Critical nutrition literacy (CNL), as an increasingly important area in public health nutrition, can be defined as the ability to critically analyse nutrition information, increase awareness and participate in action to address barriers to healthy eating behaviours. Far too little attention has been paid to establishing valid instruments for measuring CNL. The aim of the present study was to assess the appropriateness of utilizing the latent scales of a newly developed instrument assessing nursing students’ ‘engagement in dietary habits’ (the ‘engagement’ scale) and their level of ‘taking a critical stance towards nutrition claims and their sources’ (the ‘claims’ scale).

Data were gathered by distributing a nineteen-item paper-and-pencil self-report questionnaire to university colleges offering nursing education. The study had a cross-sectional design using Rasch analysis. Data management and analysis were performed using the software packages RUMM2030 and SPSS version 20.

School personnel handed out the questionnaires.

Four hundred and seventy-three students at ten university colleges across Norway responded (52 % response rate).

Disordered thresholds were rescored, an under-discriminating item was discarded and one item showing uniform differential item functioning was split. The assumption of item locations being differentiated by stages was strengthened. The analyses demonstrated possible dimension violations of local independence in the ‘claims’ scale data and the ‘engagement’ scale could have been better targeted.

The study demonstrates the usefulness of Rasch analysis in assessing the psychometric properties of scales developed to measure CNL. Qualitative research designs could further improve our understanding of CNL scales.

We examined the socio-economic differential in the self-perception of body weight, future intention for weight management and actual weight-management behaviour among normal-weight, overweight and obese women in India.

A population-based follow-up survey of ever-married women, systematically selected from the second round of the National Family Health Survey (NFHS-2, 1998–99) samples, who were re-interviewed after four years in 2003.

Information on women's perception about their own weight, intention of weight management and actual weight-management behaviour were collected through personal interview. Anthropometric measurements were obtained from women to compute their current BMI.

Three hundred and twenty-five ever-married women aged 20–54 years residing in the national capital territory of Delhi in India.

Discrepancy between self-perceived body weight and women's actual body weight was reported. One-quarter of overweight women and one in ten obese women perceived themselves as normal weight. Although a majority of overweight and obese women wanted to reduce their weight, a significant proportion of overweight (one in four) and 4 % of obese women also wanted to maintain their weight as it is. Only one in three overweight and one in four obese women were performing any physical activity to reduce their weight.

These findings are important for public health interventions in obesity care. Implementation of health promotion and health education in the community should use effective school education and mass-media programmes to raise awareness of appropriate body weight to combat the growing level of obesity among Indian women.

To examine the association between breakfast skipping and physical activity among US adolescents aged 12–19 years.

A cross-sectional study of nationally representative 2007–2008 National Health and Nutrition Examination Survey (NHANES) data.

Breakfast skipping was assessed by two 24 h dietary recalls. Physical activity was self-reported by participants and classified based on meeting national recommendations for physical activity for the appropriate age group. Multiple logistic regression analysis was used to model the association between breakfast skipping and physical activity while controlling for confounders.

A total of 936 adolescents aged 12–19 years in the USA.

After adjusting for family income, there was no association between breakfast skipping and meeting physical activity guidelines for age among adolescents aged 12–19 years (OR = 0·95, 95 % CI 0·56, 1·32).

Findings from the study differ from previous research findings on breakfast skipping and physical activity. Therefore, further research that uses large, nationally representative US samples and national recommended guidelines for physical activity 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.

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 evaluate five popular fast-food chains’ menus in relation to dietary guidance.

Menus posted on chains’ websites were coded using the Food and Nutrient Database for Dietary Studies and MyPyramid Equivalents Database to enable Healthy Eating Index-2005 (HEI-2005) scores to be assigned. Dollar or value and kids’ menus and sets of items promoted as healthy or nutritious were also assessed.

Five popular fast-food chains in the USA.

Not applicable.

Full menus scored lower than 50 out of 100 possible points on the HEI-2005. Scores for Total Fruit, Whole Grains and Sodium were particularly dismal. Compared with full menus, scores on dollar or value menus were 3 points higher on average, whereas kids’ menus scored 10 points higher on average. Three chains marketed subsets of items as healthy or nutritious; these scored 17 points higher on average compared with the full menus. No menu or subset of menu items received a score higher than 72 out of 100 points.

The poor quality of fast-food menus is a concern in light of increasing away-from-home eating, aggressive marketing to children and minorities, and the tendency for fast-food restaurants to be located in low-income and minority areas. The addition of fruits, vegetables and legumes; replacement of refined with whole grains; and reformulation of offerings high in sodium, solid fats and added sugars are potential strategies to improve fast-food offerings. The HEI may be a useful metric for ongoing monitoring of fast-food menus.

To estimate the prevalence of episodes of binge eating and to assess potential associations with nutritional status, satisfaction with current body weight, self-rated health status and self-rated body weight.

A cross-sectional population-based study. Binge eating was assessed using adapted questions from the Brazilian Portuguese version of the Questionnaire on Eating and Weight Patterns and was defined as binging one or more times over the last 3 months before the interview.

City of Pelotas, southern Brazil.

Individuals (n 2097) aged 20–59 years.

The prevalence of binge eating and recurrent binge eating was 7·9 % and 2·7 %, respectively. In the adjusted analysis, obesity, fair/poor self-rated health status and body dissatisfaction remained strongly associated with binge eating.

The study showed a high prevalence of binge eating among adults in Pelotas, being higher among younger women, the obese and those who desired to weigh less. The current results are informative, but longitudinal studies would be needed to demonstrate the causal relationship between these events.

To assess the impact of an intervention modifying dietary habits for the prevention of anaemia in rural India.

Intervention study with data on anthropometric (weight, height) measurements, Hb and diet pattern. As per the cut-off for Hb in the government programme, women with Hb <11 g/dl had to be given Fe tablets and formed the supplemented group while those with Hb > 11 g/dl formed the non-supplemented group.

Three villages near Pune city, Maharashtra, India.

Rural non-pregnant women (n 317) of childbearing age (15–35 years).

After 1 year of intervention, mean Hb increased (from 10·94 (sd 1·22) g/dl to 11·59 (sd 1·11) g/dl) significantly (P < 0·01) with a consequent reduction in the prevalence of anaemia (from 82·0 % to 55·4 %) as well as Fe-deficiency anaemia (from 30·3 % to 10·8 %). Gain in Hb was inversely associated with the initial level of Hb. Significant gain in Hb (0·57 g/dl) was observed among women attending >50 % of the meetings or repeating >50 % of the recipes at home (0·45 g/dl) in the non-supplemented group and was smaller than that observed in the supplemented group. Consumption of green leafy vegetables more than twice weekly increased substantially from 44·7 % to 60·6 %, as did consumption of seasonal fruits. Logistic regression showed that women with lower participation in the intervention had three times higher risk (OR = 3·08; 95 % CI 1·04, 9·13; P = 0·04) for no gain in Hb compared with those having high participation.

Developing action programmes for improving nutritional awareness to enhance the consumption of Fe-rich foods has great potential for preventing anaemia in rural India.

Breast-feeding counselling has been identified as the intervention with the greatest potential for reducing child deaths, but there is little experience in delivering breast-feeding counselling at scale within routine health systems. The study aim was to compare rates of exclusive breast-feeding associated with a breast-feeding counselling intervention in which community health agents (CHA) received 20 h of training directed at counselling and practical skills with rates pre-intervention when CHA received 4 h of didactic teaching.

Cross-sectional surveys of breast-feeding practices were conducted pre- and post-intervention in random samples of 1266 and 1245 infants aged 0–5·9 months, respectively.

Recife, Brazil, with a population of 2 million.

CHA (n 1449) of Brazil's Family Health Programme were trained to provide breast-feeding counselling at home visits.

Rates of exclusive breast-feeding improved when CHA were trained to provide breast-feeding counselling and were significantly higher by 10–13 percentage points at age 3–5·9 months when compared with pre-intervention rates (P < 0·05). Post-intervention point prevalence of exclusive breast-feeding for infants aged <4 months was 63 % and for those aged <6 months was 50 %.

Multifunctional CHA were able to deliver breast-feeding counselling at scale within a routine health service and this was associated with a significant increase in rates of exclusive breast-feeding. The study reinforces the need to focus training on counselling and practical skills; a key component was an interactive style that utilized the knowledge and experience of CHA. The findings are relevant to the call by international organizations to scale up breast-feeding counselling.