Influence of gender and socio-economic status on dietary patterns and nutrient intakes in 18-year-old Australians.

This study used two-day diet records to examine dietary behaviours in 504 Australian 18 year-olds in relation to gender, socio-economic status (SES) and national dietary guidelines. Fat intake exceeded 30% of energy in about 80% of subjects and was greater than 40% in about one-quarter. Saturated fat provided more than 10% of dietary energy in more than 90% of participants; less than 1% achieved a polyunsaturated to saturated fat ratio of at least one. The major food groups contributing to fat intake were convenience foods (32% in men, 28% in women) and meat (27% in men, 25% in women). Fibre intake was less than 30 g/day in 93% of women and 77% of men. Intakes of calcium, magnesium, potassium, and vitamins C and A, as a ratio of energy consumption, were greater in women than men, while sodium intake was significantly higher in men. Convenience foods were the greatest contributors to sodium intake (27% in men, 22% in women) followed by meat, bread, and soups and sauces. Greater consumption of cereals, fruit, vegetables and low-fat foods in young women of higher SES was reflected in their nutrient profile with higher intake of fibre and vitamin C and lower intake of fat. Men ate more cereals, meat and sugary foods and less fruit, vegetables and low-fat foods. Only 2.5% of men and 4.1% of women conformed with the health promotion message, widely publicised locally, to eat two fruits and five vegetables daily. Not eating breakfast was associated with lower calcium intake in men and women, and lower iron and fibre in take in women. Achieving behavioural changes in young adults must take into account differences in dietary behaviour related to gender and SES.

A controlled trial of health promotion programs in 11-year-olds using physical activity "enrichment" for higher risk children.

OBJECTIVE: To evaluate the short and long term benefits of a school and home based physical activity "enrichment" program for children at higher risk of cardiovascular disease as identified by cluster analysis. STUDY DESIGN: During two 10-week school terms, 800 11-year-olds took part in a randomized controlled trial with the standard physical activity and nutrition program in six schools, the standard program in a further seven schools but with the addition of physical activity enrichment for higher risk children in those schools, and no program in five control schools. Cluster analysis identifying the 29% or so highest risk children used systolic blood pressure, percent body fat, physical fitness, and blood cholesterol. RESULTS: Fitness improved significantly in program schools, particularly with enrichment in higher risk boys. Substantial improvements persisted 6 months later in girls from program schools. At "Enrichment" schools, cholesterol showed significant benefits in higher risk girls and, 6 months later, in both boys and higher risk girls. Sodium intake and, in girls, subscapular skinfolds were lower in "Enrichment" schools when the program ended, but not 6 months later. CONCLUSION: Two-semester health programs with physical activity enrichment for higher risk children can produce benefits sustained for at least 6 months. Improvements extend to lower risk children exposed indirectly to the enrichment. Attenuation of effects on diet and body composition in the longer-term suggest the need for on-going programs.

Associations between lifestyle and cardiovascular risk factors in 18-year-old Australians.

PURPOSE: This study aimed to examine associations between cardiovascular risk factors and variables reflecting health-related behaviors in 18-year-old Australians. METHODS: Anthropometry, blood pressure, nonfasting serum cholesterol, and physical fitness were measured in 301 male and 286 female Australian 18-year-olds. Usual physical activity, smoking, and drinking habits were assessed by questionnaire. RESULTS: Systolic (SBP), with mean SBP higher by 14 mm Hg in males, related positively to weight for height for age and "unsafe" drinking (exceeding Australian national guidelines) and negatively to fitness and birth weight. Total cholesterol, which was positively associated with waist-hip ratio and negatively with fitness, was higher in females [mean 4.4 mmol/L, 95% confidence interval (CI) 4.3, 4.5] than in males (mean 4.1 mmol/L, 95% CI 4.0, 4.2). In 24% of males and 48% of females, usual levels of physical activity were low, consistent with lower scores on fitness tests in females. Thirty percent of males and 24% of females regularly drank at "unsafe," levels while 26% of males and 29% of females smoked. Smoking was associated with "unsafe" drinking. CONCLUSION: Cardiovascular risk factors in 18-year-olds are related to smoking, "unsafe" drinking, and physical inactivity, particularly in females. These behaviors should be targeted in designing multimodal health promotion programs appropriate for these young adults.

Differences in response to nutrition and fitness education programmes in relation to baseline levels of cardiovascular risk in 10 to 12-year-old children.

OBJECTIVE: To examine associations between children's responses to nutrition and fitness programmes and their baseline levels of cardiovascular risk factors. DESIGN: A randomised controlled trial. SETTING: Primary schools in Perth, Western Australia. PARTICIPANTS: 1147 children aged 10-12 years. INTERVENTIONS: Fitness, fitness+school nutrition, school +home nutrition or home nutrition programmes and a control group. MAIN OUTCOME MEASURES: Blood pressure (BP), cholesterol, nutrient intake, fitness, and body fat. RESULTS: Fall in systolic BP was significantly greater in the higher risk groups with the fitness intervention for boys and the home nutrition intervention for girls. Overall, diastolic BP fell for girls in the fitness intervention with no differences related to cluster membership. Higher risk boys in the fitness intervention showed greater improvement in fitness than the lower risk boys. Fitness improved in girls in the fitness programme but responses did not differ significantly according to cluster membership. Decrease in triceps skinfolds was significantly greater for higher risk boys in the home nutrition group and in higher risk girls except for those receiving the school+home nutrition intervention. Home nutrition programmes were associated with decreased intake of fat and greater intake of fibre in girls in the higher risk group and of sugar in higher risk boys. CONCLUSIONS: The greatest improvement in the higher risk children were associated with fitness and home nutrition programmes. Health education programmes aiming to include higher risk children should focus on these areas.

A controlled evaluation of a fitness and nutrition intervention program on cardiovascular health in 10- to 12-year-old children.

BACKGROUND: Programs to improve cardiovascular health in schoolchildren need careful scientific evaluation. METHOD: In a randomized controlled trial of nutrition and fitness programs over a period of about 9 months, 1,147 10- to 12-year-olds from 30 schools were allocated to one of five health programs: fitness, fitness + school nutrition, school-based nutrition, school + home nutrition, home-based nutrition, or a control group. Nutrient intake, fitness, anthropometry, blood pressure, and blood cholesterol were measured before and after intervention. RESULTS: Fitness increased and diastolic blood pressure and triceps skinfolds decreased significantly for girls in the fitness groups. Baseline consumption of sugar, fat, and fiber was outside national guidelines; blood cholesterol exceeded recommendations in one-third of children. In girls, fat intake decreased significantly in the two home nutrition groups and fiber intake increased in the school + home nutrition and fitness groups. Boys in the fitness, fitness + school nutrition, and school + home nutrition group reduced sugar intake. Change in sugar intake correlated negatively with change in fat intake in both boys and girls. CONCLUSIONS: Teacher-implemented health packages are feasible with minimal training but programs should differ between boys and girls. Fitness programs were more successful than nutrition education particularly in girls. Clearer nutrition messages should prevent reciprocal changes in sugar and fat. For girls, the 3 mm Hg reduction of diastolic blood pressure, less obesity, and increased fitness could translate into a substantial reduction in cardiovascular risk in adult life.