In 2011, Dietitians of Canada added ‘My Goals’ to its website-based nutrition/activity tracking program (eaTracker®, http://www.eaTracker.ca/); this feature allows users to choose ‘ready-made’ or ‘write-your-own’ goals and to self-report progress. The purpose of the present study was to document experiences and perceptions of goal setting and My Goals, and report users’ feedback on what is needed in future website-based goal setting/tracking tools.

One-on-one semi-structured interviews were conducted with (i) My Goals users and (ii) dietitians providing a public information support service, EatRight Ontario (ERO).

My Goals users from Ontario and Alberta, Canada were recruited via an eaTracker website pop-up box; ERO dietitians working in Ontario, Canada were recruited via ERO.

My Goals users (n 23; age 19–70 years; 91 % female; n 5 from Alberta/n 18 from Ontario) and ERO dietitians (n 5).

Dietitians and users felt goal setting for nutrition (and activity) behaviour change was both a beneficial and a challenging process. Dietitians were concerned about users setting poor-quality goals and users felt it was difficult to stick to their goals. Both users and dietitians were enthusiastic about the My Goals concept, but felt the current feature had limitations that affected use. Dietitians and users provided suggestions to improve My Goals (e.g. more prominent presence of My Goals in eaTracker; assistance with goal setting; automated personalized feedback).

Dietitians and users shared similar perspectives on the My Goals feature and both felt goal use was challenging. Several suggestions were provided to enhance My Goals that are relevant to website-based goal setting/tracking tool design in general.

The mother–child breastfeeding dyad is a powerful force for achieving healthy, secure and sustainable food systems. However, food system reports exclude breastfeeding and mother’s milk. To help correct this omission and give breastfeeding women greater visibility in food systems dialogue and action, we illustrate how to estimate mother’s milk production and incorporate this into food surveillance systems, drawing on the pioneering experience of Norway to show the potential value of such analysis.

The estimates use data on the proportion of children who are breastfed at each month of age (0–24 months), annual number of live births and assumptions on daily human milk intake at each month. New indicators for temporal and cross-country comparisons are considered.

It is assumed that a breastfeeding mother on average produces 306 l of milk during 24 months of lactation.

The annual number of live births is from Statistics Norway. Data for any breastfeeding at each month of age, between 0 and 24 months, are from official surveys in 1993, 1998–1999, 2006–2007, 2013 and 2018–2019.

Estimated total milk production by Norwegian mothers increased from 8·2 to 10·1 million l per year between 1993 and 2018–2019. Annual per capita production increased from 69 to 91 l per child aged 0–24 months.

This study shows it is feasible and useful to include human milk production in food surveillance systems as an indicator of infant and young child food security and dietary quality. It also demonstrates significant potential for greater milk production.

To test whether perception of insufficient milk (PIM) supply in the breast-feeding relationship of one child predicts how long mothers breast-feed subsequent children, and whether this association differs for first-time mothers v. mothers with previous children.

Secondary analysis of Infant Feeding Practices Study II (ordinary least squares regression) and Year 6 follow-up.

Mailed, self-report survey of US mother–infant dyads, 2005–2012.

Women pregnant with a singleton were recruited from a consumer opinion panel. Exclusion criteria included: mother age <18; infant born <5 lbs, born before 35 weeks or with extended NICU stay, and mother or infant diagnosed with condition that impacts feeding. A subsample with PIM data (n 1460) was analysed.

We found that women who weaned because of PIM with the index child stopped breast-feeding 5·7 weeks earlier than those who weaned due to other reasons (4·9 weeks earlier for multiparas, P < 0·001; 7·1 weeks earlier for primiparas, P < 0·001). Using Year 6 follow-up data (n 350), we found subsequent child 1 weaned 9·2 weeks earlier if the mother experiences PIM as a multipara (P = 0·020) and 10·6 weeks earlier if the mother experiences PIM as a primipara (P = 0·019). For subsequent child 2 (n 78), the magnitude of association was even larger, although insignificant due to low power.

These findings indicate that PIM may carry forward in the reproductive life course, especially for first-time mothers. Perceptions of breast milk insufficiency and contributors to actual inadequate milk supply with the first child should be targeted, rather than intervening later in the reproductive life course.

Although most parents know that vegetables are healthful, vegetables are served at only 23 % of American dinners. If added nutrition is not a sufficient motivation, might a parent be more inspired to serve vegetables if doing so improved either the taste of the entrée or how loving and thoughtful the server would be perceived? The present paper details two studies which investigated whether serving vegetables changes the perception of the cook and the perception of an entrée's taste.

In Study 1, people evaluated the personality of a cook who either did or did not include a vegetable in a family dinner. In Study 2, five different meals that either included or did not include a vegetable were rated in terms of the taste of the entrée and of the whole meal.

US-based online survey.

American mothers (n 500), ranging in age from 18 to 65 years (mean age 38·4 years), with at least two children under the age of 18 years living at home.

Serving vegetables improved taste expectations for the entrée as well as for the whole meal. Additionally, serving a vegetable with a meal also enhanced perceptions of the meal preparer. They were evaluated as being more thoughtful and attentive as well as less lazy, boring and self-absorbed.

These two studies show new hedonic and heroic motivations for serving vegetables: (i) they increase the hedonic appeal of the meal and (ii) they increase the heroic appeal of the cook. More vegetables are likely to be served with a meal if preparers know that the addition of vegetables makes them appear to be both a better cook and a better person.

To evaluate the culinary content of key messages contained in food-based dietary guidelines (FBDG) available at the global online repository of the FAO of the UN.

Document analysis was conducted in August 2021 with data extraction of key messages explicitly related to cooking present in FBDG. Data were analysed inductively using thematic analysis.

The FAO’s global repository of FBDG.

Not applicable.

Just over half (n 39; 53·4 %) of the seventy-three FBDG analysed included at least one key message about cooking. The Latin American and Caribbean FBDG presented the greatest amount and variety of content about cooking in the key messages, whereas the Near East and North America placed less emphasis on cooking. We identified three themes: (i) healthy food preparation (n 35; 61·4 % of the fifty-seven culinary key messages identified); (ii) food hygiene (n 14; 24·6 %) and (iii) the promotion of culinary practices (n 7; 12·3 %). Albania’s key message covered two themes (food hygiene and healthy food preparation) (n 1; 1·8 %).

FBDG are official documents that express recommendations for a healthy diet. As most of these recommendations throughout the world include foods that must be cooked prior to consumption, culinary content should gain more visibility and be presented more broadly in these official documents.

Convincing evidence exists for a beneficial effect of physical activity (PA) on health and well-being for elderly women. Nevertheless, many women in Germany are insufficiently physically active. Activity promotion programmes should target women in particular need. Thus, we examined subject-related determinants of PA for postmenopausal women in Germany.

Associations of sociodemographic, anthropometric, lifestyle and health-related factors with activity since the age of 50 years were assessed with multiple linear and logistic regression models, regarding overall leisure-time PA (LPA) in metabolic equivalent hours per week, engagement in sports (ever v. never), cycling (yes v. no) and walking (≥3·5 v. <3·5 h/week).

All controls from a population-based case–control study carried out in 2002–2005 in Germany (MARIE study).

A total of 6569 postmenopausal women.

We found significant associations of overall LPA, sports, cycling and walking in postmenopausal years with several characteristics, among others: obese v. normal BMI (adjusted OR: ORsports = 0·73; ORcycling = 0·60; ORwalking = 0·63), tall v. short (ORsports = 1·49), worker v. medium employee (ORsports = 0·47), working full time v. unemployed/retired (ORsports = 0·80; ORwalking = 0·56), current v. non-smoker (ORsports = 0·62; ORcycling = 0·62; ORwalking = 0·82), non-German nationality (ORsports = 0·58; ORcycling = 0·41). Parity seemed more relevant than marital status for sports or cycling activity. Further, CVD, hypertension and diabetes were significantly associated with lower activity (ORsports = 0·77, 0·79 and 0·80; ORcycling = 0·80, 0·75 and 0·85, respectively).

Our results suggest potential target groups for promoting sports, cycling or walking activity. Postmenopausal women with chronic diseases may need to be stronger encouraged by their physicians to engage in adequate PA for the management of their diseases.

Despite efforts to improve maternal and child nutrition, undernutrition remains a major public health challenge in Ghana. The current study explored community perceptions of undernutrition and context-specific interventions that could improve maternal and child nutrition in rural Northern Ghana.

This exploratory qualitative study used ten focus group discussions to gather primary data. The discussions were recorded, transcribed and coded into themes using Nvivo 12 software to aid thematic analysis.

The study was conducted in rural Kassena-Nankana Districts of Northern Ghana.

Thirty-three men and fifty-one women aged 18–50 years were randomly selected from the community.

Most participants reported poverty, lack of irrigated agricultural land and poor harvests as the main barriers to optimal nutrition. To improve maternal and child nutrition, study participants suggested that the construction of dams at the community level would facilitate all year round farming including rearing of animals. Participants perceived that the provision of agricultural materials such as high yield seedlings, pesticides and fertiliser would help boost agricultural productivity. They also recommended community-based nutrition education by trained health volunteers, focused on types of locally produced foods and appropriate ways to prepare them to help improve maternal and child nutrition.

Drawing on these findings and existing literature, we argue that supporting community initiated nutrition interventions such as improved irrigation for dry season farming, provision of agricultural inputs and community education could improve maternal and child nutrition.

Many jurisdictions in the USA and globally are considering raising the prices of sugar-sweetened beverages (SSB) through taxes as a strategy to reduce their consumption. The objective of the present study was to identify whether the rationale provided for an SSB price increase affects young adults’ behavioural intentions and attitudes towards SSB.

Participants were randomly assigned to receive one of eight SSB price increase rationales. Intentions to purchase SSB and attitudes about the product and policy were measured.

A forty-six-item cross-sectional Internet survey.

Undergraduate students (n 494) at a large US Midwestern university.

Rationale type was significantly associated with differences in participants’ purchasing intentions for the full sample (F7,485=2·53, P=0·014). Presenting the rationale for an SSB price increase as a user fee, an effort to reduce obesity, a strategy to offset health-care costs or to protect children led to lower SSB purchasing intentions compared with a message with no rationale. Rationale type was also significantly associated with differences in perceptions of soda companies (F7,485=2·10, P=0·043); among low consumers of SSB, messages describing the price increase as a user fee or tax led to more negative perceptions of soda companies.

The rationale attached to an SSB price increase could influence consumers. However, these message effects may depend on individuals’ level of SSB consumption.

The present study explored parents’ requirements for healthy eating support prior to the development of a tailored intervention.

A cross-sectional study of parents attending children's centres.

Children's centres in Cornwall (rural south-west England) and Islington (urban London borough).

A total of 261 parents (94·2 % female) of pre-school children (aged 2–5 years) completed a questionnaire on factors influencing food choice, and preferences for and views on healthy eating support.

Parents reported that health, taste, freshness and quality were the most important factors influencing their food choices for their pre-school children. The importance of individual factors varied according to level of educational attainment. Over a third (38 %) of parents said they wanted more advice on healthy eating for children. Less educated parents showed the greatest interest in learning more about several aspects: what a ‘healthy diet’ means, how to prepare and cook healthy food, how to understand food labels, budgeting for food, examples of healthy food and snacks for children, appropriate portion sizes for children and ways to encourage children to eat well.

There was demand for healthy eating support among parents of pre-school children, especially those who are less educated, in one rural and one urban area of England.

There is limited evidence on the interaction by alcohol dehydrogenase 2 (ADH1B) (rs1229984) and aldehyde dehydrogenase 2 (ALDH2) (rs671) regarding the associations of alcohol and a methyl diet (low folate and high alcohol intake) with cancer risk, partly because of rare polymorphisms in Western populations.

In a case–control study, we estimated the ORs and 95 % CIs to evaluate the associations of ADH1B and ALDH2 genotypes with colorectal cancer (CRC) and the joint association between methyl diets and ADH1B and ALDH2 polymorphisms with CRC risk using logistic regression models.

A hospital-based case–control study.

In total, 1001 CRC cases and 899 cancer-free controls admitted to two university hospitals.

We found that alcohol intake increased the risk of CRC; OR (95 % CI) was 2·02 (1·41, 2·87) for ≥60 g/d drinkers compared with non-drinkers (Ptrend < 0·001). The associations for two polymorphisms with CRC were not statistically significant. However, we found a potential interaction of ALDH2 with methyl diets and CRC. We observed a 9·08-fold (95 % CI 1·93, 42·60) higher risk of CRC for low-methyl diets compared with high-methyl diets among individuals with an A allele of ALDH2, but the association was not apparent among those with ALDH2 GG (Pinteraction = 0·02).

Our data support the evidence that gene–methyl diet interactions may be involved in CRC risk in East Asian populations, showing that a low-methyl diet increased the risk of CRC among individuals with an A allele of ALDH2.

To compare judgements of nutrition and judgement accuracy when evaluating cereals with the current US Food and Drug Administration (FDA) nutrition facts panel (NFP) and two new proposed NFP based on FDA guidelines.

A between-subjects design randomly assigned participants to three NFP conditions (current NFP label and two modified NFP based on FDA proposals). Participants viewed breakfast cereals, and rated each on nutritional quality and on the likelihood of purchasing and consuming it. Participants provided demographic information and responses to questionnaires assessing nutrition/obesity knowledge, concern for healthy eating and nutrient importance.

USA.

Two hundred and thirteen adults who completed an online survey (66·2 % female, mean age 37·31 (sd 12·56) years).

Judged nutrition quality of cereals was positively correlated with protein, fibre and potassium and negatively correlated with sugars and sodium. This pattern appeared when using the current NFP or the modified versions. Highlighted nutrients in modified NFP formats did not affect their perceived importance. Accuracy of the nutrition quality judgements was measured in relationship to an objectively defined nutrition score, NuVal®. Nutrition judgement accuracy was highest under the current NFP (Spearman’s ρ=0·76 for the current NFP; 0·64 and 0·72 for the other formats). Regression analysis showed that nutrition judgement accuracy increased significantly (adjusted R2=0·13) with obesity knowledge (β=0·27), age (β=0·15) and current NFP (β=0·13).

The current NFP is equally or more effective in conveying nutritional information compared with NFP formats based on the FDA proposal.

To examine geographical variations, trends and projections in the prevalence of childhood anemia at national and subpopulation levels.

Repeated cross-sectional Demographic and Health Survey (DHS) conducted during 2000–2018.

Fifty-three low- and middle-income countries (LMIC)

Totally, 776 689 children aged 6–59 months.

During the latest DHS rounds between 2005 and 2018, the prevalence of child anemia was > 20 % in fifty-two out of fifty-three countries and ranged from 15·9 % in Armenia in 2016 to 87·8 % in Burkina Faso in 2010. Out of thirty-six countries with at least two surveys during 2000–2018, the prevalence of child anemia decreased in twenty-two countries, highest in Zimbabwe (–4·2 %) and increased in fourteen countries, highest in Burundi (5·0 %). Based on the trend, eleven and twenty-two out of thirty-six countries are projected to experience, respectively, moderate and severe public health problem according to the WHO criteria (moderate problem: 20–39·9 % and severe problem: ≥ 40 %) due to child anemia in 2030, with the highest prevalence in Liberia (87·5 %, 95 % credible interval 52·0–98·8 %). The prevalence of child anemia varied across the mother’s education and age, child sex, wealth quintiles, and place of residence, with the highest rate of child anemia among the poorest, rural and low-educated mothers. These scenarios are projected to continue. The probability of reducing child anemia at < 0·5 % by 2030 is 0 % for all study countries.

The prevalence of child anemia varied between and within countries. None of the thirty-six LMIC is likely to eradicate child anemia by 2030.

Due to the growing interest in the role of dietary patterns (DPs) on chronic diseases, we assessed the association between a posteriori identified DPs in the Seguimiento Universidad de Navarra (SUN) Project – a prospective cohort study in a Mediterranean country – and breast cancer (BC) risk.

DPs were ascertained through a principal component analysis based on 31 predefined food groups. BC cases were initially identified through self-report or, if deceased, from death certificates or by notification by the next kin. Women reporting BC were asked to provide a copy of their medical report and diagnoses for confirmation purposes. We fitted Cox regression models to assess the association between adherence to the identified DPs and BC risk.

Spanish university graduates.

We included 10 713 young and middle-aged – mainly premenopausal – women.

After a median follow-up of 10·3 years, we identified 100 confirmed and 168 probable incident BC cases. We described two major DPs: ‘Western dietary pattern’ (WDP) and ‘Mediterranean dietary pattern’ (MDP). A higher adherence to a WDP was associated with an increased risk of overall BC (multivariable-adjusted HR for confirmed BC Q4 v. Q1 1·70; 95 % CI 0·93, 3·12; P for trend = 0·045). Contrarily, adherence to a MDP was inversely associated with premenopausal BC (multivariable-adjusted HR Q4 v. Q1 0·33; 95 % CI 0·12, 0·91). No significant associations were observed for postmenopausal BC.

Whereas a higher adherence to the WDP may increase the risk of BC, a higher adherence to the MDP may decrease the risk of premenopausal BC.

We assessed serum homocysteine (tHcy) and folate concentrations among US adolescents before and after fortification of cereal-grain products with folic acid, and associations with demographic, behavioural and physiological factors.

Observational study conducted among participants of a randomized trial.

The Child and Adolescent Trial for Cardiovascular Health (CATCH) study.

Adolescents (n 2445) in grades 8 (pre-fortification, mean age 14 years) and 12 (post-fortification, mean age 18 years).

Average serum concentrations of tHcy, folate and vitamin B6 increased by 17 %, 16 % and 14 %, respectively, while serum concentrations of vitamin B12 decreased by 11 % post-fortification. Folic acid fortification provided, on average, an additional intake of 118 μg folate/d. Male sex (P < 0·0001) and white race (P = 0·0008) were associated with significantly greater increases in tHcy concentration, while increases in BMI (P = 0·006) and serum folate concentration (P < 0·0001) were associated with significant decreases in tHcy concentration. Female sex (P < 0·0001), non-smoking (P < 0·0001), use of multivitamins (P < 0·0001) and higher dietary intake of folate (P = 0·001) were associated with significantly greater increases in serum folate concentrations. From grade 8 to grade 12, the upward age trend in serum tHcy concentration was uninterrupted in its course (P > 0·50); whereas serum folic acid concentration showed a downward trend that incurred a discrete jump upward (17 % higher; P < 0·0001) with fortification. These trends differed significantly for males v. females (P < 0·001 for interaction).

Fortification had a significant impact on improving folate status but not serum tHcy concentrations among US adolescents.

First, to evaluate the ability of a short dietary questionnaire (SDQ) to estimate energy intake (EI) on group and individual levels compared with total energy expenditure (TEE) measured by the doubly labelled water method. Second, to compare the SDQ's performance in estimating energy, nutrient and food intakes with a sixty-six-item FFQ used in large-scale Swedish epidemiological research.

Cross-sectional.

Umeå, Sweden.

In total, sixty-five non-pregnant women, of whom thirty-one were overweight or obese, and twenty-five pregnant, normal-weight women completed the protocol.

On average, the SDQ captured 78 % and 79 % of absolute TEE in the non-pregnant and pregnant normal-weight women, respectively. Furthermore, the SDQ captured an average of 57 % of TEE in the overweight/obese non-pregnant women. The Spearman correlation of EI and TEE was significant in the overweight and obese women only (ρ = 0·37, 95 % CI 0·02, 0·64). There was no significant difference between the SDQ and the more extensive FFQ in the ability to assess EI when compared with TEE. Intakes of most nutrients and foods were significantly higher when assessed with the SDQ compared with the FFQ.

A new short dietary questionnaire with an alternative design underestimated EI of non-pregnant and pregnant, overweight and obese women on a group level but was able to rank the overweight/obese women according to EI. Furthermore, the short questionnaire captured as much or more of the energy, nutrient and food intakes of non-pregnant normal-weight and overweight/obese women on the group level as a traditional, more extensive FFQ.

To apply the Theory of Planned Behaviour to examine the relationship between the constructs of background factors and beliefs towards using policy, systems and environmental (PSE) strategies and reported use of PSE strategies to prevent obesity by a group of professional nutrition educators.

Cross-sectional study using self-reported survey.

Cooperative Extension in New York, USA.

Nutrition educators (n 58); survey response rate 100 %.

Nutrition educators’ reported use of PSE strategies to prevent obesity were positively associated with background factors of their community networking and number of staff they managed, their belief of other people’s expectations of them to make PSE changes and the belief that their communities were ready to use PSE strategies; and negatively associated with their belief that individual-level factors contributed to obesity. The relationships among these variables were complicated and their use of PSE strategies occurred only when they utilized their professional networks at a moderately high level (above mean of 5·3 on a scale of 1–7), given that their community was also ready to use PSE strategies.

Nutrition educators’ use of PSE strategies depends on several internal and external factors. Community networking needs to be emphasized as one of the most significant factors contributing to nutrition educators’ work in this area. Organizational and community support should be in place in order to facilitate nutrition educators’ effective use of PSE strategies.

To investigate seasonal variations of vitamin D status at different latitudes and if these changes are accompanied by corresponding variations in certain health parameters in children living in a broad latitudinal range in Iran.

Longitudinal study.

In total, 530 apparently healthy children aged 5–18 years were randomly selected from six regions of Iran with a latitudinal gradient from 29°N to 37·5°N. All anthropometric and biochemical assessments were performed twice during a year (summer, winter). High BMI (Z-score >1), low HDL cholesterol (<40 mg/dl, males; <50 mg/dl, females) and high TAG (>150 mg/dl) were considered cardiometabolic risk factors.

Serum 25-hydroxyvitamin D (25(OH)D) showed between-season variation, with significantly higher concentrations (mean (sd)) in summer v. winter (43 (29) v. 27 (18) nmol/l; P<0·001). Change of circulating 25(OH)D between summer and winter was negatively correlated with change of BMI (r=−0·16; P<0·001), TAG (r=−0·09; P=0·04) and total cholesterol (r=−0·10; P=0·02) and directly correlated with change of height-for-age Z-score (r=0·09; P=0·04). Multiple stepwise linear regression analysis (β; 95 % CI) showed that winter serum 25(OH)D (−0·3; −0·4, −0·2; P<0·001), gender (boys v. girls: 9·7; 5·2, 14·1; P<0·001) and latitude (>33°N v. <33°N: 4·5; 0·09, 9·0; P=0·04) were predictors of change of serum 25(OH)D between two seasons.

Summertime improvement of vitamin D status was accompanied by certain improved cardiometabolic risk factors, notably serum TAG, total cholesterol and BMI, in children.

To determine the prevalence of vitamin D supplement use in Canadian adults and associations with demographic and socio-economic variables.

Data from the Healthy Aging module of the Canadian Community Health Survey were used to investigate the prevalence of vitamin D supplement use in Canadians aged 45 years and over. The prevalence of supplement use stratified by various behavioural and demographic characteristics was calculated and adjusted models were used to find associations with those factors.

The ten provinces of Canada.

Canadians aged 45 years and over who participated in the Healthy Aging module of the Canadian Community Health Survey from 2008–2009.

The highest observed prevalence for women was 48·0 % in the 65–69 years age group and the highest prevalence for men was 25·3 % in the 70–74 years age group. Women had higher odds of vitamin D supplement use than men in all age groups. Not using supplements was more common in smokers, those who did not engage in leisure-time physical activities and who were either overweight or obese. Vitamin D supplement use increased with household income and level of education, and decreased with self-perceived health. Supplement use was higher in those with chronic conditions.

The inverse association with self-perceived health could be partly explained by age, chronic conditions and increased use of health-care services. Associations with higher income and education suggest a strong socio-economic influence and that individuals may not have the expendable income to purchase vitamin D supplements or knowledge of their health benefits.

FFQs are a popular method of capturing dietary information in epidemiological studies and may be used to derive dietary exposures such as nutrient intake or overall dietary patterns and diet quality. As FFQs can involve large numbers of questions, participants may fail to respond to all questions, leaving researchers to decide how to deal with missing data when deriving intake measures. The aim of the present commentary is to discuss the current practice for dealing with item non-response in FFQs and to propose a research agenda for reporting and handling missing data in FFQs.

Single imputation techniques, such as zero imputation (assuming no consumption of the item) or mean imputation, are commonly used to deal with item non-response in FFQs. However, single imputation methods make strong assumptions about the missing data mechanism and do not reflect the uncertainty created by the missing data. This can lead to incorrect inference about associations between diet and health outcomes. Although the use of multiple imputation methods in epidemiology has increased, these have seldom been used in the field of nutritional epidemiology to address missing data in FFQs. We discuss methods for dealing with item non-response in FFQs, highlighting the assumptions made under each approach.

Researchers analysing FFQs should ensure that missing data are handled appropriately and clearly report how missing data were treated in analyses. Simulation studies are required to enable systematic evaluation of the utility of various methods for handling item non-response in FFQs under different assumptions about the missing data mechanism.

There is an increasing concern of anaemia in Japanese women, but no national trend data has existed to date. We analysed long-term national trends of anaemia in adult women.

Secondary analyses of 15 consecutive cross-sectional nationwide surveys conducted during the period 1989–2003. Analyses were based on 5-year intervals (1989–1993, 1994–1998, 1999–2003).

Japan.

The subjects included the National Health and Nutrition Survey of Japan (NHNS-J) population. Analyses were based on 50 967 non-pregnant/non-lactating women aged 20 years and over, with complete data sets. We stratified subjects into six age groups (20–29 years, 30–39 years, 40–49 years, 50–59 years, 60–69 years and 70+ years), and three age groups (20–49 years, 50–69 years, 70+ years) for analyses on residential areas (metropolitan, cities and towns).

Decreases in trends of mean haemoglobin values (intravenous) were significant in all age groups. Changes in the prevalence of anaemia were significant only in women aged 30–39 and 40–49 years. Anaemia (haemoglobin < 12.0 g dl−1) increased from 16.8% to 20.6% in women aged 30–39 years, and from 20.2% to 26.9% in women aged 40–49 years, respectively. Prevalence was highest in women aged 70 years and older in all times, but no significant change was observed.

Haemoglobin values have declined significantly in all ages in the last 15 years. Anaemia was especially significant in women aged 30–39 years and 40–49 years. Our findings suggest that a large number of young women in Japan are at risk of anaemia, so continuous monitoring and controlling efforts of this trend are needed.