Evolution of beverage portion sizes consumed in Brazil between 2008 and 2018.

Objective: To describe the evolution of beverage portion sizes consumed in Brazil between 2008 and 2018. Methods: Data from the dietary surveys of 2008-2009 and 2017-2018 Brazilian Household Budget Surveys, conducted with 34,003 and 46,164 individuals, respectively, were used to analyze the portion size of beverages. Food consumption data were used to group beverages according to nutritional characteristics, type and size of portions into eight groups: high-calorie soft drinks, fruit refreshments, alcoholic beverages, coffee/tea, fruit juices, milk and milk substitutes and ultra-processed milk-based beverages. The two-day food record and recall were considered to analyze the consumed portions. Comparisons between the surveys were done using Chi-Square tests and linear regression models. Results: Between 2008 and 2018, the average portion consumed showed a significant increase for the group of alcoholic beverages (+29%), flavored juices (+11%), caloric soft drinks (+8%), milk and milk substitutes (+6%) and fruit juices (+5%); and reduction for the coffee/tea group (-11%). Analyzes by age group showed that among individuals between 20 and 40 years of age, the soft drinks and alcoholic beverage groups showed the greatest increase in portion size, +12 and +44%, respectively. Conclusion: The beverage portion sizes consumed in Brazil between 2008 and 2018 increased for the group of alcoholic beverages, flavored juices, caloric soft drinks, milk and milk substitutes, and fruit juices.

Determination of an Acceptable Portion Size of Daal for a Bangladeshi Community-Based Iron Intervention in Adolescent Girls: A Feasibility Study.

Widely consumed daal (lentils) in Bangladesh are an ideal vehicle for iron (Fe) fortification; however, an acceptable portion size in meals needs to be determined to carry out a community feeding study in at-risk adolescent girls. A non-randomized crossover trial was conducted with n = 100 Bangladeshi girls (12.9 ± 2.0 years of age). Two recipes (thin and thick) and three portion sizes (25 g, 37.5 g, 50 g of raw lentil) of daal were served with 250 g of cooked white rice in a counter-balanced manner over 12 weeks. Each meal was fed to participants 5 days/week for two weeks. Ratings of hunger, satiety, and palatability were measured before and after each meal using Visual Analog Scales (VAS). The thick preparation in the 37.5 g portion (~200 g cooked) elicited higher VAS ratings of hunger, satiety, and palatability compared to all other meals. The 50 g portion of the thin preparation had VAS ratings similar to those of the 37.5 g thick preparation. Consuming the 37.5 g portion of fortified daal would provide 6.9 mg Fe/day to girls in a community-based effectiveness study. This would meet ~86% and ~46% of the Recommended Dietary Allowance (RDA) for Fe for girls aged 9-13 and 14-18 years, respectively.

Can Visual Cues to Portion Size Reduce the Number of Portions of Consumed? Two Randomized Controlled Trials.

BACKGROUND: Since 1950, the portion size of many snack foods has more than doubled and obesity rates have tripled. Portion size determines energy intake, often unwittingly. PURPOSE: This paper tests whether salient visual cues to portion size on the packaging of high fat, sugar, or salty (HFSS) snacks can reduce consumption. METHODS: Two preregistered randomized controlled trials (N = 253 and N = 674) measured consumption in a lab and the home environment. Cues were salient, labeled stripes that demarcated single portions. Participants were randomized to cue condition or control. Consumption was measured without awareness. RESULTS: The main preregistered effect of the visual cue was not statistically significant. There was some variation by subgroup. In Study 1, men were more likely to eat the whole can of potato chips than women but significantly reduced consumption when visual cues were on the pack. The effect size was large: the number of men eating more than the recommended portion fell by 33%. Study 2 monitored household consumption of chocolate biscuits (cookies) sent to family homes in gift packs. Again, the main effect was nonsignificant but there was significant subgroup variation. When the person receiving the biscuits was female, households were more likely to eat more than the recommended portion per person per day, but less likely when the visual cues were displayed. The gender of the eaters was not known. The effect size was again large: the number of households eating more than the recommended portion fell by 26%. Households with children were also less likely to open packs with visual cues compared to control packs. Both studies recorded significant increases in the likelihood of observing serving size information, together with confusion about what it means. CONCLUSIONS: The studies offer some evidence that salient visual cues could play a role in tackling the high consumption of unhealthy snacks, but the effects are confined to specific subgroups and warrant further investigation.

Vending Machines and Cardiovascular Prevention: How to Implement Healthy Dietary Habits at School.

Too many children in Europe are overweight. The unregulated marketing of unhealthy products target to children, and the installation of vending machines stocked with unhealthy snacks in public venues, are contributing factors. While innovative legislation on the regulation of the nutritional quality of food and beverages sold in vending machines in schools has become law in some European countries, it is not on the political agenda in others. However, an easy alternative solution could be to introduce a clause in all new tenders for vending machines, which states that the successful supplier must commit to ensuring that at least 50% of the products sold have a medium-to-small portion size, are low in saturated fat, salt, calories, and have no added sugar. This strategy, called "A vending machine for a friend", was developed at CNR of Rome, and with the support of the SIPREC, the LHA and the EHN, and with the alliance with teachers and students, is being rolled out in some Italian and Lithuanian high schools. Creating a healthy nutritional environment with the aim of encouraging healthier choices, is a real possibility.

Portion size selection in children: Effect of sensory imagery for snacks varying in energy density.

Food sensory imagery - creating a vivid mental image of the sensory experience of eating - can lead to the selection of smaller portions because it serves as a reminder that eating enjoyment does not necessarily increase with portion size. The evidence is mostly limited to adults and to energy-dense foods for which it is particularly difficult to predict the satiating effects of consumption quantity. The objective was to study how food sensory imagery influences portion size selection of foods varying in energy density (brownie and applesauce) by 7- to 11-year-old children. During after-school time, 171 children were randomized into two conditions. Children in the food sensory imagery condition were asked to imagine the taste, smell, and texture of eating palatable foods, i.e., chocolate cereal, chocolate waffle, and chocolate candies. Children in the control condition performed a similar sensory imagery task for non-food-related activities. Children were then asked to choose between the recommended serving size, a 50% larger portion, and a 125% larger portion of either brownie or applesauce. One week later, they were placed in the same condition for the other food. Compared to the control condition, food sensory imagery led children to choose 7.1% less brownie but had no effect on applesauce portion selection. Exploratory findings showed that the food sensory imagery intervention was especially effective at reducing brownie portion size selection among children who were moderately hungry, who usually eat fast, and whose parents pressure them to eat. In conclusion, food sensory imagery may be a useful intervention to nudge children towards healthier portion size choices because it reduces the selected portion size of an energy-dense snack without reducing the selected portion size of a healthier snack.

An ethnographic study exploring factors that minimize lunch waste in Tokyo elementary schools.

OBJECTIVE: To explore factors that minimize lunch waste in Tokyo elementary schools and to consider how such factors can be modified and applied in US schools. DESIGN: Focused ethnographic study using interviews, observation, participant observation and document review. Data were analysed using thematic analysis. SETTING: Tokyo, Japan. PARTICIPANTS: Five school dietitians participated in the study. Data collection methods included in-depth interviews, observation of nutrition education lessons, participant observation of school lunchtime and review of relevant school documents (e.g. lunch menus, food waste records). RESULTS: Five themes emerged from the analysis: (i) reinforcement of social norms to eat without waste; (ii) menu planning to increase exposure to unfamiliar and/or disliked foods; (iii) integration of food and nutrition education into the school curriculum; (iv) teacher lunchtime practices related to portion sizes, distributing leftover food and time management; and (v) engagement of students in reducing school lunch waste. Practical and tangible applications to US schools include measuring and reporting lunch waste to influence social norms, teaching students about the importance of reducing food waste, offering flexible school lunch portion sizes and providing students with meaningful opportunities to contribute to solving the problem of school lunch waste. CONCLUSIONS: Japan offers a model for minimizing school lunch waste through a holistic approach that includes factors that operate at and interact across multiple levels of society. Modifying and applying such an approach in US schools is worth considering given the urgent need to address food waste in order to support healthy diets and sustainable food systems.

The Workplace Health Promotion (WHP) programme in an Italian University Hospital.

INTRODUCTION: Description of the lifestyles of employees of the Siena University Hospital (Azienda Ospedaliera Universitaria Senese: AOUS), as assessed through a Workplace Health Promotion (WHP) project in the two-year period 2017-18; assessment of possible short-term effects of integrated health promotion interventions in the workplace, within the framework of the Tuscany WHP network, as applied in the AOUS and involving about 1,000 workers. METHODS: A cross-sectional study and a pre-post evaluation of data collected by means of anonymous questionnaires in two phases: before the beginning of the programme and after 12 months. RESULTS: Twelve months after the start of the programme regarding diet (consumption of fruit and vegetables) and physical activity, the positive effects that emerged were not statistically significant. No differences were observed between gender or professional categories. The employees' perception of the programme was satisfactory. CONCLUSIONS: Albeit within the methodological limits of the assessment, the results showed that the diffusion of some major risk factors for chronic diseases had not decreased after 12 months' exposure to the programme. However, monitoring of these risk factors needs to be continued over a longer period, in order to detect the appearance of the expected changes in the long term. Moreover, it is essential to continue monitoring by sex and professional category, in order to pick out any differences and, if possible, take remedial actions. Further studies, in collaboration with the pertinent physicians, are desirable, since integrating data collected during health surveillance with a limited set of indicators of general risk factors may help to promptly identify possible health needs among employees.

"That is an Awful Lot of Fruit and Veg to Be Eating". Focus Group Study on Motivations for the Consumption of 5 a Day in British Young Men.

Young men do not consume enough fruit and vegetables, increasing their risk for future ill health. To understand what motivates their food choice, a novel conceptual framework that included key concepts from the theory of planned behavior and risk theory was developed. Thirty-four British men (18-24 years) took part in focus groups, where innovative visual qualitative methods provided insight into participants' motivations for fruit and vegetable consumption. Based on information from food diaries, participants were described as high (4+ portions) or low (up to 3 portions) consumers. Interviews were coded thematically into concepts and characteristics of the conceptual framework. Young men were generally unaware of the UK government's recommendation to consume 5 portions of fruit and vegetable a day and chronic health risks associated with low consumption. High consumers were motivated by perceived risk, perceived behavioral control, and health-conscious self-identity. They held internalized, holistic beliefs about diet and health, whereas low consumers' beliefs were externalized, based on physical appearances. Low consumers were driven by social influences to consume cheap, easily available convenience foods. The conceptual framework differentiated levels of fruit and vegetable consumption between the two groups and provided new information about young men's motivations for fruit and vegetable consumption.

Protein-Reduced Complementary Foods Based on Nordic Ingredients Combined with Systematic Introduction of Taste Portions Increase Intake of Fruits and Vegetables in 9 Month Old Infants: A Randomised Controlled Trial.

Abstract: Fruits and vegetables are healthy foods but under-consumed among infants and children. Approaches to increase their intake are urgently needed. This study investigated the effects of a systematic introduction of taste portions and a novel protein-reduced complementary diet based on Nordic foods on fruit and vegetable intake, growth and iron status to 9 months of age. Healthy, term infants (n = 250) were recruited and randomly allocated to either a Nordic diet group (NG) or a conventional diet group (CG). Infants were solely breast- or formula-fed at study start. From 4 to 6 months of age, the NG followed a systematic taste portions schedule consisting of home-made purées of Nordic produce for 24 days. Subsequently, the NG was supplied with baby food products and recipes of homemade baby foods based on Nordic ingredients but with reduced protein content compared to the CG. The CG was advised to follow current Swedish recommendations on complementary foods. A total of 232 participants (93%) completed the study. The NG had significantly higher intake of fruits and vegetables than the CG at 9 months of age; 225 ± 109 g/day vs. 156 ± 77 g/day (p < 0.001), respectively. Energy intake was similar, but protein intake was significantly lower in the NG (-26%, p < 0.001) compared to the CG. This lower protein intake was compensated for by higher intake of carbohydrate from fruits and vegetables. No significant group differences in growth or iron status were observed. The intervention resulted in significantly higher consumption of fruits and vegetables in infants introduced to complementary foods based on Nordic ingredients.

Effectiveness of Workplace Nutrition Programs on Anemia Status among Female Readymade Garment Workers in Bangladesh: A Program Evaluation.

Eight in ten female readymade garment (RMG) workers in Bangladesh suffer from anemia, a condition which damages both health and productivity. This study evaluated the effectiveness of a workplace nutrition program on anemia reduction in female RMG workers of Bangladesh. A quasi-experimental mixed method study was conducted on 1310 non-pregnant female RMG workers from four factories. Two types of intervention packages (A and C) were tested against their respective controls (B and D) over a 10-month period. Among factories that already provided lunch to workers with regular behavior change counseling (BCC), one intervention (A) and one control (B) factory were selected, and among factories that did not provide lunches to their workers but provided regular BCC, one intervention (C) and one control (D) factory were selected: (A) Lunch meal intervention package: daily nutritionally-enhanced (with fortified rice) hot lunch, once weekly iron-folic acid (IFA) supplement and monthly enhanced (with nutrition module) behavior change counseling (BCC) versus (B) Lunch meal control package: regular lunch and BCC; and (C) Non-meal intervention package: twice-weekly IFA and enhanced BCC versus (D) Non-meal control package: BCC alone. Body weight and capillary hemoglobin were measured. Changes in anemia prevalence were estimated by difference-in-difference (DID) method. Thematic analysis of qualitative in-depth interviews with RMG workers was performed and findings were triangulated. Anemia was reduced significantly in both lunch meal and non-meal intervention (A and C) group (DID: 32 and 12 percentage points, p: <0.001 and <0.05 respectively). The mean hemoglobin concentration also significantly increased by 1 gm/dL and 0.4 gm/dL in both A and C group (p: <0.001 respectively). Weight did not change in the intervention groups (A and C) but significantly increased by more than 1.5 kg in the comparison groups (B and D). The knowledge of different vitamin and mineral containing foods and their benefits was increased significantly among all participants. Workplace nutrition programs can reduce anemia in female RMG workers, with the greatest benefits observed when both nutritionally enhanced lunches and IFA supplements are provided.

Children's Eating Behaviors and Energy Intake: Overlapping Influences and Opportunities for Intervention.

The transition from risk factors in the first 1,000 days to childhood obesity occurs largely through the development of maladaptive eating behaviors that emerge early, remain stable, and support greater energy intake over time. We have examined the association between eating behaviors, energy intake, and body composition at 4.5 and 6 years of age among children from the GUSTO (Growing Up in Singapore towards Healthy Outcomes) cohort. Our findings demonstrate that when children select larger portions, eat at a faster rate, and continue to eat when sated, they consume more energy than children who do not exhibit these behaviors. We have shown that these behaviors are stable over time and independently predict higher adiposity and BMIz scores at the later time point. We observed that faster eating and greater intakes were associated with parent report measures of appetitive traits, such as the child's satiety responsiveness, food fussiness, and enjoyment of food. Importantly, faster eating rates mediated the link between these appetitive traits and child energy intakes. In addition, within-meal parental feeding practices were linked to a faster eating rate, higher energy intakes, and higher BMIz scores in some children, suggesting that parents are aware of these eating behaviors and likely adapt their feeding practices to influence their child's energy intake. These findings emphasize the need to consider the interaction and cumulative impact of these eating behaviors and parental feeding practices on children's energy intake, and, consequently, the need to develop holistic intervention approaches that target the behaviors that contribute most to a child's risk of developing overweight and obesity.

Using neuroimaging to investigate the impact of Mandolean® training in young people with obesity: a pilot randomised controlled trial.

BACKGROUND: Slowing eating rate using the Mandolean® previously helped obese adolescents to self-select smaller portion sizes, with no reduction in satiety, and enhanced ghrelin suppression. The objective of this pilot, randomised trial was to investigate the neural response to food cues following Mandolean® training using functional Magnetic Resonance Imaging (fMRI), and measures of ghrelin, PYY, glucose and self-reported appetite. METHOD: Twenty-four obese adolescents (11-18 years; BMI ≥ 95th centile) were randomised (but stratified by age and gender) to receive six-months of standard care in an obesity clinic, or standard care plus short-term Mandolean® training. Two fMRI sessions were conducted: at baseline and post-intervention. These sessions were structured as an oral glucose tolerance test, with food cue-reactivity fMRI, cannulation for blood samples, and appetite ratings taken at baseline, 30 (no fMRI), 60 and 90 min post-glucose. As this was a pilot trial, a conservative approach to the statistical analysis of the behavioural data used Cliff's delta as a non-parametric measure of effect size between groups. fMRI data was analysed using non-parametric permutation analysis (RANDOMISE, FSL). RESULTS: Following Mandolean® training: (i) relatively less activation was seen in brain regions associated with food cue reactivity after glucose consumption compared to standard care group; (ii) 22% reduction in self-selected portion size was found with no reduction in post-meal satiety. However, usage of the Mandolean® by the young people involved was variable and considerably less than planned at the outset (on average, 28 meals with the Mandolean® over six-months). CONCLUSION: This pilot trial provides preliminary evidence that Mandolean® training may be associated with changes in how food cues in the environment are processed, supporting previous studies showing a reduction in portion size with no reduction in satiety. In this regard, the study supports targeting eating behaviour in weight-management interventions in young people. However, given the variable usage of the Mandolean® during the trial, further work is required to design more engaging interventions reducing eating speed. TRIAL REGISTRATION: ISRCTN, ISRCTN84202126 , retrospectively registered 22/02/2018.

Fad Diets: Hype or Hope?

PURPOSE OF REVIEW: Obesity continues to be a growing concern globally due to association with a number of comorbidities and contributing significantly to increase in health care expenditures. Despite availability of a number of treatment modalities, lifestyle modification with dietary modification and exercise continues to be the foundation. However, the standard model of lifestyle modification is not efficacious or sustainable for many patients leading them to seek alternative approaches. We conducted a comprehensive literature review to present the data regarding efficacy and sustainability of many common dietary approaches. RECENT FINDINGS: Building upon previous work, recent randomized controlled trials have compared many popular diets head to head in varying patient populations. Along with the weight changes, studies have investigated the changes in metabolic parameters, inflammatory markers, and cardiac risk factor reduction. Though the studies do not show superiority of one diet compared to the other, the preventive benefits and other favorable metabolic changes of the diets make them worthy of consideration.

The Pattern of Complementary Foods in American Infants and Children Aged 0⁻5 Years Old-A Cross-Sectional Analysis of Data from the NHANES 2011⁻2014.

Proper nutrition early in life can influence children’s present and future health. While several authoritative sources provide eating/food recommendations, only a few studies have assessed whether these recommendations are followed. The goal of this paper was to examine food and nutrient intakes on any given day during infancy and early childhood among various ethnicities. Twenty-four-hour dietary recall data of 0⁻5 years-old children (n = 2431) from the National Health and Nutrition Examination Survey (NHANES) 2011⁻2014 was used to estimate intakes of nutrients and food groups and prevalence of inadequate intake. Data was analyzed separately for various age groups and ethnicities, and differences in means by age and or race/ethnicity were determined by t-tests with p < 0.05 as significant. The results indicate that intakes of all food groups were expectedly low at 0⁻11 months, increased with age, and were influenced by race/ethnicity. Mixed dish consumption, which also increased with age, made substantial contributions to children’s food group intakes. However, there was a substantial percentage of the population among all age and race/ethnic groups who did not consume the recommended amounts for each food group and had inadequate intakes of key nutrients, such as calcium, vitamin D, and vitamin E. Non-Hispanic black children consumed less dairy and more protein foods, and a significantly greater proportion of these children had inadequate intakes of calcium and vitamin D compared to their peers. In conclusion, the results from this study suggest that a substantial population of American infants and children from 0 to five years of age did not meet food group recommendations and had inadequate intakes of key nutrients such as calcium, vitamin D, and vitamin E from foods.

The effect of the labelled serving size on consumption: A systematic review.

Guidance for food consumption and portion control plays an important role in the global management of overweight and obesity. Carefully conceptualised serving size labelling can contribute to this guidance. However, little is known about the relationship between the information that is provided regarding serving sizes on food packages and levels of actual food consumption. The aim of this systematic review was to investigate how serving size information on food packages influences food consumption. We conducted a systematic review of the evidence published between 1980 and March 2018. Two reviewers screened titles and abstracts for relevance and assessed relevant articles for eligibility in full-text. Five studies were considered eligible for the systematic review. In three of the included studies, changes in serving size labelling resulted in positive health implications for consumers, whereby less discretionary foods were consumed, if serving sizes were smaller or if serving size information was provided alongside contextual information referring to the entire package. One study did not find significant differences between the conditions they tested and one study suggested a potentially negative impact, if the serving size was reduced. The influence of labelled serving size on consumption of non-discretionary foods remains unclear, which is partially due to the absence of studies specifically focusing on non-discretionary food groups. Studies that investigate the impact of serving size labels within the home environment and across a broad demographic cross-section are required.

The effect of daily fortified yogurt consumption on weight loss in adults with metabolic syndrome: A 10-week randomized controlled trial.

BACKGROUND AND AIMS: Obesity is a complex and multifaceted condition. Thus, functional foods need investigation as novel adjunct treatments for obesity. The objective was to determine the effects of daily consumption of a fortified yogurt (FY) on weight loss in overweight and obese patients with metabolic syndrome on a caloric-restricted diet. METHODS AND RESULTS: This was a randomized, double-blind, 10-week study. Participants were randomly allocated to two groups receiving either two servings (2 × 250 g)/day of FY with whey protein, calcium, vitamin D, prebiotic fibre and probiotic cultures (n = 44) or a low-fat plain yogurt (PY) (n = 43). All participants were put on a calorie-restricted diet throughout the 10-week study. Body composition and biochemical indices were assessed before and after the intervention. Body mass decreased by 4.3 ± 1.9 kg and 5.1 ± 3.0 kg in the PY and FY groups, respectively, following the 10-week intervention. Compared to PY, consumption of FY resulted in a significant reduction in body fat mass (FM) (p = 0.023), body fat percentage (p = 0.028), waist circumference (p = 0.002), homoeostasis model of assessment-insulin resistance (HOMA-IR) (p = 0.025), triglyceride concentration (p = 0.003), and a significant increase in total 25-hydroxyvitamin D (25(OH)D) concentration (p < 0.001), high density lipoprotein-cholesterol (HDL-C) (p = 0.009) and quantitative insulin sensitivity check index (QUICKI) (0.022). Participants consuming the FY lost less fat-free mass (FFM) compared to the PY group (Δ = -0.9 ± 3.5 kg vs. Δ = -2.0 ± 2.7 kg; p = 0.025). CONCLUSIONS: Consuming FY for 10-weeks improved body composition and metabolic parameters, while on a caloric-restricted diet. Further research is needed to elucidate whether FY can be used as a preventative strategy for metabolic syndrome in obese persons. TRIAL REGISTRATION: www.irct.ir (IRCT2017050633836N1).

The effect of a portion size intervention on French fries consumption, plate waste, satiety and compensatory caloric intake: an on-campus restaurant experiment.

BACKGROUND: One of the driving factors of dietary overconsumption throughout the last decennia is the increase of food portion sizes. Larger portions induce higher daily energy intake, so reducing portion size may reduce intake of excess calories. However, real-life studies about the effects of portion size reduction are lacking. Therefore, this study examined the effect of a French fries portion size reduction on French fries consumption, French fries plate waste, satiety and caloric intake during the subsequent afternoon among university students and employees in a Belgian on-campus restaurant setting. Moreover, this study evaluated consumers' perception about the portion size reduction. METHODS: The study took place over a two-time (i.e. baseline and intervention week) 4-day period (Tuesday-Friday) in the on-campus restaurant where ±1200 meals are served every day. French fries' portions were reduced by 20% by replacing the usual porcelain bowl served during the baseline week (±200 g) with smaller volume paper bags during the intervention week (±159 g) in a pre-post real-life experiment. French fries consumption and plate waste were measured in 2056 consumers at baseline and 2175 consumers at intervention. Additionally, interviews were conducted directly after lunch and again between 4 and 6 p.m. on the same day to assess satiety and caloric intake at pre and post in a small subsample of both French fries consumers (n = 19) and non-French fries consumers (n = 14). Post-intervention, the same subsample was interviewed about their perception of the portion size reduction (n = 28). RESULTS: Total French fries intake decreased by 9.1%, and total plate waste decreased by 66.4%. No differences were found in satiety or caloric intake between baseline and intervention week among the French fries' consumers. The majority (n = 24, 86%) of French fries consumers noticed the reduction in portion size during the intervention. Although most participants (n = 19, 68%) perceived the reduced portion size as sufficient, only a minority of participants (n = 9, 32%) indicated post-intervention that they would agree with a permanent implementation. CONCLUSIONS: Reducing portion size may lead to reduced caloric intake, without changing perceived levels of satiety.

Iodine Deficiency in a Study Population of Norwegian Pregnant Women-Results from the Little in Norway Study (LiN).

Iodine sufficiency is particularly important in pregnancy, where median urinary iodine concentration (UIC) in the range of 150⁻250 µg/L indicates adequate iodine status. The aims of this study were to determine UIC and assess if dietary and maternal characteristics influence the iodine status in pregnant Norwegian women. The study comprises a cross-sectional population-based prospective cohort of pregnant women (Little in Norway (LiN)). Median UIC in 954 urine samples was 85 µg/L and 78.4% of the samples (n = 748) were ≤150 µg/L. 23.2% (n = 221) of the samples were ≤50 µg/L and 5.2% (n = 50) were above the requirements of iodine intake (>250 µg/L). Frequent iodine-supplement users (n = 144) had significantly higher UIC (120 µg/L) than non-frequent users (75 µg/L). Frequent milk and dairy product consumers (4⁻9 portions/day) had significantly higher UIC (99 µg/L) than women consuming 0⁻1 portion/day (57 µg/L) or 2⁻3 portions/day (83 µg/L). Women living in mid-Norway (n = 255) had lowest UIC (72 µg/L). In conclusion, this study shows that the diet of the pregnant women did not necessarily secure a sufficient iodine intake. There is an urgent need for public health strategies to secure adequate iodine nutrition among pregnant women in Norway.

Development and relative validity of semi-quantitative food frequency questionnaire for Korean adults / 한국영양학회지

PURPOSE: This study was implemented to develop and validate the semi-quantitative food frequency questionnaire (SQ-FFQ) to assess energy, carbohydrates, fat, protein, minerals, and vitamins as well as fatty acids and alcohol in Korean adults. METHODS: The SQ-FFQ consisted of 88 food items, and 12 food groups were selected based on information of frequently consumed foods from the Korean Health and Nutrition Examination survey. Each portion size was categorized as one of three amounts: small (0.5 times), medium (1 time), and large (1.5 times). A total of 111 subjects finished 3-day diet records and the SQ-FFQ. The relative validity of SQ-FFQ was assessed by comparison with the 3-day diet records. RESULTS: The mean nutrient intakes obtained from the SQ-FFQ were estimated to be greater than those of the two 3-day dietary records. Spearman's correlation coefficient between the two methods was the highest for energy (r = 0.583; p < 0.001) and lowest for saturated fatty acid (r = 0.121). Correlation coefficients were energy (r = 0.583; p < 0.001), carbohydrates (r = 0.500; p < 0.001), protein (r = 0.466; p < 0.001), fat (r = 0.411; p < 0.001), dietary fiber (r = 0.467; p < 0.001), alcohol (r = 0.527; p < 0.001), calcium (r = 0.409; p < 0.001), phosphorus (r = 0.499; p < 0.001), potassium (r = 0.418; p < 0.001), magnesium (r = 0.427; p < 0.001), and zinc (r = 0.464; p < 0.001), respectively, for all subjects. CONCLUSION: The developed SQ-FFQ in this study seems to be useful for estimating nutritional status, particularly energy, carbohydrates, protein, fat, dietary fiber, alcohol, calcium, phosphorus, potassium, magnesium, and zinc of Korean adults.

Relative Validity and Reliability of a 1-Week, Semiquantitative Food Frequency Questionnaire for Women Participating in the Supplemental Nutrition Assistance Program.

BACKGROUND: The Supplemental Nutrition Assistance Program (SNAP) plays a critical role in reducing food insecurity by distribution of benefits at a monthly interval to participants. Households that receive assistance from SNAP spend at least three-quarters of benefits within the first 2 weeks of receipt. Because this expenditure pattern may be associated with lower food intake toward the end of the month, it is important to develop a tool that can assess the weekly diets of SNAP participants. OBJECTIVE: The goal of this study was to develop and assess the relative validity and reliability of a semiquantitative 1-week food frequency questionnaire (FFQ) tailored to a population of women participating in SNAP. DESIGN: The FFQ was derived from an existing 195-item FFQ that was based on a reference period of 1 month. This 195-item FFQ has been validated in a population of low-income postpartum women who were recruited from central Texas during 2004. Mean daily servings of each food item in the 195-item FFQ completed by women who took part in the 2004 validation study were calculated to determine the most frequently consumed food items. Emphasis on these items led to the creation of a shorter, 1-week FFQ of only 95 items. This new 1-week instrument was compared with 3-day diet records to evaluate relative validity in a sample of women participating in SNAP. For reliability, the FFQ was administered a second time, separated by a 1-month time interval. PARTICIPANTS/SETTING: The validity study included 70 female SNAP participants who were recruited from the partner agencies of the Central Texas Food Bank from March to June 2015. A subsample of 40 women participated in the reliability study. MAIN OUTCOME MEASURES: Outcome measures were mean nutrient intake values obtained from the two tests of the 95-item FFQ and 3-day diet records. STATISTICAL ANALYSIS PERFORMED: Deattenuated Pearson correlation coefficients examined relationships in nutrient intake between the 95-item FFQ and 3-day diet records, and a paired samples t test determined differences in mean nutrient intake. Weighted Cohen's κ indicated agreement in quartile classification of study participants by the 95-item FFQ and 3-day diet records, according to nutrient intake. Test-retest reliability was assessed by intraclass correlations and weighted Cohen's κ. RESULTS: Mean deattenuated Pearson correlation between the FFQ and 3-day diet records was 0.61, and the weighted Cohen's κ=0.39. Finally, the average test-retest correlation and weighted Cohen's κ of the FFQ was 0.66 and 0.50, respectively. CONCLUSIONS: These results suggest that the 1-week, 95-item FFQ demonstrated acceptable relative validity and reliability in low-income women participating in SNAP in southwestern United States.