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The present study was designed to determine household food security status and factors associated with food insecurity among high-school students in Esfahan, Iran.
Design
Cross-sectional surveys.
Setting
The present study was conducted in autumn 2008 in Esfahan, Iran. The samples were selected using systematic cluster sampling. Socio-economic questionnaires, food security questionnaires and FFQ were filled out during face-to-face interviews. In addition, data on participants’ weights and heights were collected.
Subjects
A total of 580 students (261 boys and 319 girls) aged 14–17 years from forty high schools in Esfahan, Iran, were selected.
Results
The prevalence of household food insecurity according to the US Department of Agriculture food security questionnaire was 36·6 % (95 % CI 0·33, 0·40). Food insecurity was positively associated with number of members in the household (P < 0·05) and negatively associated with parental education level and job status and household economic status (P < 0·05). Moreover, students living in food-insecure households more frequently consumed bread, macaroni, potato and egg (P < 0·05), while they less frequently consumed rice, red meat, sausage and hamburger, poultry, fish, green vegetables, root and bulb (coloured) vegetables, melons, apples and oranges, milk and yoghurt (P < 0·05).
Conclusions
Food insecurity was prevalent among households in Esfahan, Iran, and food security status was associated with socio-economic factors. Students who belonged to food-secure households more frequently consumed healthy foods (except sausage and hamburger), whereas those living in food-insecure households more frequently consumed cheap foods containing high energy per kilogram. The present study suggests that intervention programmes be designed and carried out.
To investigate whether the socio-economic status (SES) of elderly eastern Mediterranean islanders is associated with their dietary habits, particularly with adherence to the traditional Mediterranean diet.
Design
Cross-sectional.
Setting
Adherence to the Mediterranean diet was measured by the MedDietScore (range: 0–55), whereas SES was estimated using education and financial status.
Subjects
During 2005–2007, 300 men and women from Cyprus, 100 from Samothraki, 142 from Mitilini, 114 from Kefalonia, 131 from Crete, 150 from Lemnos, 150 from Corfu and 103 from Zakynthos (aged 65–100 years), free of known chronic diseases, participated in the survey.
Results
Multiple linear regression analysis revealed that belonging to the highest SES was associated with a higher MedDietScore (P < 0·01), after adjusting for potential sociodemographic, lifestyle, dietary and clinical confounders. A significant positive association was also found between MedDietScore and years of school (P = 0·004), as well as financial status (P = 0·001).
Conclusions
Older Greek people of higher SES seem to follow a relatively healthier diet. Both education and income seem to play a role in this issue. Thus, public health policy makers should focus on people with low SES in order to improve their quality of diet and, consequently, their health status.
To determine factors which predict non-completion of group non-dieting interventions for overweight women, and to investigate whether completion improves outcomes.
Design
First, baseline predictors of non-completion were identified; then changes at 10 weeks and 12 months were compared between completers and non-completers of 10-week non-dieting interventions.
Setting
General community.
Subjects
Participants were 119 women (aged 25–65 years, BMI ≥ 28 kg/m2) with at least one cardiovascular risk factor. Participants who attended at least eight of the ten sessions were classified as completers, and non-completers were those who attended fewer than eight sessions. Measures included BMI, blood pressure, psychological distress, lifestyle behaviours and eating self-efficacy.
Results
Logistic regression analyses indicated that women were less likely to be non-completers at non-dieting group programmes if, at baseline, they were more highly educated or had healthier nutrition behaviours (controlling for education). Only healthier nutrition behaviour was negatively associated with non-completion in the final model. Twelve months after the intervention, completers showed significantly greater improvements in body weight (mean change −0·53 kg), systolic and diastolic blood pressure (−6·3 and −4·1 mmHg, respectively), stress management behaviour score (+0·5) and psychotic symptoms score (−0·1) than non-completers (all P < 0·05).
Conclusions
Highly educated women already engaging in some healthier lifestyle choices were less likely to be non-completers in non-dieting group programmes. Since important treatment outcomes vary according to attendance, future trials of non-dieting interventions should report the effects of completion on outcomes.
To examine whether a worksite nutrition programme using a low-fat vegan diet could significantly improve nutritional intake.
Design
At two corporate sites of the Government Employees Insurance Company, employees who were either overweight (BMI ≥ 25 kg/m2) and/or had type 2 diabetes participated in a 22-week worksite-based dietary intervention study.
Setting
At the intervention site, participants were asked to follow a low-fat vegan diet and participate in weekly group meetings that included instruction and group support (intervention group). At the control site, participants received no instruction (control group). At weeks 0 and 22, participants completed 3 d dietary records to assess energy and nutrient intake.
Subjects
A total of 109 participants (sixty-five intervention and forty-four control).
Results
In the intervention group, reported intake of total fat, trans fat, saturated fat and cholesterol decreased significantly (P ≤ 0·001), as did energy and protein (P = 0·01), and vitamin B12 (P = 0·002), compared with the control group. Intake (exclusive of any use of nutritional supplements) of carbohydrate, fibre, vitamin C, magnesium and potassium increased significantly (P ≤ 0·0001), as did that for β-carotene (P = 0·0004), total vitamin A activity (P = 0·004), vitamin K (P = 0·01) and sodium (P = 0·04) in the intervention group, compared with the control group.
Conclusions
The present study suggests that a worksite vegan nutrition programme increases intakes of protective nutrients, such as fibre, folate and vitamin C, and decreases intakes of total fat, saturated fat and cholesterol.
To evaluate the association between fatty acid (α-linolenic acid (ALA), EPA, DHA, palmitic, stearic, oleic, linoleic and arachidonic acids) intake and prospective weight change in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition.
Design
Prospective cohort study with mean follow-up time of 6·5 years. In a total of 9182 men and 10867 women aged 35 to 64 years, from body weight measurement at recruitment and calibrated body weight during follow-up, weight change was expressed as mean annual weight change relative to baseline weight (%/year) and categorised into four groups (weight loss, <−2·5%/5 years; stable weight, between −2·5 and +2·5%/5 years; small weight gain, ≥2·5 to <7·5%/5 years; large weight gain, ≥7·5%/5 years). Energy-adjusted dietary fatty acid intake data were estimated from the FFQ completed at baseline. Multivariate linear regression models as well as multinomial logistic regression analyses (carbohydrate replacement models) were conducted.
Results
Stearic acid intake was linearly associated with weight gain (P < 0·01) in men and women. Linear associations also existed for ALA and arachidonic acid intake, significantly so in women. In multinomial models, women in the highest tertile of ALA and stearic acid intake showed increased OR (95 % CI) for small weight gain (1·16 (0·94, 1·88) and 1·24 (1·08, 1·43), respectively), and large weight gain (1·39 (1·03, 1·88) and 1·56 (1·27, 1·90), respectively), whereas OR were non-significantly increased in men. Dietary intake of ALA was inversely associated with large (0·80 (0·65, 0·99)) weight gain in women only.
Conclusions
These results suggest differential effects of single dietary fatty acids on prospective weight gain in adults.
To analyse the 5-year sustainability of a worksite canteen intervention of serving more fruit and vegetables (F&V).
Design
Average F&V consumption per customer per meal per day was assessed in five worksite canteens by weighing F&V served and subtracting waste. Data were collected by the canteen staff during a 3-week continuous period and compared to data from the same five canteens measured at baseline, at end point and at 1-year follow-up. The intervention used a participatory and empowering approach, self-monitoring and networking among the canteen staff, management and a consultant. The method focused on providing ideas for increased F&V for lunch, making environmental changes in the canteens by giving access to tasteful and healthy food choices and reducing the availability of unhealthy options.
Setting
Five Danish worksites serving from 50 to 500 meals a day: a military base, an electronic component distributor, a bank, a town hall and a waste-handling facility.
Subjects
Worksite canteen managers, canteen staff.
Results
Four of the five worksite canteens were able to either maintain the intervention or even increase the consumption of F&V. The average increase from baseline to 5-year follow-up was 95 g per customer per meal per day (18, 144, 66, 105 and 141 g, respectively). On average, the five canteens at the long-term follow-up had an F&V consumption of 208 g/meal per customer.
Conclusions
The present study indicates that sustainability of F&V is possible in worksites where the participatory and empowering approach, self-monitoring, environmental change, dialogue with suppliers and networking among worksite canteens are applied.
To (i) identify and describe prevailing infant feeding policy documents in five diverse European countries; (ii) analyse types of health outcomes for the infant that are associated with feeding breast milk rather than formula milk in the documents of different countries; and (iii) assess the extent to which documents reflect the WHO global recommendation of exclusive breast-feeding for 6 months.
Design
Documentary review and analysis.
Setting
Five geographically dispersed countries of Europe (England, Finland, Germany, Hungary and Spain).
Subjects
Policy documents on infant feeding were identified; statements that linked choice between breast- and formula-feeding to a health outcome for the infant were extracted.
Results
Twenty-six documents (varied authorships, dates, length and character) were identified: four from England; two from Finland; nine from Germany; six from Hungary; and five from Spain. There was no consistency in the way in which health outcomes were cited as factors in the recommendations for breast- rather than formula-feeding. Seven documents contained no reference to the health implications of infant feeding choice. Of 203 statements in remaining documents citing health outcomes, 24·1 % mentioned general health effects, 32·5 % protection against infections, 31·5 % long-term conditions (e.g. diabetes, CVD) and 11·8 % mentioned allergy. Health outcomes were linked to exclusive breast-feeding in only 25 % of statements.
Conclusions
Policy documents in the study countries varied in the extent to which they reflect the health outcomes for the baby of breast-feeding, and this may limit effective promotion by health professionals. There is scope to improve the process of bringing evidence and recommendations into policy documents.
To explore and compare nutrition knowledge, attitudes and behaviours (KAB) between non-parent and parent caregivers of children under 7 years old in Chinese rural areas, and to identify the factors influencing their nutrition KAB.
Design
Face-to-face interviews were carried out with 1691 non-parent caregivers and 1670 parent caregivers in the selected study areas; multivariate logistic regression models were used to identify the factors influencing nutrition KAB in caregivers.
Results
The awareness rate of nutrition knowledge, the rate of positive attitudes and the rate of optimal behaviours in non-parent caregivers (52·2 %, 56·9 % and 37·7 %, respectively) were significantly lower than in the parent group (63·8 %, 62·1 % and 42·8 %, respectively). Multivariate logistic regression modelling showed that caregivers’ family income and care will, and children’s age and gender, were associated with caregivers’ nutrition KAB after controlling the possible confounding variables (caregivers’ age, gender, education and occupation).
Conclusions
Non-parent caregivers had relatively poor nutrition KAB. Extra efforts and targeted education programmes aimed to improve rural non-parent caregivers’ nutrition KAB are wanted and need to be emphasized.
To examine the dietary intake of total sugar, added sugar, non-added sugar and starch as well as dietary fibre and glycaemic index (GI) and their respective associations with insulin resistance.
Design
Mixed linear models were used to study both cross-sectional and prospective associations between carbohydrate components and insulin resistance separately in girls and boys. Diet was assessed by a single 24 h recall interview and insulin resistance was calculated using the homoestasis model assessment (HOMA).
Setting
The Danish part of the European Youth Heart Studies (EYHS) I and II.
Subjects
Girls and boys at 8–10 and 14–16 years from EYHS I (n 651) and 8–10-year-olds from baseline followed up 6 years later in EYHS II (n 233).
Results
Among girls, a difference in dietary total sugar of 43 g/MJ was associated with a 1 sd difference of HOMA and a difference in dietary fibre of −8 g/MJ was associated with a 1 sd difference of HOMA, independent of age, maturity and other confounders (both P = 0·03). No baseline associations were found among boys and no prospective associations were found in either sex.
Conclusions
Dietary intake of total sugar may play an adverse role and fibre may play a beneficial role in concurrent insulin resistance among girls but not boys. Sex differences may be due to differences in maturity, physical activity, food patterns and selective reporting behaviours.