The primary objective of this study was to generate a reference table of food items and average amounts of these items consumed by South Africans, for the Department of Health. The reference table was required to be representative of foods and beverages eaten frequently by children and adults from all age and ethnic groups in order for the Department of Health to test for contaminants in these foods.

The National Food Consumption Survey (NFCS) served as a framework for compiling data on children since this was a national representative survey of 1–9-year-old children undertaken in South Africa in 1999. However, there has never been a national dietary survey on adults in South Africa. Consequently the data had to be extrapolated from existing isolated surveys on adults. Secondary data analysis was conducted on existing dietary databases (raw data) obtained from surveys undertaken on adults in South Africa between 1983 and 2000. Available datasets were regional and independent, and were not individually representative of the South African diet. It was therefore necessary to use different statistical methods, including factor analyses, weighting and correlations, to generate ethnic and geographic representative data for adults. Two methods were used: Method 1, which corresponded with results of the NFCS (over-sampled for low socio-economic status), and Method 2, which was based on ethnic proportions of the population.

The secondary data analyses generated food items most commonly consumed by the South African adult population (Method 1) in descending frequency of usage and average (mean) amount per day: maize porridge (78%/848 g), white sugar (77%/27 g), tea (68%/456 g), brown bread (55%/165 g), white bread (28%/163 g), non-dairy creamer (25%/6 g), brick margarine (21%/19 g), chicken meat (19%/111 g), full-cream milk (19%/204 g) and green leaves (17%/182 g). In 6–9-year-olds, maize porridge (72%/426 g), sugar (76%/23 g), tea (51%/258 g), full-cream milk (35%/171 g) and white bread (33%/119 g) were eaten most frequently. Similarly, in 1–5-year-olds, the foods consumed most frequently were maize porridge (80%/426 g), sugar (76%/21 g), tea (44%/224 g), full-cream milk (39%/186 g) and white bread (24%/83 g). In order to evaluate the validity of the adult data generated, kilojoule values of the individual food items (per capita) were compared with food balance sheets (FBSs). The comparison was favourable except that the FBSs had a higher overall energy intake per capita of between 22 and 28%.

Reference tables of commonly consumed foods and beverages were generated at minimal cost based on secondary data analyses of past dietary surveys in different South African populations.

To identify the factors associated with childhood undernutrition.

Cross-sectional survey.

Hlabisa health district in KwaZulu/Natal, South Africa.

Eight hundred and sixty-eight children aged 3–59 months.

Questionnaire survey and anthropometric survey of 516 random house-holds with children in the health district. Multivariate analysis took into account the hierarchical relationships between the proposed risk factors. This conceptual model was built up during qualitative studies and with reference to international research in this area.

The mean Z-scores for weight-for-age and height-for-age were −0.52 (95% confidence interval (CI)−0.44 to −0.60) and −1.25 (95% CI −1.15 to −1.35), respectively. Of the children, 26.3% (95% CI 23.3–29.3%) were stunted, 12.0% (95% CI 9.8–4.2%) were underweight-for-age (UWFA) and only 1.3% were wasted. Migrant father, mother's education, literate mother, whether the house was made of traditional materials, the presence of a toilet, whether the last child was breast-fed, duration of breast-feeding and birth weight were found to be significantly related to UWFA, the latter with an odds ratio of more than eight.

While there are individual health and feeding behaviours that need to be addressed, this study has also uncovered the maternal and socio-economic factors which present an array of constraints in the social environment shaping the infant feeding and caring practices employed by women. For the full potential of nutrition promotion activities to be realised, there is a need to address some of these ‘deeper’ constraints.

Malnutrition rates in Sierra Leone are among the highest in the world. However, policy-makers do not always recognise the fight against malnutrition as a policy priority to ensure the healthy human capital needed to fight poverty and achieve sustained positive economic growth.

The analysis presented here was conducted by an intersectoral and inter-agency group of Sierra Leonean senior policy advisors to quantify some of the potential human and economic benefits of improved policies and programmes to reduce malnutrition.

The analysis revealed that 46% of child deaths in Sierra Leone are attributable to malnutrition, the single greatest cause of child mortality in the country. In the absence of adequate policy and programme action, malnutrition will be the underlying cause of an estimated 74000 child deaths over the next five years. The analysis also revealed that if current levels of iodine deficiency remain unchanged over the next five years, 252000 children could be born with varying degrees of mental retardation as a result of intrauterine iodine deficiency. Finally, the analysis showed that, in the absence of adequate policy and programme action to reduce the unacceptable rates of anaemia in women, the monetary value of agricultural productivity losses associated with anaemia in the female labour force over the next five years will exceed $94.5 million.

Sustained investment in nutrition in Sierra Leone could bring about enormous human and economic benefits to develop the social sector, revitalise the economy, and attain the poverty reduction goals that Sierra Leone has set forth.

To describe obesity among students of public schools in São Paulo and to identify risk factors for this nutritional and physical activity disorder.

Case– control study of obese and non-obese schoolchildren to study risk factors for obesity.

Anthropometric survey including 2519 children attending eight elementary public schools in Sã o Paulo, Brazil.

Schoolchildren aged 7–10 years, of whom 223 were obese (cases; weight-for-height greater than or equal to two standard deviations(≥2SD) above the median of the National Center for Health Statistics (NCHS) reference population) and 223 were eutrophic (controls; weight-for-height ±1SD from NCHS median).

Parents or guardians of the 446 cases and controls were interviewed about the children's eating behaviours and habits.

The prevalence of obesity (weight-for-height ≥2SD) in the surveyed population was 10.5%. A logistic regression model fitted to the case–control dataset showed that obesity was positively associated with the following factors: birth weight ≥3500 g (odds ratio (OR) 1.83, 95% confidence interval (CI) 1.21–2.78), child's appetite at meals (OR 3.81, 95% CI 2.49–5.83), watching television for 4h per day or longer (OR 2.07, 95% CI 1.32–3.24), mother's schooling>4 years (OR 1.85, 95% CI 1.25–2.75) and parents' body mass index ≥ 30 kgm−2(OR 2.50, 95% CI 1.43–4.37).

The explanatory multivariate model points to preventive measures that would encourage knowledge of the children and their guardians in relation to a balanced diet and a less sedentary lifestyle, such as reducing television viewing. Schoolchildren with a birth weight of 3500g or more or whose parents are obese should receive special attention in the prevention of obesity.

Socio-economic development influences many factors that affect health, especially diet and nutrition. This investigation proposes that a system of transitions occur as societies develop, with socio-economic, physical activity, dietary, nutrition and body weight transitions operating in relationship with each other. This model of transitions was examined empirically using South Korea as an example of a nation that has undergone considerable changes.

Data were drawn from published government reports: the Korean National Nutrition Survey and annual reports at the national level for the years between 1969 and 1993. The socio-economic transition was assessed by gross national product. The physical activity transition was assessed using annual proportions of the population involved in primary, secondary and tertiary industries, as well as the number of cars and driver's licences. The dietary transition was measured by plant and animal food consumption. The nutrition transition was assessed by percentages of energy from carbohydrate, protein and fat. The body weight transition was measured by body mass index calculated from the average height and weight of adolescents.

Results revealed that the transitions were highly correlated as expected, with the socio-economic transition exhibiting major changes. South Koreans tended to decrease their physical activity and plant food consumption, and to increase animal food consumption, percentage of energy from dietary fat and body weight, in relationship to the socio-economic transition.

Examining a system of transitions on a national level in one country that has undergone rapid economic development may provide a strategy for examining how such transitions operate in other nations.

To investigate the effects of tobacco smoking on serum vitamin B12, folic acid and haematological parameters in healthy Thai smokers and non-smokers.

Cross-sectional study of smokers and non-smokers in a military unit in Bangkok, Thailand.

A military unit in Thailand.

One hundred and twenty-three male smokers from a military unit in Bangkok, who participated voluntarily in the study, were investigated. Sixty-six male non-smokers from the same unit were selected as controls. Fasting blood samples were collected for investigation of vitamin B12, folic acid and haematological variables.

The serum folic acid concentration of smokers was lower than that of non-smokers, but was not statistically significantly different. Haemoglobin was lower in smokers than in non-smokers; 16.3% of smokers were anaemic compared with only 3.0% of non-smokers. Anaemia was not related to folate deficiency. The white blood cell count was found to be higher in smokers than in non-smokers.

The results of this study suggest that there were low serum folic acid concentrations in smokers compared with non-smokers, which might contribute to the development of vascular and cardiovascular diseases. The higher white blood cell count might be indicative alterations in the immune functions of smokers.

To assess the nutrition knowledge levels and dietary intake pattern of schoolchildren belonging to two groups of different socio-economic status (SES; high income/high SES and low income/low SES).

A purposive sampling method was employed. A validated food-frequency questionnaire was administered to assess the dietary intake of schoolchildren in four schools from two different socio-economic strata in the month of January 2001. The children were divided into two groups, one serving as the experimental group and the other as the control group.

Two hundred and seventy-two children aged between 12 and 14 years.

There was a significant improvement (P < 0.001) in the knowledge levels of high-SES schoolchildren as compared with low-SES schoolchildren. A significant difference was observed in the intake of protective foods like milk and milk products, green leafy vegetables and fruits between the two income groups. However, children from the high SES background preferred fast foods such as noodles and corn flakes to traditional foods. Irrespective of income group, most of the children consumed carbonated beverages.

There was a significant difference in the intakes of protective foods and fast foods between the different income groups. However, the increased intake of fast foods and carbonated beverages by the children irrespective of SES needs to be discouraged as a part of nutrition education. The study indicated the need for repeated interventions for improvement of nutrition knowledge levels in low-SES children.

To examine associations of changes in dietary intake with education in young black and white men and women.

The Coronary Artery Risk Development in Young Adults (CARDIA) study, a multi-centre population-based prospective study. Dietary intake data at baseline and year 7 were obtained from an extensive nutritionist-administered diet history questionnaire with 700 items developed for CARDIA.

Participants were recruited in 1985–1986 from four sites: Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; and Oakland, California.

Participants were from a general community sample of 703 black men (BM), 1006 black women (BW), 963 white men (WM) and 1054 white women (WW) who were aged 18–30 years at baseline. Analyses here include data for baseline (1985–1986) and year 7 (1992–1993).

Most changes in dietary intake were observed among those with high education (≥ 12 years) at both examinations. There was a significant decrease in intake of energy from saturated fat and cholesterol and a significant increase in energy from starch for each race-gender group (P < 0.001). Regardless of education, taste was considered an important influence on food choice.

The inverse relationship of education with changes in saturated fat and cholesterol intakes suggests that national public health campaigns may have a greater impact among those with more education.

Intake of sugars is restricted in most international food guides. However, in recent recommendations quantified limits of added sugars intake have not been given, although deemed necessary by those who criticised the recommendations.

Two approaches to derive a scientifically based quantified limit of added sugars intake for German children and adolescents are suggested. For the first dietary survey approach, 5120 three-day weighed dietary records from the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) Study were used. Added sugars intakes in records of high vs. low dietary quality, measured by a nutrient intake score, were compared. For the second approach, a total dietary concept for German children and adolescents developed and evaluated by the Research Institute of Child Nutrition – the Optimised Mixed Diet – was used.

Whereas in the latter dietary concept an added sugars intake of about 6% of energy intake is tolerated, the dietary survey approach resulted in only small differences between high and low dietary quality, with a median added sugars intake of 12% of energy in records with high dietary quality.

A reasonable dietary quality is possible within higher ranges of added sugars intake than derived from the dietary concept approach. Therefore we suggest a range of intake of added sugars for German children and adolescents, from 6% to 12% of energy.

To examine associations of biomarkers of nutrient intake with overall diet quality.

A convenience sample of 102 healthy postmenopausal women in Seattle, Washington (USA).

Participants attended a study centre where they provided fasting blood specimens and completed a 122-item validated food-frequency questionnaire (FFQ). Data from the FFQ were used to calculate Diet Quality Index (DQI) scores and categorise women as having diets of excellent, good, fair or poor quality. The blood specimens were analysed for nine phospholipid fatty acids (as percentage of total) and serum concentrations of vitamin C, α-tocopherol, γ-tocopherol, vitamin B12, folate and six carotenoids. Multivariate linear regression was used to model associations of the nutrient biomarkers with DQI scores.

Compared with women with poor-quality diets, women with excellent diets, as measured by the DQI, had higher plasma concentrations of vitamin C (P for trend = 0.01), α-tocopherol (P for trend = 0.02) and β-cryptoxanthin (P for trend = 0.03). Women with excellent diets also had lower proportions of plasma phospholipid fatty acids of two potentially atherogenic fatty acids: stearic acid (P for trend = 0.01) and behenic acid (P for trend = 0.03). A group of six biomarkers explained a moderate proportion of the total variability in DQI scores (36%).

These objective measures of dietary intake support the use of the DQI as a useful tool to measure dietary patterns.

To evaluate the contribution of composite foods to vegetable and fruit intakes in Irish adults and to compliance with dietary guidelines for vegetable and fruit intake.

Data were analysed from the North/South Ireland Food Consumption Survey of 18–64-year-old adults (n = 1379; 662 men, 717 women), which used a 7-day food diary to estimate food intake.

The mean intake of vegetables (excluding potatoes) was 140g day−1 (men 149g day−1; women 132g day−1), of fruit was 136 g day−1 (men 133g day−1; women 140 g day−1) and of potatoes was 227 g day−1 (men 296g day−1; women 163 g day−1). The mean daily intakes of vegetables, fruit and potatoes from composite foods were 37 g (26%), 6 g (5%) and 17 g (7%), respectively. The mean intake of vegetables from composite foods was unrelated to age or gender, but increased with increasing social class and level of education attained. The proportions of men and women meeting the recommendation for ≥400g day−1 (5 servings of 80 g per day) of vegetables and fruit were 21% (15% excluding composite foods) and 19% (12% excluding composite foods), respectively. Compliance with the dietary recommendation decreased with decreasing levels of educational attainment and social class.

Intakes of vegetables and fruit are low compared with current dietary recommendations, particularly in those of lower levels of educational attainment and social class. Composite foods are an important source of vegetables (less importantly of fruit) and should be included when estimating vegetable intakes. Failure to do so may result in bias in estimates of intake and of compliance with dietary guidelines for population groups, as well as misclassification of individuals by level of intake.