To evaluate the relationship between dietary habits, physical activity and cognitive views and the risk of gestational diabetes mellitus (GDM) in Chinese women.

A cross-sectional study to explore the potential risk factors of GMD through the International Physical Activity Questionnaire, an FFQ and a self-designed structured questionnaire, respectively.

Guangzhou, Guangdong Province, China.

Chinese pregnant women (n 571) who underwent a 75-g oral glucose tolerance test at their 24th to 28th gestational week.

Thirteen per cent of the investigated women were identified as having GDM, and an increased intake of local featured foods and lower physical activity were observed in the GDM-positive group v. the GDM-negative group. Women who regarded early-pregnancy morning sickness as relevant to fetal abnormalities and those with unlimited dietary intake after the ending of morning sickness both had an increased risk for GDM (P = 0·018 and P = 0·038, respectively). After multiple logistic regression analysis, cognitive views for unlimited food intake subsequent to morning sickness, increased consumption of energy-dense snack foods and high-glycaemic-index fruits were strongly associated with the risk of GDM (OR = 1·911, P = 0·032; OR = 1·050, P = 0·001; and OR = 1·002, P = 0·017, respectively).

Local featured foods and incorrect cognitive views on pregnancy-related health were closely related to the risk of GDM in Chinese women. Intensive health education about pregnancy physiology and reasonable dietary and physical exercise behaviours should be strengthened for the control of GDM.

To describe diet quality (Healthy Eating Index 2010 (HEI-2010) and Healthy Eating Index 2015 (HEI-2015)) according to self-reported cannabis use among the National Health and Nutrition Examination Survey (NHANES) adult participants.

Utilizing cross-sectional data, we assessed diet quality with up to two 24-h diet recalls from NHANES participants. Usual intakes were estimated via the multivariate Markov Chain–Monte Carlo method. Diet quality scores were compared among never users, previous users and current users of cannabis.

NHANES surveys from 2005 to 2016.

Adult NHANES participants (17 855) aged 20–59 years with valid data for dietary recalls and drug use questionnaires.

Current adult cannabis users (ages 20–59 years) had significantly lower total diet quality (HEI-2010) scores (51·8 ± 0·7) compared with previous (56·2 ± 0·4) and never users (57·7 ± 0·4). Similar differences in total and individual HEI-2015 scores were observed. For the HEI-2015 scores, cannabis users had a significantly higher (better) sodium scores (4·1 ± 0·2) compared with never users (3·3 ± 0·1) and previous users (3·2 ± 0·1). Cannabis users scored lower compared with never users on total vegetables (3·1 ± 0·1 v. 3·7 ± 0·0), total fruit (2·1 ± 0·1 v. 3·0 ± 0·1) and whole fruit (2·2 ± 0·1 v. 3·3 ± 0·1) for the HEI-2015 index.

Current cannabis users’ usual intakes reflect lower diet quality compared with never or previous users, particularly lower subcomponent scores of total vegetables, greens and beans, total fruit and whole fruit. Cannabis users should increase their intake of fruit and vegetables to improve overall diet quality.

The present communication reports a strategy to calculate the intake of Fe based on data available for folic acid and evaluate the programme of flour fortification in Brazil.

Cross-sectional study conducted in Brazil during 2008 and 2009. A 2d dietary record of individuals was used. The usual intake of folic acid by sex and age group was estimated using the National Cancer Institute method. The quantity of folic acid and Fe established by mandatory food fortification in Brazil was used, and based on that quantity we calculated the amount of flour consumed and the intake of Fe from fortification and Fe from food. Then, the absorption of each nutrient was calculated.

Brazilian households (n 16 764).

Individuals (men and women, n 34 003, aged 10 to 60+ years) from a Brazilian nationwide survey.

Mean intake and absorption of Fe from fortification (electrolytic Fe) was low in men and women.

The impact from the consumption of fortified products is small in relation to Fe intake in Brazil. The strategy proposed to estimate Fe intake from the fortification programme indicates that the amount of flour intake observed in Brazil does not justify the current ranges of mandatory flour fortification and the form of Fe that is mainly used (electrolytic Fe).

To examine the gestational weight gain (GWG) trajectory and its possible association with pregnancy outcomes.

GWG trajectories were identified using the latent class growth model. Binary logistic regression was performed to examine the associations between adverse pregnancy outcomes and these trajectories.

Negeri Sembilan, Malaysia.

Two thousand one hundred ninety-three pregnant women.

Three GWG trajectories were identified: ‘Group 1 – slow initial GWG but followed by drastic GWG’, ‘Group 2 – maintaining rate of GWG at 0·58 kg/week’ and ‘Group 3 – maintaining rate of GWG at 0·38 kg/week’. Group 1 had higher risk of postpartum weight retention (PWR) (adjusted OR (AOR) 1·02, 95 % CI 1·01, 1·04), caesarean delivery (AOR 1·03, 95 % CI 1·01, 1·04) and having low birth weight (AOR 1·04, 95 % CI 1·02, 1·05) compared with group 3. Group 2 was at higher risk of PWR (AOR 1·18, 95 % CI 1·16, 1·21), preterm delivery (AOR 1·03, 95 % CI 1·01, 1·05) and caesarean delivery (AOR 1·02, 95 % CI 1·01, 1·03), but at lower risk of having small-for-gestational-age infants (AOR 0·97, 95 % CI 0·96, 0·99) compared with group 3. The significant associations between group 1 and PWR were observed among non-overweight/obese women; between group 1 and caesarean delivery among overweight/obese women; group 2 with preterm delivery and caesarean delivery were only found among overweight/obese women.

Higher GWG as well as increasing GWG trajectories was associated with higher risk of adverse pregnancy outcomes. Promoting GWG within the recommended range should be emphasised in antenatal care to prevent the risk of adverse pregnancy outcomes.

The present paper aims to review and report on the current and predicted future public health nutrition workforce in South Africa. Additionally, it examines ways in which the Department of Health (DOH) is striving to meet the increasing burden of nutrition-related diseases in South Africa.

The primary sources of data used for the review were reports from the Census office, South African health reviews, mortality and morbidity statistics, and documents from the Health Professions Council of South Africa.

There are fewer than 2000 registered dietitians in South Africa and fewer than 600 of them work in the public health sector. Furthermore, professional nurses – who are the backbone of the primary health-care system and deliver the rudiments of basic nutritional care – are not being trained in sufficient numbers to meet population growth; in 2004 there was only one nurse per 4000 persons. This situation is aggravated by the growing burden of conditions associated with both overnutrition and undernutrition, as well as the enormous demands of the HIV/AIDS epidemic. The DOH is striving to meet these increasing needs by means of the Integrated Nutrition Programme as well as a National Human Resources Plan which includes numerous strategies to improve the quantity and quality of health professionals’ training, including dietitians and nutritionists. This plan includes the objective of increasing the public health nutrition workforce to more than 250 newly trained dietitians and nutritionists per annum by 2010.

To compare the sugar content of items at four multinational fast-food chains, across three countries.

Total sugar (g)/per serving was extracted from online nutrition information, and sugar/100 g serving was calculated. Foods were categorised as: breakfast sandwiches, burgers, sandwiches, desserts and condiments. Beverages were categorised as fountain, frozen or pre-packaged. Sugar (g) was compared across countries using linear mixed-effects models. Pairwise comparisons were performed with Tukey–Kramer adjustments.

USA, Germany and Australia.

Burger King™ (Hungry Jack’s™), Kentucky Fried Chicken™, McDonald’s™ and Subway™.

Differences in total sugar/100 g or ml were observed across countries for burgers (n 104), desserts (n 110), sandwiches (n 178), pre-packaged beverages (n 36) and frozen beverages (n 72). Comparing identical items across countries (e.g. BigMacTM from McDonalds in USA, Germany and Australia), burgers (n 10 available in all three countries) had lower sugar content in Australia (3·4 g/100 g) compared with the USA (4·7 g/100 g, P = 0·02) or Germany (4·6 g/100 g, P = 0·04), yet no differences were observed in other food categories. Comparing the same beverages across countries (e.g. chocolate shake from Burger King), frozen beverages (n 4 available in all three countries) had lower sugar content in Australia (14·2 g/100 ml), compared with the USA (20·3 g/100 ml, P = 0·0005) or Germany (17·8 g/100 ml, P = 0·0148), yet no differences were observed in other beverage categories.

Heterogeneity in fast-food sugar content across countries suggests that reductions are possible and should be implemented to reduce health risks associated with excess added sugar intake.

The emphasis in school nutrition policy has been on vending and competitive items. Our study was designed to characterize and quantify the amount and source of other foods and beverages on school campuses.

A cross-sectional observational study was conducted using a specially designed objective nutrition observation system.

One low-income school district in southern California with six elementary and two middle schools.

Data were not collected from individual children. A total of 4033 students, 42 % of whom were Hispanic/Latino, 26 % African American and 21 % non-Hispanic white, were observed across school settings.

Data were collected continuously from 9 January 2008 to 16 June 2010. Healthy foods had, per serving, total energy ≤732 kJ (≤175 kcal), total fat content ≤35 %, total saturated fat ≤10 %, sugar less ≤15 g, sodium <200 mg and trans-fat ≤0·5 g. Healthy beverages were only 100 % juice or water, and unflavoured non-fat, 1 %, 2 % milk and soya or rice milk. The system had high inter-rater reliability (r = 0·78 to 0·99), percentage agreement (83 % to 100 %) and test–retest reliability (r = 0·81 to 0·98). Significantly more unhealthy foods and beverages than healthy items were observed on all campuses (P < 0·001). An average of 1·26 (sd 0·46) items per student per week was found with an average of 0·86 (sd 0·34) unhealthy items per child per week.

There were substantial amounts of unhealthy foods and beverages brought onto campuses for classroom rewards, celebrations and fundraising that should be targeted for intervention.

To summarise the existing evidence of development, validation and current status of utilisation of dish-based dietary assessment tools.

Scoping review.

Systematic search using PubMed and Web of Science.

We identified twelve tools from seventy-four eligible publications. They were developed for Koreans (n 4), Bangladeshis (n 2), Iranians (n 1), Indians/Malays/Chinese (n 1), Japanese (n 3) and Chinese Americans (n 1). Most tools (10/12) were composed of a dish-based FFQ. Although the development process of a dish list varied among the tools, six studies classified mixed dishes based on the similarity of their characteristics such as food ingredients and cooking methods. Tools were validated against self-reported dietary information (n 9) and concentration biomarkers (n 1). In the eight studies assessing the differences between the tool and a reference, the mean (or median) intake of energy significantly differed in five studies, and 26–83 % of nutrients significantly differed in eight studies. Correlation coefficients for energy ranged from 0·15 to 0·87 across the thirteen studies, and the median correlation coefficients for nutrients ranged from 0·12 to 0·77. Dish-based dietary assessment tools were used in fifty-nine studies mainly to assess diet–disease relationships in target populations.

Dish-based dietary assessment tools have exclusively been developed and used for Asian-origin populations. Further validation studies, particularly biomarker-based studies, are needed to assess the applicability of tools.

Vitamin A (VA) deficiency, more common in low- and middle-income countries (LMIC) secondary to malnutrition, is associated with increased morbidity and mortality. The prevalence and impact of VA deficiency in high-income countries (HIC) where chronic conditions may predispose is less well understood.

Interpretation of serum retinol may be affected by inflammation, so C-reactive protein (CRP) levels were sought. Binary logistic regression and generalised estimating equations were performed to review the relationship between CRP and VA.

We examined the scale of low and deficient VA status in our tertiary University Teaching Hospital (HIC).

Patients undergoing serum retinol concentrations 2012–2016 were identified from laboratory records, and records examined.

Totally, 628 assays were requested, with eighty-two patients VA low (0·7–0·99 Umol/l) or deficient (<0·7 Umol/l). Sixteen patients were symptomatic (fifteen deficient), predominantly visual. Only one symptomatic patient’s VA deficiency was secondary to poor intake. Other symptomatic patients had chronic illnesses resulting in malabsorption. The incidence of a low VA level increases significantly with a raised CRP.

The majority of patients tested either were replete or likely to have abnormal VA levels due to concomitant inflammation. A minority of patients had signs and symptoms of VA deficiency and was a cause of significant morbidity, but aetiology differs from LMIC, overwhelmingly malabsorption, most commonly secondary to surgery or hepatobiliary disease. A correlation between inflammation and low VA levels exists, which raises the possibility that requesting a VA level in an asymptomatic patient with active inflammation may be of questionable benefit.

The purpose of the present paper is to examine the prevalence of metabolic syndrome (MetS) and its components using the harmonized definition in an interviewed sub-sample of diverse, low-income, adult South Asians (SA) of both sexes residing in Maryland. We also wanted to derive a BMI cut-off value that was highly correlated with the recommended waist circumference (WC) that we could apply to a larger sample of SA Americans for whom only BMI values were available from clinic files. We also examined differences in MetS prevalence among various Asian ethnic groups (defined by country of origin) and the clustering pattern of their MetS components.

Clinical data extraction on subjects (n 1002) and interviewees (n 401) were used in a cross-sectional study of SA Americans.

Two community health centres in Montgomery and Baltimore County, MD, USA.

SA adult males and females (n 1403) aged 20–68 years.

The prevalence of MetS using harmonized WC cut-offs (90 cm in men and 80 cm in women) was 47 % in men and 54 % in women. Using a BMI of 23·0 kg/m2 gave a similar prevalence of MetS for males (48 %) and females (47 %). Of the five MetS components, the prevalence pattern differed among the ethnic groups, particularly for SA Indians.

The prevalence of MetS in a diverse, low-income, SA American immigrant group using the harmonized definition was 51 %. Derived lowered BMI cut-off of 23·0 kg/m2 should be used by clinicians in studies on SA when WC values are not available for detecting metabolic risk. SA Indians had a higher prevalence of abnormal TAG and blood glucose values compared with other SA, and therefore results for SA Indians should not be generalized to all SA ethnic groups.

To assess progress towards the elimination of trans-fatty acids (TFA) in foods after the 2008 Pan American Health Organization (PAHO) recommendation of virtual elimination of TFA in Latin America.

A descriptive, comparative analysis of foods that were likely to contain TFA and were commonly consumed in four cities in Latin America.

San José (Costa Rica), Mexico City (Mexico), Rio de Janeiro (Brazil), Buenos Aires (Argentina).

Foods from each city were sampled in 2011; TFA content was analysed using GC. TFA of selected foods was also monitored in 2016.

In 2011–2016, there was a significant decrease in the content of TFA in the sampled foods across all sites, particularly in Buenos Aires (from 12·6–34·8 % range in 2011–2012 to nearly 0 % in 2015–2016). All sample products met the recommended levels of TFA content set by the PAHO. TFA were replaced with a mixture of saturated and unsaturated fats.

Our results indicate a virtual elimination of TFA from major food sources in the cities studied. This could be due to a combination of factors, including recommendations by national and global public health authorities, voluntary and/or mandatory food reformulation made by the food industry.

To study the magnitude and predictors of underweight, incident underweight and recovery from underweight among rural Indian adults.

Prospective cohort study. Each participant’s BMI was measured in 2008 and 2012 and categorized as underweight (BMI<18·5 kg/m2), normal (BMI=18·5–22·9 kg/m2) or overweight/obese (BMI ≥23·0 kg/m2). Incident underweight was defined as a transition from normal weight or overweight/obese in 2008 to underweight in 2012, and recovery from underweight as a transition from underweight in 2008 to normal weight in 2012. Bivariate and multivariable logistic regression analyses were employed.

The Birbhum Health and Demographic Surveillance System, West Bengal, India.

Predominantly rural individuals (n 6732) aged ≥18 years enrolled in 2008 were followed up in 2012.

In 2008, the prevalence of underweight was 46·5 %. From 2008 to 2012, 25·8 % of underweight persons transitioned to normal BMI, 12·9 % of normal-weight persons became underweight and 0·1 % of overweight/obese persons became underweight. Multivariable models reveal that people aged 25–49 years, educated and wealthier people, and non-smokers had lower odds of underweight in 2008 and lower odds of incident underweight. Odds of recovery from underweight were lower among people aged ≥36 years and higher among educated (Grade 6 or higher) individuals.

The current study highlights a high incidence of underweight and important risk factors and modifiable predictors of underweight in rural India, which may inform the design of local nutrition interventions.

The introduction of voluntary fortification of some foods with folic acid in Australia has been implemented since evidence of the prevention of neural tube defects with periconceptional folic acid was published. Our objectives were to determine how many women were aware of folate and when they became aware, what was the awareness of labels on foods that mentioned folate, and how much folate-fortified food women ate.

To address these objectives we collected data by self-administered questionnaire from a random sample of 578 recently pregnant women in Western Australia between September 1997 and March 2000.

Overall, 89% of women had heard, seen or read anything about the link between folate and birth defects such as spina bifida, 62% first became aware of the folate message before their recent pregnancy and 42% of women noticed any labels on foods that mention folate before or during their recent pregnancy. Overall, 53% of women were aware of foods that have folate added to them and 33% usually or always read the labels on food packaging. The folate-fortified foods most often consumed by women were cereals (69%), breads (34%) and milk (15%). Of the women who consumed folate-fortified foods (78%), the earlier they became aware of the folate message and noticed labels on food, the more fortified foods they consumed.

These results indicate that staple foods fortified with folate are consumed by almost 80% of women in the population. Therefore, mandatory fortification of staple foods may reach most women, providing improved opportunity for the prevention of neural tube defects in Australia.

To study the association between density of stores (food and beverage stores, stores selling only fruits and vegetables, and supermarkets) and the BMI of adults aged ≥20 years in Mexico.

A cross-sectional study was performed. Individual data came from the 2012 National Health and Nutrition Survey, while information on stores was taken from the National Institute of Geography and Statistics’ National Statistics Directory of Economic Units. A weighted least-squares model was estimated to test the association between density of stores and BMI of adults adjusting for sex, age, education, presence of hypertension, diabetes or both, household assets index and marginality index at the municipality level.

Mexico.

An additional 1 sd in the density of fruit and vegetable stores was associated with a reduction of 0·24 (95 % CI −0·37, −0·12) kg/m2 in BMI when the densities of the other stores were at their mean values. For food and beverage store density, a difference of 1 sd was associated with an increase of 0·50 (95 % CI 0·33, 0·67) kg/m2 in BMI, while for supermarkets the corresponding association was a reduction of 0·48 (95 % CI −1·52, 0·56) kg/m2 in BMI.

In places with a higher density of stores that offer unhealthy foods, the BMI of adults tends to be higher.

To describe availability and frequency of use of local snack-food outlets and determine whether reported use of these outlets was associated with dietary intakes.

Data were cross-sectional. Availability and frequency of use of three types of local snack-food outlets were reported. Daily dietary intakes were based on the average of up to four 24 h dietary recalls. Multivariable linear regression models estimated average daily intakes of energy, sugar-sweetened beverages (SSB) and snack foods/sweets associated with use of outlets.

Multi-site, observational cohort study in the USA, 2004–2006.

Girls aged 6–8 years (n 1010).

Weekly frequency of use of local snack-food outlets increased with number of available types of outlets. Girls with access to only one type of outlet reported consuming food/beverage items less frequently than girls with access to two or three types of outlets (P <0·001). Girls’ daily energy, SSB and snack foods/sweets intakes increased with greater use of outlets. Girls who reported using outlets>1 to 3 times/week consumed 0·27 (95 % CI 0·13, 0·40) servings of SSB more daily than girls who reported no use. Girls who reported using outlets>3 times/week consumed 449·61 (95 % CI 134·93, 764·29) kJ, 0·43 (95 % CI 0·29, 0·58) servings of SSB and 0·38 (95 % CI 0·12, 0·65) servings of snack foods/sweets more daily than those who reported no use.

Girls’ frequency of use of local snack-food outlets increases with the number of available types of outlets and is associated with greater daily intakes of energy and servings of SSB and snack foods/sweets.

To assess the impact of the 1996–2005 integrated community-based micronutrient and health (MICAH) programme on linear growth retardation (stunting) in Malawian preschool children living in rural areas.

Prospective study of three large-scale cross-sectional surveys conducted in 1996, 2000 and 2004 in MICAH and Comparison populations.

Rural areas in Malawi.

Preschool children (6·0–59·9 months) from randomly selected households (474 from the 1996 baseline survey; 1264 from 2000 MICAH areas; 1500 from 2000 Comparison areas; 1959 from 2004 MICAH areas; and 1008 from 2004 Comparison areas), who responded to a household questionnaire, were weighed and measured using standard protocols.

At the baseline in 1996, the prevalence of stunting (60·2 %) was very high. By 2000, the prevalence of stunting had declined to 50·6 % and 56·0 % (χ2 = 7·8, P = 0·005) in MICAH and Comparison areas, respectively. In 2004, the prevalence of stunting did not differ significantly between MICAH and Comparison areas (43·0 % v. 45·1 %; χ2 = 1·11, P = 0·3). Severe stunting affected 34·7 % of children at baseline, which declined to 15·8 % and 17·1 % (χ2 = 0·86, P = 0·4) in MICAH and Comparison areas, respectively, by 2004. Regional variations existed, with proportionately fewer children from the Northern region being stunted compared to their Central and Southern region counterparts.

Given the length of implementation, wide-scale coverage and positive impact on child growth in Phase I (1996–2000), the MICAH programme is a potential model for combating linear growth retardation in rural areas in Malawi, although the catch-up improvement in Comparison areas during Phase II (2000–2004) cannot be adequately explained.

Peer counselling (PC) programmes have been shown to improve breast-feeding outcomes in populations at risk for early discontinuation. Our objective was to describe associations between programme components (individual and combinations) and breast-feeding outcomes (duration and exclusivity) in a PC programme for low-income women.

Secondary analysis of programme data. Multivariable-adjusted Cox proportional hazards models were used to examine associations between type and quantity of peer contacts with breast-feeding outcomes. Types of contacts included in-person (hospital or home), phone or other (e.g. mail, text). Quantities of contacts were considered ‘optimal’ if they adhered to standard programme guidelines.

Programme data collected from 2005 to 2011 in Michigan’s Breastfeeding Initiative Peer Counseling Program.

Low-income (n 5886) women enrolled prenatally.

For each additional home, phone and other PC contact there was a significant reduction in the hazard of discontinuing any breast-feeding by 6 months (hazard ratio (HR)=0·90 (95 % CI 0·88, 0·92); HR=0·89 (95 % CI 0·87, 0·90); and HR=0·93 (95 % CI 0·90, 0·96), respectively) and exclusive breast-feeding by 3 months (HR=0·92 (95 % CI 0·89, 0·95); HR=0·90 (95 % CI 0·88, 0·91); and HR=0·93 (95 % CI 0·89, 0·97), respectively). Participants receiving greater than optimal in-person and less than optimal phone contacts had a reduced hazard of any and exclusive breast-feeding discontinuation compared with those who were considered to have optimum quantities of contacts (HR=0·17 (95 % CI 0·14, 0·20) and HR=0·28 (95 % CI 0·23, 0·35), respectively).

Specific components of a large PC programme appeared to have an appreciable impact on breast-feeding outcomes. In-person contacts were essential to improving breast-feeding outcomes, but defining optimal programme components is complex.

The present study examined associations of several home and neighbourhood environmental variables with fruit consumption and explored whether these associations were mediated by variables derived from the Theory of Planned Behaviour (TPB) and by habit strength.

Data of the Dutch GLOBE study on household and neighbourhood environment, fruit intake and related factors were used, obtained by self-administered questionnaires (cross-sectional), face-to-face interviews and audits.

The city of Eindhoven in the Netherlands

Adults (n 333; mean age 58 years, 54 % female).

Multiple mediation analyses were conducted using regression analyses to assess the association between environmental variables and fruit consumption, as well as mediation of these associations by TPB variables and by habit strength. Intention, perceived behaviour control, subjective norm and habit strength were associated with fruit intake. None of the neighbourhood environmental variables was directly or indirectly associated with fruit intake. The home environmental variable ‘modelling behaviour by family members’ was indirectly, but not directly, associated with fruit intake. Habit strength and perceived behaviour control explained most of the mediated effect (71·9 %).

Modelling behaviour by family members was indirectly associated with fruit intake through habit strength and perceived behaviour control. None of the neighbourhood variables was directly or indirectly, through any of the proposed mediators, associated with adult fruit intake. These findings suggest that future interventions promoting fruit intake should address a combination of the home environment (especially modelling behaviour by family members), TPB variables and habit strength for fruit intake.

The study aimed to assess differences in dietary intake and growth of pre-schoolers and schoolchildren living in two limitary Greek islands; Samos, situated on the eastern border, and Corfu, situated on the western border.

Cross-sectional two-site study.

A total of 248 children aged 3–12 years from the two islands participated in the survey. Body weight and height were recorded and Z-scores were calculated. A 3 d food record was collected for each child, computer-analysed and compared with the Recommended Daily Allowances (RDA). Intakes ≤70 % of the RDA were considered inadequate.

The prevalence of overweight in participants from Samos and Corfu was 10·7 % and 6·5 % respectively, according to the Centers for Disease Control and Prevention growth charts. In Corfu, the diet comprised 52 % carbohydrate, 34 % fat and 14 % protein, all different from the composition of the Samian diet (42 % carbohydrate, 39 % fat, 19 % protein; P ≤ 0·05). Inadequacies in micronutrient intake were evident only in the diet of Samos and concerned folate and P of the pre-schoolers and biotin of the school-aged participants. The diet in Corfu was more similar to the overall Mediterranean pattern as well as that of Italian children. Growth and overweight trends in Corfu resembled the ones in Italy, whereas in Samos, similarities were identified with trends from Turkey.

Border areas at a distance from the mainland exhibit different dietary intakes compared with rest of the country; thus when designing nutrition surveys the setting should also include such limitary areas.

The growing interest in maintaining good health status through optimal nutrition has boosted the launch of a number of functional foods on the market. The objective of the present study was to theoretically evaluate the nutritional relevance of incorporating selected enriched foods in the diet.

A 28 d dietary plan, designed to be balanced under the recommended macronutrients criteria, was used as a basal diet. Some conventional foods were exchanged with foods enriched in fibre, calcium, iodine, vitamins A, D, E or n-3 fatty acids.

Nutritional composition of basal and modified diets was derived and compared to the Spanish recommended intakes (RI).

The basal diet covered the recommendations for fibre and calcium with mean intake of 28 g and 1241 mg, respectively. The current intake of salt, if iodized, or bread elaborated with this salt, allowed reaching the daily intake of iodine every day, with a mean supply of 216 μg/d and 278 μg/d, respectively. The deficient supply of vitamin E in the basal diet (mean = 8 mg/d) was covered by including enriched margarine and dairy products (mean = 15 mg/d). The low n-3 fatty acids intake in the basal diet (1·1 g/d) increased up to 1·9 g/d after the use of enriched margarine, butter and biscuits and soya drink instead of milk.

In order to improve the accomplishment of the RI iodine, vitamin E and n-3 fatty acids, interesting strategies dealing with the incorporation of enriched foods in the diet were successfully initiated.