, P < 0·001) than when they used the monochrome GDA system.

Compared with the monochrome GDA front-of-pack nutritional label, the multiple-traffic-light system helped adolescents to differentiate between healthier and less healthy food, theoretically making it possible for them to choose a diet closer to dietary recommendations.

(i) To assess change in confidence in having conversations that support parents with healthy eating and physical activity post-training. (ii) To assess change in staff competence in using ‘open discovery’ questions (those generally beginning with ‘how’ and ‘what’ that help individuals reflect and identify barriers and solutions) post-training. (iii) To examine the relationship between confidence and competence post-training.

A pre–post evaluation of ‘Healthy Conversation Skills’, a staff training intervention.

Sure Start Children's Centres in Southampton, England.

A total of 145 staff working in Sure Start Children's Centres completed the training, including play workers (43 %) and community development or family support workers (35 %).

We observed an increase in median confidence rating for having conversations about healthy eating and physical activity (both P < 0·001), and in using ‘open discovery’ questions (P < 0·001), after staff attended the ‘Healthy Conversation Skills’ training. We also found a positive relationship between the use of ‘open discovery’ questions and confidence in having conversations about healthy eating post-training (r = 0·21, P = 0·01), but a non-significant trend was observed for having conversations about physical activity (r = 0·15, P = 0·06).

The ‘Healthy Conversation Skills’ training proved effective at increasing the confidence of staff working at Sure Start Children's Centres to have more productive conversations with parents about healthy eating. Wider implementation of these skills may be a useful public health nutrition capacity building strategy to help community workers support families with young children to eat more healthy foods.

The present study sought to identify both the ingredients for success and the potential impediments to social marketing effectiveness for healthy eating behaviour, focusing on studies conducted over the last 10 years.

A comprehensive literature review was undertaken examining seventeen databases to identify studies reporting the use of social marketing to address healthy eating. Thirty-four empirical studies were analysed to examine the effectiveness of social marketing interventions to improve healthy eating behaviour using Andreasen's (2002) social marketing benchmark criteria. Statistical analysis was undertaken to quantitatively evaluate whether effectiveness varied between study categories (subsets).

Healthy eating empirical studies published from 2000 onwards.

Empirical studies that self-identified as social marketing.

Sixteen social marketing studies (subset 1) were identified in the review. These were systematic studies which sought to change behaviour through tailored solutions (e.g. use of marketing tools beyond communication was clearly evident) that delivered value to the target audience. For these sixteen studies, the mean number of criteria identified was five. Six studies met all six criteria. Positive change to healthy eating behaviour was found in fourteen of sixteen studies. The sixteen studies that met the definition of social marketing used significantly more of Andreasen's (2002) criteria and were more effective in achieving behavioural change than the eighteen studies in subset 2.

Social marketing is an involved process and it is important that studies identifying as social marketing adopt social marketing benchmark criteria. Social marketing when employed to its full extent offers the potential to change healthy eating.

The present study was conceived in response to a perceived lack of data about the nutritional status of free-living elderly Yoruba people living in a poor urban area in south-western Nigeria. The major focus was to assess the micronutrient status of elderly Yoruba people living in a slum of Ibadan.

A cross-sectional descriptive study was designed to collect data on dietary intake and micronutrient status.

By means of a structured questionnaire and the estimated food record method, nutrient intake was assessed. Blood was taken from 120 people to determine serum micronutrient levels.

A total of 240 elderly Yoruba people were selected from Ibadan, Oyo State, Nigeria using a random sampling technique.

The diet of the elderly Yoruba participants was mainly plant based and inadequate in B vitamins (especially B1, B6 and folic acid) and micronutrients such as Zn. The intake of vitamin A ranged from 269 to 487 μg/d, while vitamin B1 and B2 intakes ranged from 0·20 to 0·82 mg/d in both males and females. The intake of vitamin C varied from 24·8 to 42·8 mg/d. The majority of participants had insufficient serum levels of vitamins and minerals relative to reference values. Forty per cent were deficient in serum Ca, 71 % were deficient in serum Zn and 51 % were deficient in serum 25-hydroxyvitamin D.

The majority of the elderly Yoruba people were deficient in Zn, ferritin and vitamin B6. This is the result of a diet lacking in vitamins and minerals.