Employing Rothschild’s Motivation–Opportunity–Ability framework, the present study examines the extent to which heterogeneity in barriers regarding the motivation, the perceived opportunity and the perceived ability to choose low-calorie over high-calorie snacks is associated with the proportion of low-calorie snack choices in real life. Furthermore, the study investigates which dominant barrier profiles can be discerned.

Data were obtained from a survey about participants’ motivation, opportunity and ability to choose low-calorie over high-calorie snacks and an FFQ that measured habitual consumption of snack foods and beverages. Data were analysed using R packages lavaan and NbClust, and IBM SPSS Statistics.

A representative sample (n 1318) of the Dutch population based on gender (686 women), age and education level.

For both snack foods and beverages, motivation to choose low-calorie over high-calorie snacks was associated strongest with proportions of low-calorie choices. The perceived ability and perceived opportunity were also associated with proportions of low-calorie choices, albeit to a lesser extent. Furthermore, three dominant profiles of barriers were identified: the no-barrier profile, the lack-of-opportunity profile and the lack-of-motivation profile. These profiles differed significantly on proportions of low-calorie snack choices, daily meal consumption and sociodemographic characteristics.

Heterogeneity in barriers regarding the motivation, the perceived opportunity and the perceived ability to choose low-calorie over high-calorie snacks is associated with the proportion of low-calorie snack choices in real life. By identifying and appreciating heterogeneity in barriers, the present study provides further incentives for the tailoring of intervention strategies.

To assess the adequacy of milk and alternatives, Ca and vitamin D intakes in First Nations (FN) youth in Ontario, Canada. Intakes were compared with the general population and dietary standards. Variation in intakes by community (proxy for remoteness) and BMI was examined.

Data were collected by 24 h recall between November 2003 and June 2010. Intakes were analysed descriptively. Variation in intakes, by community and BMI category, was assessed using ANOVA.

Five remote FN communities of the Mushkegowuk Territory (northern Ontario, Canada) and two less-remote southern Ontario FN communities.

Schoolchildren (n 457) in grades 6 to 12.

Compared with Canada's Food Guide recommendations, 72·6 to 84·7 % had an inadequate intake of milk and alternatives depending on age and sex group; 86·2 % of individuals fell below the RDA for Ca; 96·4 % fell below the RDA for vitamin D. Community variation in intakes was detected, although in all cases Fort Albany had higher intakes, even when it was the more northern (remote) community. A BMI × sex interaction was found for intake of milk and alternatives (P = 0·041): an inverse relationship between intake and BMI was seen in females; in males, those who were overweight had the highest intake, followed by normal-weight and obese youth.

The nutritional inadequacies parallel the results of other Canadian studies of Aboriginal populations. Population health interventions to improve intakes are warranted. Moreover, community variation in intakes exists among FN youth in the present study (Fort Albany pairs only), but results were not as expected.

International definitions of childhood obesity based on body mass index (BMI) are intended to be used for international comparisons of obesity prevalence. In general, they are not appropriate to be used in clinical practice. The objective of this study is to compare international-ecological vs. national-clinical reference data of obesity in Spain, as well as to describe trends.

Cross-sectional study from a representative national random sample of Spanish children and youth conducted between 1998 and 2000. Prevalence estimates of obesity in a national random sample of Spanish children and youth are presented in this paper, defined by age- and sex-specific BMI national reference standards for the 85th percentile (overweight) and 95th percentile (obesity), as well as by Cole et al. criteria. The study protocol included personal data, data on education and socio-economic status for the family and anthropometric measurements.

Population-based study set in Spain.

A random sample of 3534 individuals, aged 2–24 years.

Prevalence of obesity using national reference data was higher (15.3%) than using international data (5.8%), but overweight rates were similar. Agreement observed for both definitions was low for obesity but higher for overweight. Obesity trends among children and adolescents in Spain show increasing patterns in boys but not in girls.

Results indicate the need to standardise the definitions of obesity and overweight in childhood and recommend the use of overweight due to the greater degree of agreement observed among the different methods used. The IOTF reference method underestimates obesity rates in Spanish schoolchildren.

Adequate assessment of energy balance-related behaviours in adolescents is essential to develop and evaluate effective obesity prevention programmes. The present study examined the test–retest reliability and construct validity of a questionnaire assessing energy balance-related behaviours in adolescents during the evaluation of the DOiT (Dutch Obesity Intervention in Teenagers) intervention.

To assess test–retest reliability, adolescents filled in the questionnaire twice (n 111). To assess construct validity, the results from the first test were compared with data collected in a personal cognitive interview (n 20, independent from the reliability study). For both reliability and validity, intraclass correlation coefficients for continuous data or Cohen's kappa coefficients for categorical data were calculated as well as percentage agreement.

Data were collected during school time from February to May 2010.

Study participants were Dutch adolescents aged 12–14 years attending pre-vocational secondary schools.

In more than three-quarters of the ninety-five questionnaire items the test–retest reliability appeared to be good to excellent. Moderate reliability was found for all other twenty-one items. Fifty-one items (of ninety-five items) showed good to excellent construct validity. Construct validity appeared moderate in twenty-three items and poor in twenty-one items. Most items with poor construct validity concerned consumption of sugar-containing beverages and high-energy snacks/sweets.

Our study showed good test–retest reliability and largely moderate to good construct validity for the majority of items of the DOiT questionnaire. Items with poor construct validity (most of them found for items concerning energy intake-related behaviours) should be revised and tested again to improve the questionnaire for future use.

There remain inconclusive findings from previous observational epidemiological studies on whether consumption of artificially sweetened soft drinks (ASSD) increases the risk of gastrointestinal (GI) cancer. We investigated the associations between the consumption of ASSD and the risk of GI cancer using a meta-analysis.

Systematic review and meta-analysis.

PubMed and EMBASE were searched using keywords until May 2020 to identify observational epidemiological studies on the association between the consumption of ASSD and the risk of GI cancer.

Twenty-one case–control studies and seventeen cohort studies with 12 397 cancer cases and 2 474 452 controls.

In the random-effects meta-analysis of all the studies, consumption of ASSD was not significantly associated with the risk of overall GI cancer (OR/relative risk (RR), 1·02; 95 % CI, 0·92, 1·14). There was no significant association between the consumption of ASSD and the risk of overall GI cancer in the subgroup meta-analyses by study design (case–control studies: OR, 0·95; 95 % CI, 0·82, 1·11; cohort studies: RR, 1·14; 95 % CI, 0·97, 1·33). In the subgroup meta-analysis by type of cancer, consumption of ASSD was significantly associated with the increased risk of liver cancer (OR/RR, 1·28; 95 % CI, 1·03, 1·58).

The current meta-analysis of observational epidemiological studies suggests that overall, there is no significant association between the consumption of ASSD and the risk of GI cancer.

To quantify the energy, nutrients-to-limit and total gram amount consumed and identify their top food sources consumed by Latin Americans.

Data from the Latin American Study of Nutrition and Health (ELANS).

ELANS is a cross-sectional study representative of eight Latin American countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela.

Two 24-h dietary recalls on non-consecutive days were used to estimate usual dietary intake of 9218 participants with ages between 15–65 years. ‘What We Eat in America’ food classification system developed by United States Department of Agriculture was adapted and used to classify all food items consumed by the ELANS population. Food sources of energy, added sugars, SFA, Na and total gram amount consumed were identified and ranked based on percentage of contribution to intake of total amount.

Three-highest ranked food categories of total energy consumed were: rice (10·3%), yeast breads (6·9%), and turnovers and other grain-based items (6·8 %). Highest ranked food sources of total gram amount consumed were fruit drinks (9·6%), other 100% juice (9·3%) and rice (8·3%). Three highest ranked sources for added sugars were other 100% juice (24·1 %), fruit drinks (16·5%), and sugar and honey (12·4%). SFA ranked foods were turnovers and other grain-based (12·6 %), cheese (11·9%), and pizza (10·3%). Three top sources of Na were rice (13·9%), soups (9·1 %) and rice mixed dishes (7·3 %).

Identification of top sources of energy and nutrients-to-limit among Latin Americans is critical for designing strategies to help them meet nutrient recommendations within energy needs.

To assess the relationships between maternal breast-feeding intention, attitudes, self-efficacy and knowledge at 7 months’ gestation with exclusive or full breast-feeding at 3months postpartum.

Prospective cohort study with structured home interviews during pregnancy and 3 months after delivery.

Two rural sub-districts of Kishoreganj district, Bangladesh.

Mother–infant dyads.

Over 80 % of 2178 pregnant women intended to exclusively breast-feed (EBF). Maternal positive attitudes, self-efficacy and knowledge about breast-feeding were positively associated with EBF intention (all P<0·05). All mothers except one reported initiating breast-feeding and 99·6 % of children were still breast-fed at 3 months. According to 24 h dietary recalls, we categorized 985 (45·2 %) infants as EBF at 3 months (47·8 % among mothers with EBF intention; 31·7 % among mothers with no EBF intention; P<0·05) and 551 (25·3 %) infants as predominantly breast-fed at 3 months (24·2 % among mothers with EBF intention; 30·8 % among mothers with no EBF intention; P<0·05). Prenatal EBF intention was associated with EBF (OR=1·48, 95 % CI 1·14, 1·91) and with full breast-feeding (OR=1·34, 95 % CI 1·04, 1·72) at age 3 months. EBF at age 3months was not associated with maternal breast-feeding knowledge, attitudes or self-efficacy.

Despite widespread expressed maternal EBF intention and universal breast-feeding initiation, prevalence of both exclusive and full breast-feeding at 3months remains lower than WHO recommendations. EBF intention predicts breast-feeding behaviours, suggesting the importance of prenatal counselling to improve infant feeding behaviours.

Health and related claims on food labels can support consumer education initiatives that encourage purchase of healthier foods. A new food Standard on Nutrition, Health and Related Claims became law in January 2013. Implementation will need careful monitoring and enforcement to ensure that claims are truthful and have meaning. The current study explored factors that may impact on environmental health officers’ food labelling policy enforcement practices.

The study used a mixed-methods approach, using two previously validated quantitative questionnaire instruments that provided measures of the level of control that the officers exercised over their work, as well as qualitative, semi-structured, in-depth interviews.

Local government; Australia.

Thirty-seven officers in three Australian states participated in semi-structured in-depth interviews, as well as completing the quantitative questionnaires. Senior and junior officers, including field officers, participated in the study.

The officers reported a high level of autonomy and control of their work, but also a heavy workload, dominated by concerns for public health and food safety, with limited time for monitoring food labels. Compliance of labels with proposed health claims regulations was not considered a priority. Lipsky's theory of street-level bureaucracy was used to enhance understanding of officers’ work practices.

Competing priorities affect environmental health officers’ monitoring and enforcement of regulations. Understanding officers’ work practices and their perceptions of enforcement is important to increase effectiveness of policy implementation and hence its capacity to augment education initiatives to optimize health benefits.

To examine the association between parenting styles and overall child dietary quality within households that are low-income and food-insecure.

Child dietary intake was measured via a 24 h dietary recall. Dietary quality was assessed using the Healthy Eating Index-2005 (HEI-2005). Parenting styles were measured and scored using the Parenting Styles and Dimensions Questionnaire. Linear regressions were used to test main and interaction associations between HEI-2005 scores and parenting styles.

Non-probability sample of low-income and food-insecure households in South Carolina, USA.

Parent–child dyads (n 171). Parents were ≥18 years old and children were 9–15 years old.

We found a significant interaction between authoritative and authoritarian parenting style scores. For those with a mean authoritarian score, each unit increase in authoritative score was associated with a higher HEI-2005 score (b = 3·36, P < 0.05). For those with an authoritarian score that was 1 sd above the mean authoritarian score, each unit increase in authoritative score was associated with a higher HEI-2005 score (b = 8.42, P < 0.01). For those with an authoritarian score that was −1 sd below the mean authoritarian score, each unit increase in authoritative score was associated with a lower HEI-2005 score; however, this was not significant (b = −1·69, P > 0·05). Permissive parenting style scores were negatively associated with child dietary quality (b = −2·79, P < 0·05).

Parenting styles should be considered an important variable that is associated with overall dietary quality in children living within low-income and food-insecure households.

To assess coffee consumption in the Sami and Norwegian populations and to investigate the impact of unfiltered boiled coffee consumption on serum cholesterol concentrations.

A cross-sectional study. Information was collected by self-administrated questionnaires and total serum cholesterol was analysed. Participants were divided into three ethnic groups: Sami I (Sami used as home language in the last three generations), Sami II (at least one Sami identity marker) and Norwegian.

In an area with Sami, Kven/Finnish and Norwegian populations, the SAMINOR study, 2003–2004.

A total of 5647 men and 6347 women aged 36–79 years.

More than 90 % of the study populations were coffee drinkers. Only 22 % were unfiltered coffee consumers. Sami I had the highest proportion of participants who consumed nine or more cups of unfiltered coffee per day, although the number of participants was limited. Total coffee consumption was associated with increased total cholesterol for men (P < 0·01) and women (P < 0·0001). For those who drank only unfiltered coffee, a significant association was found only in Norwegian men, adjusted for physical activity in leisure time, BMI and smoking habits (P < 0·001). From the lowest (less than five cups) to the highest (nine or more cups) unfiltered coffee consumption category, the mean total cholesterol levels increased by 0·29 mmol/l in Norwegian men.

Unfiltered coffee consumption was lower in the present study compared to previous reports. In general, total coffee consumption was positively associated with total cholesterol levels. However, for unfiltered coffee consumption, an association was found only in Norwegian men.

We examined whether or not the effect of elevated blood lead levels on children's psychomotor development was modified by their nutritional status.

Anthropometry, developmental quotients (DQs), blood lead levels and haemoglobin were measured in lead exposed and unexposed children with different levels of nutritional status. Social background and maternal height and verbal intelligence were also measured. Testers, anthropometrists and interviewers established reliabilities with a trainer before the study began.

Children were from two suburban areas in Kingston, Jamaica. All measurements on the children were carried out at a research unit. Social background and maternal measurements were carried out at the children's homes.

The exposed group comprised 58 children (3–6 years) attending the same preschool which was situated in a lead contaminated environment. The unexposed group comprised 53 children attending a nearby preschool without lead contamination.

The exposed children had significantly higher blood lead levels and lower DQs, and their homes had poorer facilities than the unexposed children. The deficit in DQ was greater (10.6 points) among children with weight for height less than –1 SD (National Center for Health Statistics references) than among better nourished Children (2 points).

Undernourished children exposed to lead may have more serious developmental deficits than better nourished children.

Poor nutritional habits and physical inactivity are two health behaviours believed to be linked with increasing rates of overweight and obesity in children. The objective of the present study was to determine whether children who reported healthier behaviours, specifically in relation to nutrition and physical activity, also had lower health-care utilization.

Population-based cross-sectional study, linking survey data from the 2003 Children's Lifestyle and School Performance Study (CLASS) with Nova Scotia administrative health data. Health-care utilization was defined as both (i) the total physician costs and (ii) the number of physician visits, for each child from 2001 to 2006. Exposures were two indices of healthy eating, the Diet Quality Index and the Healthy Eating Index, and self-reported physical activity and screen time behaviours.

Elementary schools in the Canadian province of Nova Scotia.

Grade 5 students and their parents; of the 5200 students who participated in CLASS and completed surveys, 4380 (84 %) could be linked with information in the administrative data sets.

The study found a relationship between both indices of healthy eating and a borderline significant trend towards lower health-care utilization in this population sample of children. No statistically significant relationships were seen for physical activity or screen time.

Both measures of diet quality produced similar results. The study suggests that healthy eating habits established in childhood may be associated with lower health-care utilization, although further research over a longer time frame is needed to demonstrate statistical significance.

To validate a brief FFQ developed for capturing short-term antioxidant intake in a sample of US college students.

A seventy-four-item antioxidant FFQ was developed based on major antioxidant sources in the American diet. The FFQ was validated against 30 d food records (FR) and plasma antioxidant concentrations. The reliability of the FFQ was evaluated by two FFQ administered at a 1-month interval.

University of Connecticut, CT, USA.

Sixty healthy college students.

Estimates of dietary antioxidants from the FFQ were moderately to highly correlated with those estimated from the 30 d FR (r = 0·29–0·80; P < 0·05) except for γ-tocopherol and β-cryptoxanthin. Total antioxidant capacity from diet only or from diet and supplements estimated by the 30 d FR and FFQ were highly correlated (r = 0·67 and 0·71, respectively; P < 0·0001). The FFQ categorized 91 % of participants into the same or adjacent tertiles of antioxidant intake as the 30 d FR. Most dietary carotenoids estimated from the FFQ were correlated with plasma levels (P < 0·05). Correlation coefficients for test–retest reliability ranged from 0·39 to 0·86. More than 94 % of the participants were classified in the same or adjacent tertiles between the two administrations of the FFQ.

The brief FFQ demonstrated reasonable validity for capturing a comprehensive antioxidant intake profile. This FFQ is applicable in epidemiological or clinical studies to capture short-term antioxidant intake or to simply document the variations of antioxidant intake in intervention trials. Cross-validation studies are warranted in other target populations.

This study examined psychological constructs (delay discounting, grit, future time perspective and subjective social status) in relation to food security status and body weight.

A simultaneous triangulation mixed methods design was used to collect quantitative and qualitative data. Quantitative data were collected in fifty-six adults. Independent variables included food security status (food secure or food insecure) and BMI category (normal weight or overweight/obese). Participants, matched on race (African American and White), were categorised into four food security status by BMI category groups. Psychological constructs were measured via validated questionnaires. Qualitative data were collected in a subsample of twelve participants via in-depth interviews.

This study was conducted in Baton Rouge, Louisiana.

The sample was 66 % female and 48 % African American with a mean age of 32·3 (sd 9·2) years and BMI of 28·8 (sd 7·7) kg/m2.

Quantitative results showed that food-insecure participants with overweight/obesity had greater delay discounting (–3·78 v. –6·16, P = 0·01; –3·78 v. –5·75, P = 0·02) and poorer grit (3·37 v. 3·99, P = 0·02; 3·37 v. 4·02, P = 0·02 ) than their food-secure counterparts and food-insecure participants with normal weight. Food-insecure participants with overweight/obesity also had a shorter time period for financial planning (0·72 v. 4·14, P = 0·02) than food-secure participants with normal weight. Qualitative data largely supported quantitative findings with participants discussing varied perceptions of psychological constructs.

This study found differences in delaying gratification, grit and financial planning between food security status and body weight groups.

Although a high intake of fat, particularly SFA, is a well-known risk factor for CVD, fat intake in Japan has attracted relatively little attention from health professionals to date due to the low intake in the Japanese population. However, recent surveys have shown an increase in fat intake in younger Japanese populations. Here, we described the fat intake and dietary sources of SFA in Japanese schoolchildren. Also, we experimentally exchanged a high-SFA food with a low-SFA substitute in the data, and calculated the resulting changes in nutrient intakes.

The study was conducted nationwide under a cross-sectional design. A non-consecutive, three-day diet record was performed on two school days and a non-school day.

Fourteen elementary and thirteen junior high schools.

Elementary-school children (n 629) and junior high-school children (n 281).

Prevalence of excess fat intake was 35·4 % in boys and 45·0 % in girls. Excess SFA intake was suspected in 97·7 % of boys and 99·4 % of girls when the dietary reference intake values for adults were applied. Major dietary sources of SFA were meat (26·4 % of total SFA intake), dairy products (25·7 %) and confectioneries (11·3 %).

Since one-third to nearly one-half of our Japanese schoolchildren consumed excess fat, careful monitoring of fat intake in the Japanese population should be continued. Adoption of low-fat milk and/or lean meat in daily meals might be a suitable means of reducing fat, particularly SFA intake, in schoolchildren.

To investigate socio-economic differences in changes in fruit and vegetable intake between 2004 and 2011 and explore the mediating role of financial barriers in this change.

Respondents completed a self-reported questionnaire in 2004 and 2011, including questions on fruit and vegetable intake (frequency per week), indicators of socio-economic position (education, income) and perceived financial barriers (fruits/vegetables are expensive, financial distress). Associations were analysed using ordinal logistic regression. The mediating role of financial barriers in the association between socio-economic position and change in fruit and vegetable intake was studied with the Baron and Kenny approach.

Longitudinal GLOBE study.

A total of 2978 Dutch adults aged 25–75 years.

Respondents with the lowest income in 2004 were more likely to report a decrease in intake of cooked vegetables (P-trend<0·001) and raw vegetables (P-trend<0·001) between 2004 and 2011, compared with those with the highest income level. Respondents with the lowest education level in 2004 were more likely to report a decrease in intake of fruits (P-trend=0·021), cooked vegetables (P-trend=0·033), raw vegetables (P-trend<0·001) and fruit juice (P-trend=0·027) between 2004 and 2011, compared with those with the highest education level. Financial barriers partially mediated the association between income and education and the decrease in fruit and cooked vegetable intake between 2004 and 2011.

These results show a widening of relative income and educational differences in fruit and vegetable intake between 2004 and 2011. Financial barriers explained a small part of this widening.

To assess the association between dietary patterns and glycaemic control among Qatari adults with type 2 diabetes (T2DM).

Cross-sectional analysis using data from the Qatar Biobank Study. Poor glycaemic control was defined as HbA1c ≥7·0 %. Dietary patterns were constructed using factor analysis based on habitual food intake assessed by a FFQ. Medication use was based on self-report. Multivariable logistic regression was used to assess the association.

Qatar.

Adults aged ≥18 years (n 1000) with known diabetes.

The mean age of the participants was 52·3 (sd 11·5) years. Overall, the prevalence of poor glycaemic control was 57·6 %, and 27·7 % of the participants were insulin users. Three dietary patterns were identified. The modern dietary pattern (high intake of fast food, croissants, white bread and cheese) was inversely associated with poor glycaemic control. The sd increments of the modern pattern had OR for poor glycaemic control of 0·86 (95 % CI 0·68, 1·08) in men and 0·76 (95 % CI 0·61, 0·95) in women. There was a significant interaction between the modern pattern and diabetes medication in men but not in women. In men without diabetes medication, the modern pattern was positively associated with poor glycaemic control with an OR of 2·35 (95 % CI 1·13, 4·87).

Male diabetes patients took medication to control diabetes but ate more unhealthy food. In men who were not taking diabetes medication, modern dietary pattern was associated with poor glycaemic control. Promoting healthy eating should be encouraged especially among those under diabetes medication.

To adapt and test the relative validity of an instrument measuring the usual food intake of 6–10-year-old children.

An FFQ encompassing the preceding 6 months was adapted and compared with the average of three 24 h dietary recalls.

Private and public schools in Porto Alegre, capital city of Rio Grande do Sul, the southernmost state in Brazil, with 1·5 million inhabitants.

Children aged 6–10 years attending grades 1–4 in private and public schools in Porto Alegre.

Ninety-one children were studied. The FFQ overestimated all nutrients. Correlations with the values obtained by 24 h dietary recalls were mostly above 0·50. The deattenuated correlations increased for all nutrients. The κ coefficients for the adjusted nutrients varied from 0·12 (weak) to 0·34 (reasonable). Graphically, the FFQ was shown to underestimate some of the parameters and to overestimate others, with a wide CI for all nutrients.

The FFQ does not have the required relative validity to classify the intake levels of schoolchildren, and further investigation is required to understand the sources of error.

Dietary intake of toddlers has been of growing interest due to its long-term consequences on health. However, previous works have focused largely on Caucasian populations and less is known about Asian toddlers. We aimed to validate a semi-quantitative FFQ designed to assess dietary intakes of 18-month-old toddlers in a multi-ethnic Asian cohort.

An FFQ of ninety-four food items, identified based on food records of 12-month-old GUSTO children, the Southampton Women’s Survey 12 Month Infancy Questionnaire and inputs from paediatric dietitians, was filled out two weeks before the 18th-month clinic visit. As the reference method, two non-consecutive 24 h recalls (24HR) were administered during and two weeks after the clinic visit. FFQ nutrient intakes were validated against averaged 24HR nutrient intakes, using the Wilcoxon signed-rank test, Spearman’s rank-order correlation, cross-classification and the Bland–Altman method.

Data from the Singapore Growing Up in Singapore Towards Healthy Outcomes (GUSTO) mother–offspring birth cohort.

Toddlers (n 188) aged 18 months.

Absolute nutrient intakes from the FFQ were significantly higher than from the 24HR, except for vitamin A. After energy adjustments, r range was 0·56–0·78 (macronutrients) and 0·40–0·54 (micronutrients). De-attenuation increased r to 0·58–0·96 and 0·45–0·65 for macro- and micronutrients, respectively. Of participants, ≥82·4 % (macronutrients) and ≥77·7 % (micronutrients) were classified in the same and adjacent quartiles. No clear systematic increase in intake differences with increasing mean intake was observed in Bland–Altman plots.

This FFQ can provide a satisfactory assessment of toddlers’ energy-adjusted nutrient intakes, as well as accurately rank them in a group.

We aimed to examine associations between early educators’ feeding practices and opinions and children’s dietary intake at pre-school, in a context where uniform meals are served and pre-schools are highly regulated.

Cross-sectional study. Food consumption data of the children consisted of two-day food records from pre-school kept by early educators. Early educators also reported their feeding practices and opinions on pre-school food. Serving style was observed.

Municipal pre-schools in Southern and Western Finland.

Pre-schoolers (n 586) aged 3–6 years and early educators (n 378).

Early educators’ positive opinion of the food served at pre-school and the opinion that sufficient vegetables were available for the children were positively associated with children’s vegetable consumption. Early educators’ role modelling and a positive opinion of the food were negatively associated with children’s energy intake. Encouragement to eat fruit and vegetables was associated with higher fibre intake. Intake of added sugar was low (4·4 % of energy).

Some of the feeding practices and opinions of early educators were related to healthier dietary intake (higher vegetable consumption and fibre intake) among the children. However, in some respects, the results contradicted previous findings. Overall, early educators’ feeding practices and opinions contribute to children’s dietary intake and should be taken into account when promoting healthy food intake among pre-school children.