Gross for kids but good for parents: differing messages in advertisements for the same products

OBJECTIVES: There has been surprisingly little research into the effects of food advertising on parents' perception of commonly consumed children's food items, although the available research suggests that parents may find nutritional claims in these advertisements confusing. The purpose of the present study was to investigate parents' perceptions of branded snack foods targeted at children, and the extent to which these perceptions are influenced by advertising messages. DESIGN: Using an intercept survey, participants were shown either adult-targeted or child-targeted advertisements for the same food products. SETTING: Central business district of a major Australian city. SUBJECTS: One hundred adults, mean age 40 years. RESULTS: The study results suggest that: (1) adults' perceptions of advertised food products and, most importantly, purchase intentions for those products differ according to the version of the advertisement seen (for three of the products, 42-54% would buy the product after seeing the child version compared with 82-84% after seeing the adult version); and (2) adults clearly perceive distinctly different messages in advertisements for the same products which are targeting parents vs. those targeting children (e.g. for three of the products, 74-92% perceived that the adult version of the advertisement suggested the food was nutritionally beneficial compared with 2-14% perceiving this for the child version). CONCLUSIONS: It is clear that the messages conveyed to children about specific foods are quite different to the messages conveyed to adults - and importantly parents - about the same foods.     

A multipurpose tool to evaluate the nutritional quality of individual foods: Nutrimap

BACKGROUND/OBJECTIVES: With obesity and nutrition-related diseases rising, public health authorities have recently insisted nutritional quality be included when advertising and labelling food. The concept of nutritional quality is, however, difficult to define. In this paper we present an innovative, science-based nutrient profiling system, Nutrimap, which quantifies nutritional assets and weaknesses of foods. METHODS: The position of a food is defined according to its nutritional composition, food category, the consumer's nutritional needs, consumption data and major public health objectives for nutrition. Amounts of each of 15 relevant nutrients (in 100 kcal) are scored according to their ability to 'rebalance' or 'unbalance' the supply in the whole diet, compared with current recommendations and intakes. These scores are weighted differently in different food categories according to the measured relevance of the category to a nutrient's supply. Positive (assets) and negative (weaknesses) scores are totalled separately. RESULTS: Nutrimap provides an overall estimate of the nutritional quality of same-category foods, enabling easy comparisons as exemplified for cereals and fruit/vegetables. Results are consistent with major nutritional recommendations and match classifications provided by other systems. Simulations for breakfasts show that Nutrimap can help design meals of controlled nutritional value. CONCLUSIONS: Combining objective scientific bases with pragmatic concerns, Nutrimap appears to be effective in comparing food items. Decision-makers can set their own limits within the Nutrimap-defined assets and weaknesses of foods and reach categorisations consistent with their objectives--from regulatory purposes to consumer information or support for designing meals (catering) or new products (food industry).     

BRAC initiative towards promoting gender and social equity in health: a longitudinal study of child growth in Matlab, Bangladesh

OBJECTIVE: To explore the effect of BRAC (formerly Bangladesh Rural Advancement Committee) initiatives towards promoting gender and social equity in health among children of poor mothers who are BRAC members. DESIGN: A cohort of 576 children from the prospective study of a BRAC- International Centre for Diarrhoeal Disease Research, Bangladesh joint research project was analysed. Data were collected three times during 1995-1996 with approximately 4-month intervals. Stunting, defined as height-for-age below minus two standard deviations from the reference median, was the outcome health measure. The study children were stratified into three groups according to their mother's social and BRAC membership status: poor and BRAC member (BM), poor non-member (TG) and non-poor non-member (NTG). SETTING: Matlab, rural area of Bangladesh. SUBJECTS: Children aged 6-72 months. RESULTS: The overall prevalence of stunting was 76%; the highest prevalence was found among TG (84.6%) children and no significant difference was observed between BM and NTG children (67.3% and 69.4%, respectively). In all groups, a significantly larger proportion of girls was stunted compared with boys in the first round. Group-level analysis showed that stunting decreased among all children except BM boys at the end of third round, with the largest decline among BM girls. In contrast, stunting prevalence increased among BM boys. A similar trend was found in the individual-level analysis, where a larger proportion of BM girls recovered from stunting compared with other groups and no recovery was observed among BM boys. At the end of the third round, the nutritional status of BM girls was almost equal to that of the BM boys, while gender inequity remained large among TG and NTG children. CONCLUSION: The BRAC initiative appeared to contribute to a significant equity gain in health for girls, as well as to decreased differences in ill health between the poor and the non-poor.     

The humanitarian emergency in Burundi: evaluation of the operational strategy for management of nutritional crisis

OBJECTIVE: To evaluate the impact and appropriateness of programmes for the management and treatment of severe malnutrition in emergency situations. DESIGN: A central unified database was set up with all data and statistics provided by nutritional centres (NC) active in Burundi. SETTING: The paper describes the case of Burundi as an example of the response of the humanitarian community to nutritional crisis. SUBJECTS: Since 1999, more than one million (1,054,210) severely malnourished patients were treated in NC established in Burundi. RESULTS: Peaks of beneficiaries were registered in 2000 and 2001; the admission rate started to decrease in 2002. In 2004, twenty therapeutic feeding centres (TFC) and 224 supplementary feeding centres (SFC) were active for the treatment of 127,420 beneficiaries. Nutritional programmes were present in every province with a coverage rate of 55%. The most convincing impact of the nutritional programme in Burundi was the reduction of mortality rate in children under 5 years of age; an impact on the prevalence of acute malnutrition could not be demonstrated. Children under 5 years old accounted for 62% of beneficiaries in TFC and 76% in SFC. TFC performance indicators fulfilled the minimum standards in disaster response; the performance of SFC was not so optimal with a low recovery rate (69% v. >80%) and a high non-respondent rate (16% v. <5%). With the combination of coverage and cure rate, the programme met 44% of the assessed needs in 2004. CONCLUSIONS: In Burundi the stabilisation of security conditions permitted a combination of humanitarian responses ranging from emergency activities to strengthening of community-based initiatives that could correct the coverage and impact limitations.     

Consumption of fruit, vegetables, sweets and soft drinks are associated with psychological dimensions of eating behaviour in parents and their 12-year-old children

OBJECTIVE: We investigated associations between consumption of fruits, vegetables, sweets and soft drinks and the psychological dimensions of eating in parents and their children. The role of the parent's characteristics for their children's food intake was also explored. DESIGN: Food intake patterns were assessed by self-reported consumption of the respective foods. Eating behaviour was measured by the Dutch Eating Behaviour Questionnaire and self-esteem by Harter self-perception scale. The participants were 1441 families (mother, father and their 12-year-old child), and additionally 354 mothers and thirty fathers. RESULTS: Among parents, reported intake of fruit and vegetables were associated with restrained eating, higher self-esteem, and higher education and age. Intake of sweets was related to more external and less restrained eating, and for mothers also emotional eating. Parent's intake of soft drink was foremost related to a younger age, and also weakly associated with psychological characteristics. The food intake of parents was more important for the children's food intake than any other characteristics. However, children's intake of sweets showed clear-cut positive associations with external eating. CONCLUSIONS: Psychological dimensions of eating behaviour are associated with patterns of food intake, in particular for consumption of sweets, and are most prominent in the parents. The children's food intake mirrored their parents' intake. Being sensitive to external food cues may increase unhealthy food consumption in our society, whereas more restrained eating may indicate proneness or intention to healthier food choices among parents. Emotional eating may imply a proneness to consume sweets for comfort, in particular among mothers.     

Linear programming can help identify practical solutions to improve the nutritional quality of food aid

OBJECTIVES: To assess the nutritional quality of food aid delivered by food banks in France and to identify practical modifications to improve it. DESIGN: National-level data were collected for all food aid distributed by French food banks in 2004, and its nutrient content per 2000 kcal was estimated and compared with French recommendations for adults. Starting with the actual donation and allowing new foods into the food aid donation, linear programming was used to identify the minimum changes required in the actual donation to achieve the French recommendations. RESULTS: French food-bank-delivered food aid does not achieve the French recommendations for dietary fibre, ascorbic acid, vitamin D, folate, magnesium, docosahexaenoic acid, alpha-linolenic acid and the percentage of energy from saturated fatty acids. Linear programming analysis showed that these recommendations are achievable if more fruits, vegetables, legumes and fish were collected and less cheese, refined cereals and foods rich in fat, sugar and/or salt. In addition, new foods not previously collected are needed, particularly nuts, wholemeal bread and rapeseed oil. These changes increased the total edible weight (42%) and economic value (55%) of the food aid donation, with one-third of its edible weight coming from fruits and vegetables, one-third from staples, one-quarter from dairy products and approximately a tenth from meat/fish/eggs. CONCLUSIONS: Important changes in the types and amounts of food collected will improve the nutritional quality of food-bank-delivered food aid in France. Such changes are recommended to improve the diets of deprived French populations.     

Traditional food diversity predicts dietary quality for the Awajún in the Peruvian Amazon

OBJECTIVE: Our goal was to assess the potential for evaluating strengths of the Awajún traditional food system using dietary assessment, a traditional food diversity score and ranking of local foods. DESIGN: The method was used for dietary data obtained from mothers and children in the Awajún culture of the Peruvian Amazon where >90% of the dietary energy is derived from local, traditional food. Traditional food diversity scores were calculated from repeat 24-hour recalls. Group mean intakes of energy, fat, protein, iron, vitamin A and vitamin C from each food item were used to rank foods by nutrient contribution. SETTING: The study took place in six remote communities along the lower Cenepa River in the Amazonas District of Peru, South America. SUBJECTS: Dietary data were collected from 49 Awajún mothers and 34 children aged 3-6 years, representative of the six communities. RESULTS: Higher traditional food diversity was associated with greater protein, fibre, vitamin and mineral intakes when controlling for energy (partial correlations = 0.37 to 0.64). Unique sources for iron, total vitamin A and vitamin C were found in the Awajún traditional food system. CONCLUSIONS: A traditional food diversity score was a useful tool for predicting nutrient adequacy for the Awajún. Promotion of the Awajún traditional food system should focus on dietary diversity and unique nutrient-dense local foods.     

'The bigger the better'--mothers' social networks and child nutrition in Andhra Pradesh

OBJECTIVE: It is hypothesised that mothers' social networks can positively affect child nutrition through the sharing of health knowledge and other resources. The present study describes the composition of mothers' networks, examines their association with child nutrition, and assesses whether health knowledge is shared within networks. DESIGN AND SETTING: Cross-sectional data for mothers of young children from Andhra Pradesh (south India) were combined with existing data from the Young Lives study, in which the mothers were participating (n = 282). RESULTS: The composition of social networks varied between urban and rural areas, with urban networks being larger, more female, more literate and with a greater proportion of members living outside the household and being non-family. There was a positive association between child's height-for-age Z-score and mother's network size and network literacy rate. The association with network literacy was stronger among the poorest households. Women commonly reported seeking or receiving health advice from network members.CONCLUSION: Big and literate social networks are associated with better child nutrition, especially among the poor. The dissemination of health knowledge between network members is a plausible way in which social networks benefit child nutrition in India. Further research into the underlying mechanisms is necessary to inform the development of interventions that channel health information through word of mouth to the most excluded and vulnerable families.     

Nutrition professionals' perception of the 'healthiness' of individual foods

OBJECTIVES: This paper describes the development of an online questionnaire for testing nutrition professionals' perceptions of the 'healthiness' of individual foods and the results of administering that questionnaire. The questionnaire was designed to produce a standard ranking of foods that can be used as a tool for testing nutrient profile models. DESIGN: The questionnaire asked respondents to categorise 40 foods (from a master list of 120) in one of six positions, ranging from less to more healthy. The 120 foods were selected to be representative of the British diet. The questionnaire was sent via email to nutrition professionals from the British Dietetic Association and the (British) Nutrition Society. RESULTS: Eight hundred and fifty responses were received. These responses were used to rank the 120 foods by the average score which they received from the nutrition professionals. A regression analysis was also carried out to examine the relationship between the scores awarded by the nutrition professionals and various features of the foods: their nutritional content, their average serving size, their frequency of consumption, whether they were drinks or foods, etc. Nearly 50% of the variance in the average scores was explained by the nutritional content of the foods. When other variables were included in the analysis the percentage of variance that was explained increased to 64%. CONCLUSIONS: The average scores of the foods produce a standard ranking, which can be used as a tool for validating and comparing nutrient profile models. The regression analysis provides some information about how nutrition professionals rank the 'healthiness' of individual foods.     

Demographic, familial and trait predictors of fruit and vegetable consumption by pre-school children

OBJECTIVE: To examine the contribution to fruit and vegetable eating in children of potential predictive variables within the domains of demographics, parental feeding practices and personality traits. DESIGN: Cross-sectional survey. SETTING: Questionnaires were distributed to parents through 22 London nursery schools. SUBJECTS: Questionnaires were completed and returned by 564 parents or principal caregivers of 2-6-year-old children. RESULTS: Significant predictors of children's fruit and vegetable intake emerged from all three domains examined. Demographic variables associated with child's vegetable consumption were mother's education and child's age and gender. Only ethnicity was significantly associated with fruit consumption. Parental consumption, breast-feeding and early introduction to fruit and vegetables were related to intake of both. Family meal times were associated with higher intake of vegetables, but not of fruit. Two characteristics of children themselves (food neophobia and enjoyment of food) were strongly related to the consumption of fruit and vegetables. Subsequent multivariate analyses revealed that parental intake and child food neophobia independently predicted intake of both foods. In the presence of these, fruit consumption was affected by breast-feeding and early introduction to fruit, whereas vegetable consumption was related only to child's gender and enjoyment of food. CONCLUSIONS: These findings may be used to inform future interventions aimed at increasing children's consumption of fruit and vegetables. Parents should be made aware of the possible impact of their own behaviour on the eating habits of their children.     

Community-based assessment of infant feeding practices within a programme for prevention of mother-to-child HIV transmission in rural Zimbabwe

OBJECTIVE: To describe the infant feeding practices and attitudes of women who used prevention of mother-to-child transmission of HIV (PMTCT) services in rural Zimbabwe. DESIGN: A cross-sectional study including structured interviews and focus group discussions was conducted between June 2003 and February 2004. SETTING: The study took place in Murambinda Mission Hospital (Buhera District, Manicaland Province), the first site offering PMTCT services in rural Zimbabwe. SUBJECTS: The interviews targeted HIV-infected and HIV-negative women who received prenatal HIV counselling and testing and minimal infant feeding counselling, and who delivered between 15 August 2001 and 15 February 2003. The focus groups were conducted among young and elderly men and women. RESULTS: Overall, 71 HIV-infected and 93 HIV-negative mothers were interviewed in clinics or at home. Most infants (97%) had ever been breast-fed. HIV-negative mothers introduced fluids/foods other than breast milk significantly sooner than HIV-infected mothers (median 4.0 vs. 6.0 months, P = 0.005). Infants born to HIV-negative mothers were weaned significantly later than HIV-exposed infants (median 19.0 vs. 6.0 months, P = 10(-5)). More than 90% of mothers reported that breast-feeding their infant was a personal decision, a third of whom also mentioned having taken into account health workers' messages. CONCLUSION: The HIV-infected mothers interviewed were gradually implementing infant feeding practices recommended in the context of HIV. Increased infant feeding support capacity in resource-limited rural populations is required, i.e. training of counselling staff, decentralised follow-up and weaning support.     

Determinants of nutrition improvement in a large-scale urban project: a follow-up study of children participating in the Senegal Community Nutrition Project

OBJECTIVE: To study individual determinants of differential benefit from the Senegal Community Nutrition Project (CNP) by monitoring improvement in children's weight-for-age index (WA) or underweight status (WA < -2 Z-scores) during participation. DESIGN: A follow-up study using the CNP child monitoring data. Linear general models compared variations in WA according to 14 factors describing the beneficiaries and CNP services. SETTING: Poor neighbourhoods of Diourbel, a large city in Senegal, West Africa. Over a 6-month period, the CNP provided underweight or nutritionally at-risk 6-35-month-old children with monthly growth monitoring and promotion and weekly food supplementation, provided that mothers attended weekly nutrition education sessions. SUBJECTS: All the children who participated in the first two years of the project (n=4084). RESULTS: Mean WA varied from -2.13 (standard deviation (SD) 0.82) to -1.58 (SD 0.81) Z-scores between recruitment and the end of the follow-up. The lower the child's initial WA, the greater was their increase in WA but the lower was the probability of recovery from underweight. Only 61% of underweight children recovered. Six months of CNP services may not be sufficient for catch-up growth of severely underweight children. The number of food supplement rations received was not a direct indicator of the probability of recovery. After adjustment for services received and initial WA, probability of recovery was lower in girls, in younger children, in twins and when mothers belonged to a specific ethnic group. CONCLUSIONS: Determinants of benefit from CNP differed from the risk factors for underweight. Identification of participants with a lower probability of recovery can help improve outcome. Moreover, an explanation for the lack of recovery could be that many underweight children are stunted but not necessarily wasted.     

Nutritional status of Amerindian children from the Beni River (lowland Bolivia) as related to environmental, maternal and dietary factors

OBJECTIVES: To report the nutritional status of children aged up to 15 years and their mothers living in a remote Amazonian area of Bolivia, and to study its main social, familial and maternal determinants.SETTING: Fifteen Beni River communities located at the foot of the Andes.DESIGN: Cross-sectional survey of riverside populations. All childbearing mothers and their children in the 15 communities were examined.METHODS: Information on household production, dietary habits and demography was collected. Individual clinical, anthropometric and parasitological examinations were carried out.SUBJECTS: A total of 631 persons were examined: 171 mothers and 460 children and adolescents aged 0 to 15 years.Results: There were no cases of severe wasting, but 41% of 0-5-year-olds and 36% of 5-10-year-olds were stunted. Among 346 stool specimens examined, 75% were positive for at least one helminth. Diversity of food and quality of diet were satisfactory in 54% of households, but 27% had low diversity scores. Mothers were lighter and shorter than those observed at the national level: 20% had height below 145 cm. Prevalence of anaemia (42%) was also higher. In pre-school children, multivariate analysis indicated a relationship between growth retardation and household factors such as dietary quality, ethnic group and clinical state, but not maternal anthropometry. In contrast, in school-age children and adolescents, growth retardation was related to maternal characteristics.CONCLUSIONS: Growth retardation appeared mainly during the weaning period and did not seem to improve thereafter. To ameliorate this situation, an effort should be made to prevent common parasitic and infectious diseases in young children. Follow-up of pregnant mothers during pregnancy and delivery also needs to be reinforced.     

Identifying 'unhealthy' food advertising on television: a case study applying the UK Nutrient Profile model

OBJECTIVES: To evaluate the feasibility of the UK Nutrient Profile (NP) model for identifying 'unhealthy' food advertisements using a case study of New Zealand television advertisements. DESIGN: Four weeks of weekday television from 15.30 hours to 18.30 hours was videotaped from a state-owned (free-to-air) television channel popular with children. Food advertisements were identified and their nutritional information collected in accordance with the requirements of the NP model. Nutrient information was obtained from a variety of sources including food labels, company websites and a national nutritional database. RESULTS: From the 60 h sample of weekday afternoon television, there were 1893 advertisements, of which 483 were for food products or retailers. After applying the NP model, 66 % of these were classified as advertising high-fat, high-salt and high-sugar (HFSS) foods; 28 % were classified as advertising non-HFSS foods; and the remaining 2 % were unclassifiable. More than half (53 %) of the HFSS food advertisements were for 'mixed meal' items promoted by major fast-food franchises. The advertising of non-HFSS food was sparse, covering a narrow range of food groups, with no advertisements for fresh fruit or vegetables. CONCLUSIONS: Despite the NP model having some design limitations in classifying real-world televised food advertisements, it was easily applied to this sample and could clearly identify HFSS products. Policy makers who do not wish to completely restrict food advertising to children outright should consider using this NP model for regulating food advertising.     

Impact of food advertising on food purchases by students in primary and secondary schools in south-eastern Poland

AIM: The aim of the present study was to determine the impact of food advertising in primary and secondary schools on the food purchasing habits of children. METHODS: All forty-four primary and secondary schools in Rzeszow, Poland were included in the investigation; 15000 children attend primary and secondary schools in the region. Schools were visited by members of the research team, who filled in a questionnaire regarding the type of food products displayed or advertised in the school shop window and recorded the presence of direct corporate advertising in the proximity of the school shop. Shop owners were asked to fill in a form describing food purchases by students within the week preceding the visit. The school principal (or one of teachers) completed a form describing the school's policy regarding food advertising and the sponsorship of school activities by food companies. RESULTS: Recommended foods like milk, yogurts and fruit were offered by only 40.9 % of shops. There was a correlation between foods offered in the shop and foods purchased by students. In schools, 40.9% (95% CI 25.8, 56.0%) of shop windows displayed or advertised 'healthy' foods while 9.1% (95% CI 0.0, 17.9%) of shops displayed advertisements of food companies. The difference between display of 'healthy' food in shop windows and display of food on company advertisements was significant (likelihood ratio chi2 test, P < 0.04). Type of school (primary v. secondary) was not significant factor in advertising or purchasing pattern. CONCLUSIONS: Educational programmes should be introduced in schools with the aim of improving the understanding of nutritional principles among pupils, teachers and parents.     

An evaluation of the impact of a school nutrition programme in Vietnam

OBJECTIVE: To evaluate the effectiveness of a school nutrition programme on the weight gain and growth of Vietnamese schoolchildren. DESIGN: A proximate cluster evaluation of children in seven schools, in which fortified milk and biscuits supplying 300 kcal of energy were being given on school days, compared with children in 14 nearby schools with no feeding. All children were dewormed. SETTING: Twenty-one primary schools in Dong Thap Province, Vietnam. SUBJECTS: A cohort of 1080 children in grade 1 of 21 primary schools, and a cross-sectional interview of 400 children in grade 3. RESULTS: The programme gave children the equivalent of 90 kcal day- 1 over 17 months. t-Tests showed a small but statistically significant difference between groups in their average gain in weight and height: 3.19 versus 2.95 kg (P < 0.001) and 8.15 versus 7.88 cm (P = 0.008). A multiple-level model showed that the programme was statistically significant after controlling for clustering of children in schools, sex, age and initial underweight (P = 0.024). A significant impact on height was also seen in a regression model, but not when controlling for school. The most undernourished children tended to gain the least weight. There was no evidence of substitution. CONCLUSION: The programme had a small but significant effect on weight gain, but the most undernourished children benefited the least. Methods need to be developed to target them. This design may offer a means of estimating the impact of school feeding on growth in other programme settings.     

Rapid prediction of gross energy and utilizable energy in cereal food products using near-infrared reflectance spectroscopy

Near-infrared (NIR) spectroscopy has been used in foods for the rapid assessment of several macronutrients; however, little is known about its potential for the evaluation of the utilizable energy of foods. Using NIR reflectance spectra (1104-2494 nm) of ground cereal products (n = 127) and values for energy measured by bomb calorimetry, chemometric models were developed for the prediction of gross energy and available energy of diverse cereal food products. Standard errors of cross-validation for NIR prediction of gross energy (range = 4.05-5.49 kcal/g), energy of samples after adjustment for unutilized protein (range = 3.99-5.38 kcal/g), and energy of samples after adjustment for unutilized protein and insoluble dietary fiber (range = 2.42-5.35 kcal/g) were 0.053, 0.053, and 0.088 kcal/g, respectively, with multiple coefficients of determination of 0.96. Use of the models on independent validation samples (n = 58) gave energy values within the accuracy required for U.S. nutrition labeling legislation. NIR spectroscopy, thus, provides a rapid and accurate method for predicting the energy of diverse cereal foods.     

家禽健康养殖营养调控技术研究进展

近年来家禽业在规模化、商业化上得到了很大发展,越来越多的人开始关注行业的安全和可持续发展,健康养殖问题已成为人们关注研究的焦点。健康养殖应该包括饲养条件、选种、疾病控制、饲料营养、饲养管理、产品质量、动物福利、生态系统,以及工作管理等。该义通过国内外相关文献的调查分析,着重阐述了当前阻碍家禽健康养殖可持续发展的主要营养性问题(如动物食品质量安全、饲料安全、环境污染、生态环境恶化、动物源性耐药菌增多等。)及家禽业健康养殖营养调控技术(如禽产品品质的营养调控技术、生态环境的营养调控、饲料配方、添加剂及饲养方式等),指出畜牧业必须主动生产适应人们现代健康安全膳食所需要的畜产品,这是畜牧业可持续发展的关键所在。     

Improving the nutritional status of food-insecure women: first, let them eat what they like

OBJECTIVE: To determine the extent to which identified nutrient inadequacies in the dietary intakes of a sample of food-insecure women could be ameliorated by increasing their access to the 'healthy' foods they typically eat. DESIGN: Merged datasets of 226 food-insecure women who provided at least three 24-hour dietary intake recalls over the course of a month. Dietary modelling, with energy adjustment for severe food insecurity, explored the effect of adding a serving of the woman's own, and the group's typically chosen, nutrient-rich foods on the estimated prevalence of nutrient inadequacy. SETTING AND SUBJECTS: One study included participants residing in 22 diverse community clusters from the Atlantic Provinces of Canada, and the second study included food bank attendees in Toronto, Ontario, Canada. Of the 226 participants, 78% lived alone with their children. RESULTS: While nutritional vulnerability remained after modelling, adding a single serving of either typically chosen 'healthy' foods from women's own diets or healthy food choices normative to the population reduced the prevalence of inadequacy by at least half for most nutrients. Correction for energy deficits resulting from severe food insecurity contributed a mean additional 20% improvement in nutrient intakes. CONCLUSIONS: Food-insecure women would sustain substantive nutritional gains if they had greater access to their personal healthy food preferences and if the dietary compromises associated with severe food insecurity were abated. Increased resources to access such choices should be a priority.     

Vitamin A status among children in China

OBJECTIVE: The objective of this study was to assess the prevalence of vitamin A deficiency (VAD) in children under 6 years old in China and to identify risk groups for VAD. DESIGN: A cross-sectional survey was conducted in 14 provinces from coastal, inland and western geographic areas in China. SETTING: One city (urban) and two counties (rural) were randomly selected from each province as survey areas. SUBJECTS: About 200 children aged 0-6 years were randomly selected in each survey area. A blood sample was collected from each child. Data on sociodemographics and nutrition were obtained by interview of the mother or principal caregiver. Fluorescence microanalysis was used to analyse serum retinol concentration. RESULTS: VAD (serum retinol <0.7 micro mol l(-1)) was observed in 957 out of 7,826 children aged 0-6 years (12.2% of the entire study population), whereas severe VAD (serum retinol <0.35 micro mol l(-1)) was found in 39 children (0.5%). The highest prevalences of VAD at >1 year of age were observed among children of mothers with minority ethnicity (22.7%) or poor education (19.8%) and in the poor western area (17.4%). CONCLUSIONS: VAD is a nutritional problem in children in China. Children living in the poor western area, having a mother with minority ethnicity or a mother with poor education have a high risk of VAD.