Do we know how much we put on the plate? Assessment of the accuracy of self-estimated versus weighed vegetables and whole grain portions using an Intelligent Buffet at the FoodScape Lab.

The aim of this study was to assess the accuracy of self-estimated vegetable and whole grain serving sizes in a self-served buffet meal. The study took place in a laboratory setting where an Intelligent Buffet was used to register the exact weight of each food type that was self-served by each participant. The initial sample consisted of 58 participants recruited from Aalborg University in Copenhagen, of which 52 participants (59% male) provided complete estimates on the weight of whole grains and 49 participants (63% male) provided complete estimates on the weight of vegetable servings in their meal. The majority of the participants were students aged 20-29 years (85% for whole grain responses and 82% for vegetable responses). Significant differences between self-estimated and actual portion size estimates were observed for both vegetables and whole grains (P < 0.001). The mean self-estimated weight of a vegetable serving was 218(±134) g compared to the mean actual weight of 74(±44) g. The mean self-estimated and mean actual weights of a whole grain serving were 36(±34) g and 10(±9) g, respectively. There was no significant correlation between self-estimated and actual weights for each food group (P > 0.05). In conclusion, the participants' ability to accurately assess the serving size of vegetables and whole grains in a self-served meal did not correspond with the actual amount served. This may have implications for consumer interpretation of dietary recommendations used in nutrition interventions in Denmark.

[Success factors in public healthy eating campaigns: a case study]. / Factores de éxito en campañas de alimentación saludable: un estudio de casos.

INTRODUCTION: Public campaigns and interventions are rarely fully evaluated regarding their effectiveness. The analysis of past, successful activities can contribute to the future development of public campaigns and interventions for healthier eating. OBJECTIVES: The study of public campaigns and interventions for healthier eating aimed at identifying the underlying success factors and describing their relation. METHODS: Interviews were conducted with representatives of 11 cases that had been identified as especially successful in an earlier research step. The interviews were analysed with regard to possible success factors and the latter used to develop a model of success factor interrelation. RESULTS: It was found that success of the cases was first, attributed to characteristics of the macro environment or to public private partnerships in the initiation of campaigns, second, to the engagement of social communities, elements of empowerment of the target group and the implementation of social marketing measures, and thirdly, in citizens adoption of the campaign and in accompanying structural changes. CONCLUSIONS: The model and identified success factors underline that success can stem from three crucial phases: the set up of a campaign, the conduction and finally, the interrelation with the citizen. The model can serve as a guide in the future development of campaigns.

Attitudinal determinants of fish consumption in Spain and Poland.

OBJECTIVE: To identify attitudinal determinants of fish consumption in Spain and Poland, and to discuss the potential impact of local healthy eating policies in the observed reported frequency of fish consumption. DESIGN: Repeated survey analysis , multivariate linear regression analysis. Data collected through a questionnaire that included socio-demographics, self-reported anthropometrics, as well as validated items of attitudinal and involvement scales, validated items of knowledge about fish, and behaviours (reported fish consumption). SETTING: Consumer survey in Poland and Spain, 1800 respondents in 2004 and 1815 respondents in 2008. RESULTS: In Poland, intentions to consume more fish and reported fish consumption increased in the four years period between both surveys, together with objective knowledge regarding fish. In Spain with the exception of subjective knowledge, fish consumption at home and total fish consumption, all attitudinal and involvement scale changes were statistically significant. Multivariate regression revealed that age had a small but significant positive effect in all scales, except for satisfaction with life, fish consumption out of home and subjective health. Satisfaction with life and subjective knowledge were significantly determined by household size. The differences between countries were statistically significant for involvement with health and fish, for intention to eat fish, the general attitudes and objective knowledge regarding fish. CONCLUSIONS: In Poland, a more positive attitude towards fish, and increased levels of knowledge about this product were observed and could partially be attributed to national policy efforts. In Spain, an interesting feature was observed: more people reported choosing fish when eating out in 2008 compared with respondents in 2004. Such a trend suggests that people slowly move towards healthier choices even in the out of home eating.

Consumer satisfaction with dry-cured ham in five European countries.

The objective is to investigate consumer satisfaction with dry-cured ham in five European countries. A logistic regression model has been fitted using data collected through a cross-sectional web-based survey carried out in Belgium, Germany, Denmark, Poland and Greece during January 2008 (n=2437 of which 2156 were dry-cured ham consumers). Satisfaction was evaluated as overall satisfaction, as well as specific satisfaction with healthfulness, price, convenience and taste. The findings show that the main determinant of overall satisfaction is taste satisfaction, hence, producers are recommended to focus on matching sensory acceptability of dry-cured ham. No significant between-country differences were found, reflecting the wide availability of this product in all countries. Consumer characteristics influenced their level of satisfaction. Men, older (age > 52 years) and frequent consumers of dry-cured ham consumption were more likely to be satisfied with dry-cured ham. Consumers trust the butcher's advice and they preferred purchasing dry-cured ham at a butcher shop rather than in a supermarket.

International BMI-for-age references underestimate thinness and overestimate overweight and obesity in Bolivian adolescents.

BACKGROUND: Since no growth standards for adolescents exist and a single reference applicable everywhere is still in debate, it is recognized that the best reference should be derived from the growth pattern of the healthy population that will use it. In 2007 a study developed references for body mass index for 12th to 18th y Bolivian school adolescent (BAP. OBJECTIVES: To compare nutritional status outcomes applying BMI references from the BAP, the Center for Disease Control and Prevention CDC 2000, the International Task Force (IOTF), and the 2007 WHO, to determine appropriateness of use in Bolivian adolescents. SUBJECTS/METHODS: References were applied in 3306 adolescents, 45.0% male, 55% female, 12th to 18th y selected from a nationally representative sample. RESULTS: Main findings reveal that the CDC and the 2007 WHO underestimate underweight (p<0.001) and the three international references overestimate overweight (p<0.001) with variation between ages and gender. CONCLUSIONS: Bolivian health providers are advised to replace CDC, OITF and 2007 WHO references for the use of BAP in Bolivia which reflects its healthy adolescent population growth pattern. International references may lead to incorrect conclusions when applied on Bolivian adolescents. They could deflect efforts from population which need prompt intervention and mislead treatments and budget to unnecessary ones. We recommend validation of international references where appropriate until a standard is released.

Interventions to promote healthy eating habits: evaluation and recommendations.

Although in several EU Member States many public interventions have been running for the prevention and/or management of obesity and other nutrition-related health conditions, few have yet been formally evaluated. The multidisciplinary team of the EATWELL project will gather benchmark data on healthy eating interventions in EU Member States and review existing information on the effectiveness of interventions using a three-stage procedure (i) Assessment of the intervention's impact on consumer attitudes, consumer behaviour and diets; (ii) The impact of the change in diets on obesity and health and (iii) The value attached by society to these changes, measured in life years gained, cost savings and quality-adjusted life years. Where evaluations have been inadequate, EATWELL will gather secondary data and analyse them with a multidisciplinary approach incorporating models from the psychology and economics disciplines. Particular attention will be paid to lessons that can be learned from private sector that are transferable to the healthy eating campaigns in the public sector. Through consumer surveys and workshops with other stakeholders, EATWELL will assess the acceptability of the range of potential interventions. Armed with scientific quantitative evaluations of policy interventions and their acceptability to stakeholders, EATWELL expects to recommend more appropriate interventions for Member States and the EU, providing a one-stop guide to methods and measures in interventions evaluation, and outline data collection priorities for the future.

Anthropometry of height, weight, arm, wrist, abdominal circumference and body mass index, for Bolivian adolescents 12 to 18 years: Bolivian adolescent percentile values from the MESA study.

Anthropometry is important as clinical tool for individual follow-up as well as for planning and health policy-making at population level. Recent references of Bolivian Adolescents are not available. The aim of this cross sectional study was to provide age and sex specific centile values and charts of Body Mass Index, height, weight, arm, wrist and abdominal circumference from Bolivian Adolescents. Data from the MEtabolic Syndrome in Adolescents (MESA) study was used. Thirty-two Bolivian clusters from urban and rural areas were selected randomly considering population proportions, 3445 school going adolescents, 12 to 18 y, 45% males; 55% females underwent anthropometric evaluation by trained personnel using standardized protocols for all interviews and examinations. Weight, height, wrist, arm and abdominal circumference data were collected. Body Mass Index was calculated. Smoothed age- and gender specific 3rd, 5th, 10th, 25th, 50th, 75th, 85th, 90th, 95th and 97th Bolivian adolescent percentiles(BAP) and Charts(BAC) where derived using LMS regression. Percentile-based reference data for the antropometrics of for Bolivian Adolescents are presented for the first time.

Prevalence of overweight in Bolivia: data on women and adolescents.

Secondary analysis of Bolivian Demographic and Health Surveys 1994, 1998 and 2003 revealed a steady raising trend in levels of overweight and obesity among women in childbearing age (20-45 years), reaching 30% and 15% respectively in 2003. Adolescents' cross-sectional data suggest that overweight and obesity are mainly found in urban areas. Applying the Bolivian body mass index-for-age reference, obesity reached 5% in adolescents, while overweight affects 14% of adolescents. This overview highlights the importance of including the prevention of weight gain among the public health nutrition policies in Bolivia.

[Nutritional status and diet characteristics of a group of adolescents from the rural locality Calama, Bolivia]. / Estado nutricional y características de la dieta de un grupo de adolescentes de la localidad rural de Calama, Bolivia.

In 2003 a pilot study was carried out in the rural area of the Bolivian Department of La Paz aiming at the identification of dietary patterns among a group of secondary school adolescents who have little or scarce contact with the urban centres. The study consisted of a food intake survey (24 h recall), the measurement of anthropometrics and sociodemographic information. Nine percent was the global prevalence of overweight, although it was more present in girls. No statistically significant differences were found between nutrients in the diets of boys and girls. The energy intake was distributed in the five usual eating times as follows: 22% breakfast, 20% break time at school, 24% lunch, 12% tea time and 22% dinner. Furthermore, the anthropometric measures of boys were compared with their urban counterparts, where the differences were only significant with students in private schools. The present study can be used for the formulation of nutritional policies in Bolivia.

Changes in the nutritional status of Bolivian women 1994-1998: demographic and social predictors.

INTRODUCTION: Bolivia, as one of the poorest Latin American countries, has dealt with the problems of undernutrition for the last 50 y. Little importance has been given to the increase in overweight and obesity among the population, despite the scientific evidence linking overweight and obesity with mortality and morbidity. OBJECTIVE: To describe the social and demographic determinants of the nutritional status among women in Bolivia between 1989 and 1998 to gain a better understanding of the nutrition transition phenomena and to identify urgent research needs. METHODOLOGY: Secondary analysis of the raw data of the Bolivian National Demographic and Health Surveys of 1994 and 1998. Changes in the prevalence of underweight, obesity and overweight are described by sociodemographic characteristics of Bolivian women. Social and demographic determinants of nutritional status have been fitted into a logistic model. RESULTS: The prevalence of overweight (defined as 25< or =BMI<30 kg/m2) among women of reproductive age (20-44 y) increased by 9 percentage points between 1994 and 1998 (P<0.001), while the prevalence of normal BMI decreased by 10 percentage points (P<0.001). The decrease in the prevalence of underweight (defined as BMI <18.5 kg/m2) from 2.4% in 1994 to less than 1% in 1998 was statistically significant (P<0.001). Obesity (defined as BMI> or =30 kg/m2) was positively associated with geographical region (P=0.001), educational level (P<0.001), age (P=0.003) and total number of children (P=0.001) and negatively associated to rural locality (P=0.001) and native languages (P<0.001). Overweight was inversely associated with rural locality (P=0.013) and with Quechua language (P=0.04), while the total number of children (P<0.001) and year of survey (P<0.001) were positively associated. Underweight decreased dramatically (P<0.001), being positively associated with the region of residence (P=0.04) and inversely associated with the total number of children (P=0.006). CONCLUSION: The present study suggests that the population of Bolivia is in a transitional stage, with overweight becoming as much of a problem as undernutrition.