Northern rural areas of Tehran have been shown to have severe iodine deficiency in our previous studies. In 1989 the inhabitants of these villages received an injection of iodised oil, followed by iodised salt distribution in 1993. The aim of the present study was to evaluate the effect of the iodine supplementation on iodine-deficient schoolchildren with hypothyroidism in these villages.

In total, 571 students aged 6–14 years were studied. Goitre was graded according to the World Health Organization classification. Serum concentrations of thyroid hormones (thyroxine (T4) and triiodothyronine (T3)) and thyroid-stimulating hormone (TSH) were determined using commercial kits, and urinary iodine was measured using a digestion method. The results were compared with data from our previous study in 1989.

Total goitre rate decreased by 42% in 1999 compared with that in 1989. A significant decrease in Grade 2 goitre concomitant with an increase in Grade 1 goitre was seen (P < 0.001). Values of the variables studied before (1989) and 10 years after iodine supplementation (1999) were: median urinary iodine excretion, 2.0 vs. 19.0 μg dl−1 (P < 0.001); T4, 6.5 ± 2.0 vs. 8.4 ± 1.6 μg dl−1 (P < 0.001); T3, 177 ± 38.0 vs. 145 ± 29.0 ng dl−1 (P < 0.001); TSH, 10.8 ± 15.1 vs. 1.8 ± 0.8 μU ml−1 (P < 0.001). No correlation was found between thyroid hormones and TSH on the one hand, and goitre and urinary iodine, on the other. Serum T4, T3 and TSH concentrations were within normal ranges in all schoolchildren in 1999.

This study showed that euthyroidism induced by administration of iodised oil in iodine-deficient schoolchildren with hypothyroidism is sustained following the consumption of iodised salt.

To describe the living conditions of Senegalese adolescent girls according to their migration status, and to define the main socio-economic and biological determinants of their nutritional and growth status.

Health and living conditions, sexual maturation, and nutritional and growth status of adolescent girls were determined within the framework of a longitudinal study on growth.

The capital city of Senegal (Dakar) and a rural community (Niakhar), 120 km south-east of Dakar.

Three hundred and thirty-one girls, 14.5–16.6 years of age, were recruited from the same villages. Thirty-six per cent of the sample remained in the villages to attend school and/or to help with household subsistence tasks (non-migrants). The remaining (64%) migrated to cities to work as maids (migrants) and lived in two different socio-economic environments: at the home of a guardian during the night and in the house of the employer during the daytime.

Family rural environment and guardian and employer urban environments were socio-economically different (P < 0.001). Living conditions in urban areas were better than in rural areas and the employer's environment was socio-economically more favourable. Migrants had more advanced sexual maturation and higher body mass index (BMI), fat mass index (FMI) and mid-upper arm circumference than non-migrants. However, migrants were smaller than non-migrants. BMI, FMI and weight-for-age were related to socio-economic levels and duration of migration. Schooling was positively related to height and negatively related to BMI.

Migrants enjoyed better living conditions than non-migrants. This could be partly due to the better socio-economic environment of the employer. It was associated with earlier puberty and better nutritional status, but not with a better growth.

To study the dynamics of childhood overweight and the influence of dietary intake on tracking of overweight.

A follow-up study conducted in China.

Ninety-five overweight children, 6–13 years old, identified from 1455 children at baseline, were followed over a 2-year period.

Data on anthropometry and 3-day dietary intake were collected at baseline and during follow-up. Overweight was defined using the International Obesity Task Force reference of body mass index (BMI)-for-age. Differences between groups were tested using analysis of variance and Cochran-Mantel-Haenszel tests.

Of the 95 overweight children, 36.8% remained overweight 2 years later (‘tracking group’). Urban boys were the three times more likely than rural boys to remain overweight (63.2% vs. 21.9%). At baseline, the tracking group had higher BMI, body weight and fat intake (% of energy), and lower carbohydrate intake (% of energy), than the non-tracking group (who shifted from overweight to not overweight); they were more likely to have a high-fat or high-meat diet, but less likely to have a diet high in carbohydrate or vegetables and fruit. During the follow-up, the tracking group increased fat intake and reduced carbohydrate intake while the non-tracking group did not; and they also grew slower in height but faster in weight. Tracking of overweight seemed to be related to tracking of high-meat (relative risk (RR) 2.4, 95% confidence interval (CI) 1.0–5.6, P < 0.05) and high-fat (RR 1.5, 95% CI 0.9–2.5, P < 0.1) diets.

Considerable changes in children's overweight status during childhood and adolescence were observed in China, a transitional society. Dietary patterns, particularly dietary composition, seemed to influence the tracking patterns of overweight.

To identify food sources of fat, to compare food and nutrient intakes at different levels of relative fat intake, and to examine the contribution of different food groups to the variation in relative fat intake. Relative fat intake was expressed as energy contributed by fat in percentage of non-alcohol energy.

Cross-sectional analysis of baseline data from the Malmö Diet and Cancer Study. An interview-based diet history method, a structured questionnaire and anthropometric measurements were used to obtain data. Analysis of variance compared food and nutrient intakes across quintiles of relative fat intake. Stepwise regression examined the contribution of food groups to the variation in relative fat intake.

Baseline examinations were conducted between 1991 and 1996 in the city of Malmö, southern Sweden.

A sub-sample of 7055 women and 3240 men of the Malmö Diet and Cancer cohort.

The major fat sources were dairy products, margarines, meat & meat products, and cakes & buns. Most plant foods, especially fruit, vegetables and breakfast cereals, were negatively associated with fat intake. Low fat consumers had significantly higher intakes of dietary fibre, vitamin C, β-carotene, folic acid, iron, zinc and calcium. Intakes of all types of fatty acids and fat-soluble vitamins were positively associated with fat consumption.

The results suggest that many food groups and nutrients may confound the associations between relative fat intake and disease. Plant foods, especially, are important to consider in studies of fat intake and disease risk.

Household budget surveys (HBSs) have been used to assess nutritional information for epidemiological purposes. The agreement between this information and other comparable data needs to be examined. The aim of this project was to compare household food expenditure data between two British HBSs: the National Food Survey (NFS) and the Family Expenditure Survey (FES).

Household food expenditure data were compared between the NFS and the FES for the years from 1982 to 1993. Differences in expenditure were assessed by year, by household composition, by income group and by region; for trends across time for all households and for regional, household composition and income group variations.

Great Britain.

Approximately 88 000 NFS households and 85 000 FES households surveyed between 1982 and 1993 were used in this analysis.

Marked differences between the food expenditure data provided by the two surveys were observed. Furthermore, differences in time trends were substantial, which can lead to different conclusions regarding changes in consumption patterns.

There is no obvious reason for the differences in household food expenditure between the NFS and the FES. Methodological differences between the two surveys cannot provide a full explanation for these discrepancies. The NFS and FES are now merged into a single survey (the Expenditure and Food Survey). If HBSs are to be used for epidemiological purposes their validity needs to be established.

In the Health Behaviour in School-Aged Children (HBSC) survey, the frequency of consumption of a limited number of food items – focusing on fibre, calcium and less healthy items – is queried using a 15-item food-frequency questionnaire (FFQ). The present study was conducted to assess the reliability and relative validity of the HBSC FFQ among school pupils in Belgium.

To assess the reliability of the FFQ, 207 pupils aged 11–12 years and 560 pupils aged 13–14 years completed the questionnaire twice, with a test–retest interval of 6 to 15 days. To assess the relative validity of the FFQ, in a first study data were collected as part of the Flemish HBSC 2000 survey: 7072 pupils (11–18 years) completed the FFQ and a 24-hour food behaviour checklist (FBC). In a second study, 101 pupils (11–12 years) completed the FFQ and a 7-day food diary (FD).

Reliability – weighted kappa values between test and retest ranged from 0.43 to 0.70, percentage agreement from 37 to 87%, and Spearman correlations from 0.52 to 0.82. Relative validity – comparison of the FBC with the percentage of respondents who should have consumed the food items on a random day, computed from the FFQ, showed good agreement between the FFQ and the FBC for most items. Only for cereals, diet soft drinks and other milk products were considerably higher food frequencies than expected found from the FBC. Comparison of the FFQ with the FD showed overestimation for all but three food items (cheese, soft drinks and chips). Spearman correlations ranged between 0.10 for crisps and 0.65 for semi-skimmed milk.

The HBSC FFQ is a reliable questionnaire that can be used for ranking subjects for most food items, although one must consider the overestimation when the FFQ is used for estimating prevalences.

To compare food expenditure patterns between low-income households and higher- income households in the Canadian population, and to examine the relationship between food expenditure patterns and the presence or absence of housing payments among low-income households.

Secondary data analysis of the 1996 Family Food Expenditure Survey conducted by Statistics Canada.

Sociodemographic data and 1-week food expenditure data for 9793 households were analysed.

Data were collected from a nationally representative sample drawn through stratified multistage sampling. Low-income households were identified using Statistics Canada's Low Income Measures.

Total food expenditures, expenditures at stores and expenditures in restaurants were lower among low-income households compared with other households. Despite allocating a slightly greater proportion of their food dollars to milk products, low-income households purchased significantly fewer servings of these foods. They also purchased fewer servings of fruits and vegetables than did higher-income households. The effect of low income on milk product purchases persisted when the sample was stratified by education and expenditure patterns were examined in relation to income within strata. Among low-income households, the purchase of milk products and meat and alternatives was significantly lower for households that had to pay rents or mortgages than for those without housing payments.

Our findings indicate that, among Canadian households, access to milk products and fruits and vegetables may be constrained in the context of low incomes. This study highlights the need for greater attention to the affordability of nutritious foods for low-income groups.

This paper describes a conceptual framework and associated intelligence requirements for problem-based workforce development for public health nutrition.

A conceptual framework for public health nutrition workforce development was constructed based on a review of the literature and consideration of the intelligence needs to inform workforce development planning.

A cyclical conceptual framework including five intelligence-linked components including public health nutrition problems and priorities, solutions and best buys, work needed, capacity to do the work and workforce development needs. This framework applied to the Australian situation illustrates its applications in workforce development research and planning. Although the existing availability of workforce development intelligence in each of these components varies, the framework does provide a systematic approach for workforce development research and planning directly related to public health nutrition problem resolution.

This framework highlights deficiencies in the existing public health nutrition workforce development intelligence and the need for further research to inform workforce development strategy planning.

To investigate the attitudes, experiences and beliefs of advanced-level public health nutritionists with respect to public health nutrition workforce composition, core functions, competency requirements and existing workforce capacity.

Qualitative study using structured interviews.

Australia.

Forty-one advanced-level public health nutritionists employed in academic and senior technocratic positions in state health systems.

Advanced-level public health nutritionists recognise the diversity of the public health nutrition workforce but clearly identify the need for a specialist public health nutrition workforce tier to provide workforce leadership. Nominated core functions for public health nutrition reflect broader public health core functions but, in the context of nutrition, specific problem resolution. Opinions about competency needs were similar to many of the cross-cutting competencies identified in the public health field but with specific application to nutrition problems. Competency in the scientific underpinning of nutrition was considered particularly important and delineated this public health nutrition workforce from the broader public health workforce. Public health nutrition was identified as a specialisation within public health and dietetics. Workforce capacity assessments by this group indicate a need for workforce development.

Qualitative data from a large proportion of the Australian public health nutrition leadership group have identified core functions, competencies and workforce development priorities that can be a basis for further systematic research and workforce strategy development.

To assess the level of agreement amongst a panel of public health nutrition leaders regarding the key descriptors used to define the field of public health nutrition.

Cross-sectional survey requiring quantitative and qualitative responses representing the first round of a consensus development Delphi technique.

International.

Expert panel of 24 public health nutrition leaders from nine countries in the European Union, the USA and Australia.

All but one of the panel agreed it was important to have a consensus definition for public health nutrition to describe the field consistently. Opinion about the length and complexity of this definition tended to vary depending on the intended use of the definition. The large majority (18/24) supported the inclusion of specific reference to physical activity in a definition of public health nutrition, although there was not consensus (>83% agreement as criterion) on this point. Consensus descriptors regarded as important in a definition of public health nutrition included: population-based, focus on health promotion, food and nutrition systems focus, wellness maintenance, primary prevention, applies public health principles, education, environmental and political descriptors. Treatment as a descriptor was rated as unimportant by a majority (14/24) of panellists, delineating public health nutrition from clinical practice.

There is strong international agreement amongst public health nutrition leaders in Europe, the USA and Australia about a range of descriptors that can be used to define public health nutrition. The limitations of using word-for-word definitions between and within countries may be overcome by explicit use of the consensus descriptors identified in this process.