Household coverage of vitamin A fortification of edible oil in Bangladesh.

Mandatory fortification of edible oil (soybean and palm) with vitamin A was decreed in Bangladesh in 2013. Yet, there is a dearth of data on the availability and consumption of vitamin A fortifiable oil at household level across population sub-groups. To fill this gap, our study used a nationally representative survey in Bangladesh to assess the purchase of fortifiable edible oil among households and project potential vitamin A intake across population sub-groups. Data is presented by strata, age range and poverty-the factors that potentially influence oil coverage. Across 1,512 households, purchase of commercially produced fortifiable edible oil was high (87.5%). Urban households were more likely to purchase fortifiable oil (94.0%) than households in rural low performing (79.7%) and rural other strata (88.1%) (p value: 0.01). Households in poverty were less likely to purchase fortifiable oil (82.1%) than households not in poverty (91.4%) (p <0.001). Projected estimates suggested that vitamin A fortified edible oil would at least partially meet daily vitamin A estimated average requirement (EAR) for the majority of the population. However, certain population sub-groups may still have vitamin A intake below the EAR and alternative strategies may be applied to address the vitamin A needs of these vulnerable sub-groups. This study concludes that a high percentage of Bangladeshi population across different sub-groups have access to fortifiable edible oil and further provides evidence to support mandatory edible oil fortification with vitamin A in Bangladesh.

A computer-based incentivized food basket choice tool: Presentation and evaluation.

OBJECTIVE: To develop and evaluate a low-cost computer-based tool to elicit dietary choices in an incentive compatible manner, which can be used on-line or as part of a laboratory study. METHODS: The study was conducted with around 255 adults. Respondents were asked to allocate a fixed monetary budget across a choice of around a hundred grocery items with the prospect of receiving these items with some probability delivered to their home by a real supermarket. The tool covers a broad range of food items, allows inference of macro-nutrients and calories, and allows the researcher to fix the choice set participants can choose from. We compare the information derived from our incentivized tool, and compare it to alternative low-cost ways of measuring dietary intake, namely the food frequency questionnaire and a one-shot version of the 24-hour dietary recall, which are both based on self-reports. We compare the calorie intake indicators derived from each tool with a number of biometric measures for each subject, namely weight, body-mass-index (BMI) and waist size. RESULTS: The results show that the dietary information collected is only weakly correlated across the three methods. We find that only the calorie intake measure from our incentivized tool is positively and significantly related to each of the biometric indicators. Specifically, a 10% increase in calorie intake is associated with a 1.5% increase in BMI. By contrast, we find no significant correlations for either of the two measures based on self-reports. CONCLUSION: The computer-based tool is a promising new, low-cost measure of dietary choices, particularly in one-shot situations where such behaviours are only observed once, whereas other tools like 24-hour dietary recalls and food frequency questionnaires may be more suited when they are administered repeatedly. The tool may be useful for research conducted with limited time and budget.

Optimising design and cost-effective implementation of future pan-African dietary studies: a review of existing economic integration and nutritional indicators for scenario-based profiling and clustering of countries.

Most of the African countries are undergoing a complex nutrition and epidemiologic transition associated with a rapid increase in the prevalence of diverse non-communicable diseases. Despite this alarming situation, the still limited and fragmented resources available in Africa impede the implementation of effective action plans to tackle the current and projected diet-disease burden. In order to address these common needs and challenges, the African Union is increasingly supporting continental approaches and strategies as reflected in the launching of the Agenda 2063 and the African regional nutrition strategy 2015-2025, among others. To assure the successful implementation of pan-African nutritional and health initiatives, cost-effective approaches considering similarities/disparities in economy, regional integration, development and nutritional aspects between countries are needed. In the absence of pre-existing models, we reviewed regional economic integration and nutritional indicators (n 13) available in international organisations databases or governmental agencies websites, for fifty-two African countries. These indicators were used to map the countries according to common languages (e.g. Arabic, English, French, Portuguese), development status (e.g. human development index), malnutrition status (e.g. obesity) and diet (e.g. staples predominantly based on either cereals or tubers). The review of the indicators showed that there exist similarities between African countries that can be exploited to benefit the continent with cross-national experiences in order to avoid duplication of efforts in the implementation of future pan-African health studies. In addition, including present and future nutrition surveillance programmes in Africa into national statistical systems might be cost-effective and sustainable in the longer term.

Quality of food choices of Brazilian adolescents according to individual earnings.

OBJECTIVE: To evaluate the quality of food choices according to adolescent individual earnings in Brazil. DESIGN: Adolescents were classified according to their individual earnings as having or not having spending power for their own expenses. Food records from two non-consecutive days of the Brazilian National Dietary Survey (NDS 2008-2009) were used to estimate food intake. Quality of food choices was based on two approaches: (i) the NOVA classification, which classifies processed and ultra-processed foods and drinks as unhealthy food groups; and (ii) traditional classification, with beans, milk, fruits and vegetables as healthy food groups, and soft drinks, sweets, snacks and crackers classified as unhealthy. We compared mean food intake (g/kJ or ml/kJ) according to per capita household income (tertiles) and adolescent individual earnings, with adolescent earnings adjusted for household income, using multiple linear regression. SETTING: Brazilian households (n 13 569). SUBJECTS: Adolescents aged 14-18 years (n 3673). RESULTS: Males without individual earnings had higher per capita household income than those with individual earnings. Household income was associated with all three food groups of the NOVA classification and seven of the eight groups of the traditional classification. However, only beans and snacks were consumed in significantly greater quantities by adolescents with individual earnings compared with those without earnings. CONCLUSIONS: Adolescent individual earnings were not the main driver of food choices; however, per capita household income was associated with food choices. The consumption of both healthy and unhealthy items increased with increasing household income.

Evolución del consumo de alimentos y del estado nutricional de la población adulta canaria entre 1964 y 2013 / Evolution of food consumption and nutritional status of the Canary adult population between 1964 and 2013

Fundamentos: Canarias ha experimentado cambios muy rápidos tanto en el consumo de alimentos como en su estado nutricional. El objetivo es conocer la evolución del consumo de los alimentos más importantes y del estado nutricional en el periodo comprendido entre los años 1964 y 2013, así como las defunciones relacionadas con la nutrición entre 1980 y 2013. Métodos: Se revisaron las Encuestas de Presupuestos Familiares para conocer el consumo de diferentes alimentos. Las fuentes para el cálculo del IMC fueron la Encuesta Nutricional de Canarias, Encuesta Nacional de Salud y las Encuestas de Salud de Canarias. Para el cálculo de los niveles de actividad física se utilizaron las preguntas sobre actividad física en el tiempo libre de las Encuestas de Salud de Canarias de los años 1997 y 2004. La fuente de información utilizada para las defunciones relacionadas con la nutrición fueron los microdatos de defunciones para Canarias solicitados al Instituto Nacional de Estadística de los años 1980 y 2013. Resultados: Se ha pasado de un gran consumo de hidratos de carbono en la década de los 60 a una disminución de los mismos y a un consumo exagerado de bebidas azucaradas no alcohólicas con un aumento progresivo de embutidos y bollería industrial donde más del 50% de la población adulta se encuentra en situación de sobrepeso y obesidad y sedentarismo. Las causas de mortalidad relacionadas con la nutrición han disminuido aunque la mortalidad por diabetes se incrementa. Conclusiones: La fuerte caída del consumo de los hidratos de carbono con un alto consumo de bebidas azucaradas y altas tasas de sedentarismo es congruente con altas tasas de obesidad y sobrepeso y la mortalidad por diabetes (AU)

Background: Canary Islands have experienced very rapid changes in both food intake and nutritional status. The objective set is to know the evolution of consumption of the most important food and nutritional status in the period 1964 and 2013. Method: Household Budget Surveys were revised to meet the consumption of different foods. The sources for BMI calculation were the Canary Nutrition Survey, National Survey of Health and Health Surveys Canary Islands. To calculate levels of physical activity questions about physical activity were used at the time of the Canary Islands Health Surveys of 1997 and 2004. The source of information used for nutrition-related deaths were the micro data Canary requested deaths for the National Institute for Statistics 1980 and 2013. Results: It has gone from a high consumption of carbohydrates in the 60s to a decrease thereof and to excessive consumption of sugary soft drinks with a progressive increase of sausages and bakery where over 50 % of the adult population is in a situation of overweight and obesity and physical inactivity. The causes of nutrition-related mortality have decreased although mortality from diabetes increases. Conclusions: The sharp drop in the consumption of carbohydrates with a high consumption of sugary and high rates of sedentary lifestyle beverages is consistent with high rates of obesity and overweight and mortality from diabetes (AU)

Custo da alimentação e densidade energética da dieta no Brasil, 2008-2009 / Cost and energy density of diet in Brazil, 2008-2009

Este estudo tem por objetivo avaliar a relação entre o custo da alimentação e a densidade energética da dieta consumida nos domicílios brasileiros. Utilizaram-se dados da Pesquisa de Orçamentos Familiares (POF-2008/2009) para identificação dos alimentos com consumo mais relevante e seus preços. Tais alimentos foram agrupados, resultando em uma cesta de 67 produtos. Empregou-se a programação linear para composição de cestas isoenergéticas, minimizando o afastamento da dieta média encontrada nos domicílios. Foram impostos limites para quantidade de inclusão dos itens e contribuição energética dos grupos de alimentos; e uma redução no custo médio da dieta foi aplicada a intervalos de R$0,15 até o menor custo possível. Identificou-se associação inversa entre densidade energética e preço da dieta (p < 0,05), e, no menor custo possível, obteve-se o valor máximo de densidade energética. Verificou-se que restrições no custo da alimentação resultaram na seleção de dietas com maior densidade energética, indicando que o custo da alimentação pode conduzir à adoção de dietas inadequadas no Brasil.

This study aimed to evaluate the relationship between the cost and energy density of diet consumed in Brazilian households. Data from the Brazilian Household Budget Survey (POF 2008/2009) were used to identify the main foods and their prices. Similar items were grouped, resulting in a basket of 67 products. Linear programming was applied for the composition of isoenergetic baskets, minimizing the deviation from the average household diet. Restrictions were imposed on the inclusion of items and the energy contribution of the various food groups. A reduction in average cost of diet was applied at intervals of R$0.15 to the lowest possible cost. We identified an inverse association between energy density and cost of diet (p < 0.05), and at the lowest possible cost we obtained the maximum value of energy density. Restrictions on the diet's cost resulted in the selection of diets with higher energy density, indicating that cost of diet may lead to the adoption of inadequate diets in Brazil.

Dietary diversity and food expenditure as indicators of food security in older Taiwanese.

Food quality is a measure of food security in vulnerable groups. The elderly are often nutritionally vulnerable, but how much of this is reflected in food quality and determined by financial status is unclear. We determined whether expenditure on dietary quality challenges food security in the aged. We used the representative Elderly Nutrition and Health Survey in Taiwan during 1999-2000 (n=1783), and evaluated dietary quality by a Dietary Diversity Score (DDS, range: 0-6) based on a 24-h dietary recall. Monthly mean national food prices were used to estimate food expenditure. In general, it was found to cost more to achieve a greater DDS. The food expenditure of subjects whose DDS=6 was 2.20 times greater than the DDS ≤3 group, after controlling for covariates. Elders of lower socioeconomic status tended to choose foods which would have cost less. However, a sub-group of elders who achieve the highest DDS with limited money offer approaches to food-money management. Nutrition policy directed to food insecure groups, like the aged, could employ health promotion strategies which reduce financial barriers to healthy eating.

[Cost and energy density of diet in Brazil, 2008-2009]. / Custo da alimentação e densidade energética da dieta no Brasil, 2008-2009.

This study aimed to evaluate the relationship between the cost and energy density of diet consumed in Brazilian households. Data from the Brazilian Household Budget Survey (POF 2008/2009) were used to identify the main foods and their prices. Similar items were grouped, resulting in a basket of 67 products. Linear programming was applied for the composition of isoenergetic baskets, minimizing the deviation from the average household diet. Restrictions were imposed on the inclusion of items and the energy contribution of the various food groups. A reduction in average cost of diet was applied at intervals of R$0.15 to the lowest possible cost. We identified an inverse association between energy density and cost of diet (p < 0.05), and at the lowest possible cost we obtained the maximum value of energy density. Restrictions on the diet's cost resulted in the selection of diets with higher energy density, indicating that cost of diet may lead to the adoption of inadequate diets in Brazil.

[Food behavior of consumers (for example, Chelyabinsk)].

Sociological poll of inhabitants of Chelyabinsk concerning a balanced diet was conducted. Every second chelyabinets needs change of the food, but thus has for this purpose no sufficient money resources. Deficiency in a food of animal protein, the majority of vitamins, macro- and microelements and saturation of a diet by carbohydrates and fats was shown. It was established that the products of mass consumption: bakery, dairy, meat,fat-and-oil products and sweets can be considered as potential products for enrichment, oriented for low-and middle-income countries primarily.

Comparison between an interactive web-based self-administered 24 h dietary record and an interview by a dietitian for large-scale epidemiological studies.

Online self-administered data collection, by reducing the logistic burden and cost, could advantageously replace classical methods based on dietitian's interviews when assessing dietary intake in large epidemiological studies. Studies comparing such new instruments with traditional methods are necessary. Our objective was to compare one NutriNet-Santé web-based self-administered 24 h dietary record with one 24 h recall carried out by a dietitian. Subjects completed the web-based record, which was followed the next day by a dietitian-conducted 24 h recall by telephone (corresponding to the same day and using the same computerised interface for data entry). The subjects were 147 volunteers aged 48-75 years (women 59·2 %). The study was conducted in February 2009 in France. Agreement was assessed by intraclass correlation coefficients (ICC) for foods and energy-adjusted Pearson's correlations for nutrients. Agreement between the two methods was high, although it may have been overestimated because the two assessments were consecutive to one another. Among consumers only, the median of ICC for foods was 0·8 in men and 0·7 in women (range 0·5-0·9). The median of energy-adjusted Pearson's correlations for nutrients was 0·8 in both sexes (range 0·6-0·9). The mean Pearson correlation was higher in subjects ≤ 60 years (P = 0·02) and in those who declared being 'experienced/expert' with computers (P = 0·0003), but no difference was observed according to educational level (P = 0·12). The mean completion time was similar between the two methods (median for both methods: 25 min). The web-based method was preferred by 66·1 % of users. Our web-based dietary assessment, permitting considerable logistic simplification and cost savings, may be highly advantageous for large population-based surveys.

Use of a web-based questionnaire in the Black Women's Health Study.

The authors assessed the utility and cost-effectiveness of using a World Wide Web-based questionnaire in a large prospective cohort study, the Black Women's Health Study (BWHS). In 1995, 59,000 African-American women were recruited into the BWHS through a paper questionnaire. Follow-up paper questionnaires have been mailed every 2 years since then. During the 2003, 2005, and 2007 questionnaire cycles, participants were given the option of completing a Web-based questionnaire. The cost of developing and processing a returned paper questionnaire was 4 times that of a returned Web questionnaire, primarily because of return postage costs and greater processing time for paper questionnaires. The proportion of respondents who completed a Web questionnaire doubled from 2003 to 2007, from 10.1% to 19.9%, but the characteristics of those completing the Web questionnaire remained the same. Web response was greatest at younger ages (20.9% of those aged <30 years) and declined with age to 3.6% among women aged 60 years or more. Web questionnaires were filled out more completely than paper questionnaires, regardless of the sensitivity of a question. The use of a Web questionnaire in the BWHS resulted in cost savings and more complete responses. Although there are advantages to using a Web questionnaire, the use of multiple means of soliciting questionnaire responses is still needed.

Cambios en el consumo aparente de nutrientes en el Gran Santiago 1988-1997 en hogares según ingreso y su probable relación con patrón de enfermedades crónicas no transmisibles / Changes in household food and nutrient consumption in Metropolitan Santiago 1988-97 by income

Background: The rise in the prevalence of obesity, diabetes, and other risk factors for cardiovascular diseases and cancer observed in Chile over the past decades may be related to changes in dietary patterns of the population. Aim: To report changes in household apparent food-nutrients consumption (HAFNC) for Metropolitan Santiago-Chile 1988-97. Material and Methods: The analysis is based on data from household expenditure surveys conducted by the Instituto Nacional de Estadísticas (INE) on a representative sample of the population to define changes in food prices. Information on food and drink purchases were grouped by specific items and expen-ditures standardized across the two surveys. HAFNC was determined based on unit consumed at home and out of home by the total group and by income quintile using national food composition tables. Results: Apparent energy consumption increased over the study period by 25 percent, this was mainly explained by increased consumption of meat and dairy (rich in saturated fats of animal origin) and of processed foods (fat spreads, sweets and pastries) and foods rich in added sugars (sugary drinks and juices). Dietary fiber derived from whole grains, legumes and cereals decreased. The HAFNC of items protective against nutrition related chronic diseases, such as vegetables, fruits and other fiber rich foods remained stable or frankly decreased (legumes and non-starchy vegetables) Fish and other marine foods rich in omega- 3 fats remained low. Conclusions: The changes in apparent food consumption patterns can be characterized by an increase in energy dense, fat and sugar rich foods with a low consumption of fi sh, whole grains, legumes, vegetables and fruits.

[Changes in household food and nutrient consumption in Metropolitan Santiago 1988-97 by income]. / Cambios en el consumo aparente de nutrientes en el Gran Santiago 1988-1997 en hogares según ingreso y su probable relación con patrón de enfermedades crónicas no transmisibles.

BACKGROUND: the rise in the prevalence of obesity, diabetes, and other risk factors for cardiovascular diseases and cancer observed in Chile over the past decades may be related to changes in dietary patterns of the population. AIM: to report changes in household apparent food-nutrients consumption (HAFNC) for Metropolitan Santiago-Chile 1988-97. MATERIAL AND METHODS: the analysis is based on data from household expenditure surveys conducted by the Instituto Nacional de Estadísticas (INE) on a representative sample of the population to define changes in food prices. Information on food and drink purchases were grouped by specific items and expen-ditures standardized across the two surveys. HAFNC was determined based on unit consumed at home and out of home by the total group and by income quintile using national food composition tables. RESULTS: apparent energy consumption increased over the study period by 25%, this was mainly explained by increased consumption of meat and dairy (rich in saturated fats of animal origin) and of processed foods (fat spreads, sweets and pastries) and foods rich in added sugars (sugary drinks and juices). Dietary fiber derived from whole grains, legumes and cereals decreased. The HAFNC of items protective against nutrition related chronic diseases, such as vegetables, fruits and other fiber rich foods remained stable or frankly decreased (legumes and non-starchy vegetables) Fish and other marine foods rich in omega- 3 fats remained low. CONCLUSIONS: the changes in apparent food consumption patterns can be characterized by an increase in energy dense, fat and sugar rich foods with a low consumption of fi sh, whole grains, legumes, vegetables and fruits.