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1.
BACKGROUND: In areas where vitamin A deficiency (VAD) is prevalent, vitamin A repletion reduces child mortality by 23% on average. OBJECTIVES: To estimate the potential child survival benefits of policies and programmes aimed at controlling VAD in Mozambique, and to make policy and programme recommendations. METHODS: The potential contribution of VAD to child mortality in Mozambique was estimated by combining the observed VAD prevalence in the under-5s (71.2%), the measured child mortality effects of VAD (risk of death in children with VAD=1.75 times higher than in children without VAD) and the observed under-5 mortality rate in the country (210 per 1000 live births). RESULTS: In Mozambique, an estimated 2.3 million children below the age of 5 years are vitamin-A-deficient. In the absence of appropriate policy and programme action, VAD will be the attributable cause of over 30,000 deaths annually in the under-5s. This represents 34.8% of all-cause mortality in this age group. DISCUSSION: Vitamin A supplementation (VAS) has been adopted as a short- to medium-term strategy to control VAD in children, and is integrated into routine child health services. However, the last VAS coverage survey showed that only 46% of children received a vitamin A supplement in the 6 months preceding the survey. If VAS coverage is to increase significantly in the foreseeable future, four areas appear to be of paramount importance: (1) reduce missed opportunities for VAS such as visits of sick children to child health services and community outreach activities; (2) take advantage of all potential opportunities for accelerating VAS coverage, such as additional vaccination campaigns and emergency response activities; (3) strengthen health workers' training, supervision and monitoring skills; and (4) increase community demand for VAS of children. Biannual VAS, as the primary component of an integrated strategy for VAD control in children, has the promise to be among the most cost-effective/high-impact child survival interventions in Mozambique.  相似文献   

2.
OBJECTIVE: To define the prevalence of overweight and obesity among school-aged children resident in mountain areas, rural areas and urban areas.Design, setting and subjectsThe sample (n = 12 832; 50.7% boys) included 9- and 11-year-old children of the Veneto Region of north-east Italy. Overweight and obesity status were determined using the International Obesity Task Force cut-off points for body mass index. The prevalence of overweight and obese subjects was calculated with a confidence interval of 95%. The Mantel-Haenszel method was used to compare the combined prevalence of overweight and obesity among children resident in mountain areas, rural areas and urban areas. RESULTS: Among boys the prevalence of overweight was 21.06%, while obesity prevalence was 5.92%; among girls overweight prevalence was 21.30%, while obesity prevalence was 5.15%. The prevalence was higher among 11-year-old boys (odds ratio (OR) = 1.19; 95% confidence interval (CI): 1.06-1.33) and 9-year-old girls (OR = 1.13; 95% CI: 1.01-1.26). Children resident in rural areas presented a higher risk of overweight and obesity compared with children resident in mountain areas (Mantel-Haenszel OR = 1.27; 95% CI: 1.13-1.42; chi2 = 17.55; P < 0.0001) and in urban areas (Mantel-Haenszel OR = 1.18; 95% CI: 1.07-1.31; chi2 = 10.39; P < 0.001). CONCLUSIONS: A relevant prevalence of overweight and obesity was found; the excess weight concerns one child in four. There are differences linked to different geographical areas that must be further investigated.  相似文献   

3.
OBJECTIVES: To determine missed opportunities and problems relating to implementation of the Vitamin A Supplementation Programme in urban and rural regions of the Western Cape Province of South Africa.MethodA cross-sectional survey was conducted at primary health-care (PHC) clinics in Cape Metropole, an urban region, and West Coast Winelands, a rural region, of the Western Cape. A purposive sample of clinics where more than 30 children were seen per day was drawn from 10 of the 11 districts in the Cape Metropole region and the two districts of the West Coast Winelands region. The number of children selected from each district was weighted in terms of population size for the two regions. At each clinic visited, the first five to 10 children seen on a day, and meeting the inclusion criteria for vitamin A supplementation (VAS) based on the vitamin A provincial policy guidelines, were selected. These included children with low birth weight (LBW), growth faltering, underweight and severe undernutrition, recurrent diarrhoea and lower respiratory tract infection (LRTI), tuberculosis, measles, HIV/AIDS and eye signs of vitamin A deficiency. Clinic records were reviewed following consultation with the PHC nurse to identify if the child required vitamin A, exit interviews were conducted with mothers/caregivers, and Road to Health Charts (RTHCs) were reviewed. At the end of the study, PHC managers were interviewed to determine if problems could be identified with the Programme. RESULTS: Forty-three of 123 (35%) and 13 of 40 (33%) of the fixed PHC clinics in the Cape Metropole and West Coast Winelands regions were visited, and a total of 300 children (234 from Cape Metropole, 66 from West Coast Winelands) with a mean (standard deviation) age of 24.3 (16.3) months and who met the inclusion criteria for VAS were selected. Of the total sample of children, 198 (66%) had multiple (i.e. more than one) indication and 102 (34%) had a single indication for VAS. There were a total of 617 indications for VAS in the two regions; 238 (39%) for growth faltering, 119 (19%) for underweight, 98 (16%) for LBW, 70 (11%) for LRTI, 51 (8%) for diarrhoea, 21 (3%) for HIV/AIDS and 20 (3%) for tuberculosis. A total of 102 (34%) of the children in the two regions received vitamin A supplements (Cape Metropole 29%; West Coast Winelands 52%). A record was made on the RTHC of 79 (77%) of the children who received VAS (Cape Metropole 76%; West Coast Winelands 79%). Twenty-four per cent of the mothers knew why their child had been given vitamin A (Cape Metropole 29%; West Coast Winelands 12%). Eleven per cent of the mothers had previously heard about the Vitamin A Supplementation Programme (Cape Metropole 12%; West Coast Winelands 6%). More than 81% of PHC managers indicated that health staff had been trained to implement the Vitamin A Supplementation Programme. The main problems identified by health staff in the two regions were lack of vitamin A capsules, inadequate training and difficulties in implementing the Programme. CONCLUSIONS: Opportunities to administer vitamin A were underutilised in both regions. Recommendations such as improving mothers' awareness of the benefits of vitamin A and training of PHC nurses were made to the provincial Department of Health and are being implemented to improve the effectiveness of the Programme.  相似文献   

4.
OBJECTIVE: Investigate the relationship between body mass index (BMI) and intake of sugars and fat in New Zealand adults and children. DESIGN: Secondary analyses of National Nutrition Survey (1997) and Children's Nutrition Survey (2002) data for the New Zealand population. BMI calculated from height and weight; fat, sugars and sucrose (used as a surrogate for added sugars) intakes estimated from 24-hour diet recall. Ethnic-specific analyses of children's data. Relationships (using linear regression) between BMI and sugars/sucrose intakes; per cent total energy from fat; mean total energy intake from sucrose. Subjects classified into diet-type groups by levels of intake of fat and sucrose; relative proportions of overweight/obese children in each group compared with that of normal weight subjects using design-adjusted chi2 tests. SETTING: New Zealand homes and schools. SUBJECTS: 4379 adults (15+ years); 3049 children (5-14 years). RESULTS: Sugars (but not sucrose) intake was significantly lower among obese compared to normal weight children. In adults and children, those with the lowest intake of sugars from foods were significantly more likely to be overweight/obese. Sucrose came predominantly from beverages; in children, 45% of this was from powdered drinks. Sucrose intake from sugary beverages was not related to BMI. Per cent total energy (%E) from sucrose was significantly inversely related to %E from fat among adults and children. Proportions of overweight/obese adults or children in each diet-type group did not differ from that of normal weight individuals. CONCLUSIONS: Current sugars or sucrose intake is not associated with body weight status in the New Zealand population.  相似文献   

5.
OBJECTIVE: To determine vitamin A (retinol) and fat concentrations in breast milk during early lactation. METHODS: Healthy lactating women (n 88) aged between 18 and 35 years were randomly selected for the study from urban, semi-urban, rural and estate (plantation) sectors of Galle District. Their anthropometry was recorded; breast milk samples were collected from the right breast one hour after the last feed. Breast milk retinol was determined by HPLC and fat content by the crematocrit method. RESULTS: Subjects were in the 2nd to 9th month of lactation. Retinol concentrations of the breast milk samples ranged from 0.10 to 2.46 micromol/l, with a mean of 0.50 micromol/l, and correlated positively with parity (Pearson correlation coefficient, r = 0.307; P = 0.01) and negatively with period of lactation (r = -0.209; P = 0.05). The fat content of breast milk ranged between 5.09 and 56.46 g/l with a mean of 26.95 g/l. A significant difference in either breast milk fat or retinol content and mean birth weight of the babies was not seen between the groups. The ratio of retinol to fat in breast milk was positively correlated with weight (r = 0.274; P = 0.01) and height (r = 0.328; P < 0.001) of the mothers. CONCLUSIONS: In this primary investigation on breast milk quality the fat content was found to be marginal; the majority of lactating mothers (92.0%) were not providing the minimum daily requirement (1.05 micromol/l) of retinol to their babies.  相似文献   

6.
OBJECTIVE: To report on the fruit, vegetable and salad intakes of Liverpool schoolchildren aged 9-10 years over a 5-year period (2000-2005). DESIGN: Cross-sectional observational study. SETTING: Between 75 and 100 Liverpool primary schools took part in each survey year. SUBJECTS: Subjects consisted of five separate cohorts of 9-10-year-old children from all areas of the city. MAIN OUTCOME MEASURES: Number and proportion of boys and girls who reported eating fruit, vegetables and salad on the previous day. RESULTS: There was an upward trend in the reported intake of fruit between 2002 and 2005. Girls were more likely than boys to report eating fruit (P < 0.001). The trend in salad intake was positive. Between 2000 and 2005 there were significant increases in the number of boys (chi2 = 17.57, P = 0.001) and girls (chi2 = 80.56, P = 0.001) eating salad. Girls were significantly more likely to eat salad than boys in all years (chi2 = 58.75, P = 0.001). Trends in vegetable intake were similar to those for salad, with both sexes reporting yearly increases over the 5-year period. The increase in the number of boys who reported eating vegetables between 2000 and 2005 was 23.5% (chi2 = 32.9, P = 0.000). In girls there was a 44.8% increase over the same period (chi2 = 110.3, P < 0.000). CONCLUSIONS: The data reveal positive trends in the fruit, vegetable and salad intakes of Liverpool schoolchildren between 2000 and 2005. Further research is needed to elucidate the specific factors that have enabled the changes to take place.  相似文献   

7.
OBJECTIVE: To compare serum lipids and their changes during a family-based health education in children aged 6-17 years with or without the epsilon4 allele of the gene encoding apolipoprotein E (apoE). DESIGN: An intervention study. SETTING: A family-based prevention of risk factors of coronary heart disease in Eastern Finland. The programme consisted of two counselling meetings at children's schools and three at children's homes. SUBJECTS: Four hundred and thirty-nine children with a family history of cardiovascular diseases (CVD) participated in a family-based health education. The children were divided into two groups according to apoE genotype. The risk group consisted of 143 children having apoE epsilon4 allele (genotype epsilon3/4 or epsilon4/4) and the non-risk group of 296 children without apoE epsilon4 allele (epsilon2/3 or epsilon3/3). The final sample of the follow-up study included 354 (81%) children (114 and 240, respectively). RESULTS: Baseline differences were found in low-density lipoprotein cholesterol (LDL-C) (P=0.007) and LDL-C/high-density lipoprotein cholesterol (HDL-C) ratio (P=0.030) among boys and in total cholesterol (TC)/HDL-C (P=0.008) and LDL-C/HDL-C ratios (P=0.006) among girls. Differences between groups in changes during the follow-up were observed only for TC/HDL-C ratio (P-value adjusted for age=0.049) among boys. CONCLUSIONS: At baseline, children with apoE epsilon4 allele had on average a more unfavourable lipid profile than those without apoE epsilon4 allele. However, the effect of about 33 months' family-based health education on plasma lipids did not depend on apoE genotype in children with a family history of CVD.  相似文献   

8.
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9.
OBJECTIVE: To assess changes in the Fe and vitamin A status of the population of Nangweshi refugee camp associated with the introduction of maize meal fortification. DESIGN: Pre- and post-intervention study using a longitudinal cohort. SETTING: Nangweshi refugee camp, Zambia. SUBJECTS: Two hundred and twelve adolescents (10-19 years), 157 children (6-59 months) and 118 women (20-49 years) were selected at random by household survey in July 2003 and followed up after 12 months. RESULTS: Maize grain was milled and fortified in two custom-designed mills installed at a central location in the camp and a daily ration of 400 g per person was distributed twice monthly to households as part of the routine food aid ration. During the intervention period mean Hb increased in children (0.87 g/dl; P < 0.001) and adolescents (0.24 g/dl; P = 0.043) but did not increase in women. Anaemia decreased in children by 23.4% (P < 0.001) but there was no significant change in adolescents or women. Serum transferrin receptor (log10-transformed) decreased by -0.082 microg/ml (P = 0.036) indicating an improvement in the Fe status of adolescents but there was no significant decrease in the prevalence of deficiency (-8.5%; P = 0.079). In adolescents, serum retinol increased by 0.16 micromol/l (P < 0.001) and vitamin A deficiency decreased by 26.1% (P < 0.001). CONCLUSIONS: The introduction of fortified maize meal led to a decrease in anaemia in children and a decrease in vitamin A deficiency in adolescents. Centralised, camp-level milling and fortification of maize meal is a feasible and pertinent intervention in food aid operations.  相似文献   

10.
OBJECTIVE: To evaluate the effectiveness of a vitamin-fortified maize meal to improve the nutritional status of 1-3-year-old malnourished African children. DESIGN: A randomised parallel intervention study was used in which 21 experimental children and their families received maize meal fortified with vitamin A, thiamine, riboflavin and pyridoxine, while 23 control children and their families received unfortified maize meal. The maize meal was provided for 12 months to replace the maize meal habitually consumed by these households. METHODS: Sixty undernourished African children with height-for-age or weight-for-age below the 5th percentile of the National Center for Health Statistics' criteria and aged 1-3 years were randomly assigned to an experimental or control group. Baseline measurements included demographic, socio-economic and dietary data, as well as height, weight, haemoglobin, haematocrit, serum retinol and retinol-binding protein (RBP). Anthropometric, blood and serum variables were measured again after 12 months of intervention. Complete baseline measurements were available for 44 children and end data for only 36. Changes in these variables from baseline to end within and between groups were assessed for significance with paired t-tests, t-tests and analysis of variances using the SPSS program, controlling for expected weight gain in this age group over 12 months. Relationships between changes in variables were examined by calculating correlation coefficients. RESULTS: The children in the experimental group had a significantly (P < or = 0.05) higher increase in body weight than control children (4.6 kg vs. 2.0 kg) and both groups had significant (P < or = 0.05) but similar increases in height. The children in the experimental group showed non-significant increases in haemoglobin and serum retinol, while the control children had a significant (P = 0.007) decrease in RBP. The change in serum retinol showed a significant correlation with baseline retinol (P = 0.014), RBP (P = 0.007) and weight (P = 0.029), as well as with changes in haemoglobin (P = 0.029). CONCLUSION: Despite a small sample size, this study showed positive effects of a vitamin-fortified maize meal on weight gain and some variables of vitamin A status in 1-3-year-old African children. The study confirmed the relationship between vitamin A and iron status. The results suggest that fortification of maize meal would be an effective strategy to address micronutrient deficiencies in small children in South Africa.  相似文献   

11.
OBJECTIVE: To investigate the effect of television food advertising on children's food intake, specifically whether childhood obesity is related to a greater susceptibility to food promotion. DESIGN: The study was a within-subject, counterbalanced design. The children were tested on two occasions separated by two weeks. One condition involved the children viewing food advertisements followed by a cartoon, in the other condition the children viewed non-food adverts followed by the same cartoon. Following the cartoon, their food intake and choice was assessed in a standard paradigm. SETTING: The study was conducted in Liverpool, UK. SUBJECTS: Fifty-nine children (32 male, 27 female) aged 9-11 years were recruited from a UK school to participate in the study. Thirty-three children were normal-weight (NW), 15 overweight (OW) and 11 obese (OB). RESULTS: Exposure to food adverts produced substantial and significant increases in energy intake in all children (P < 0.001). The increase in intake was largest in the obese children (P = 0.04). All children increased their consumption of high-fat and/or sweet energy-dense snacks in response to the adverts (P < 0.001). In the food advert condition, total intake and the intake of these specific snack items correlated with the children's modified age- and gender-specific body mass index score. CONCLUSIONS: These data suggest that obese and overweight children are indeed more responsive to food promotion, which specifically stimulates the intake of energy-dense snacks.  相似文献   

12.
OBJECTIVES: To investigate the prevalence of anaemia and iron deficiency and vitamin A status among school-aged children in rural Kazakhstan and identify factors associated with anaemia in this population. DESIGN: A cross-sectional design. SETTING: School-aged children in rural Kazakhstan. SUBJECTS: Socio-economic and anthropometric information was collected from 159 school-aged children living in the Kzyl-Orda region of Kazakhstan. Blood samples were collected and the concentrations of haemoglobin (Hb), serum iron, serum ferritin (SF), erythrocyte protoporphyrin (EP), serum retinol and beta-carotene, total iron binding capacity (TIBC), transferrin saturation (TS) and other haematological indices were measured. RESULTS: Among the 159 children, the prevalence of anaemia and iron deficiency defined by the multiple criteria model (SF, TS and EP) was 27% and 13%, respectively. Nine per cent had iron-deficiency anaemia and 21% had serum retinol value < 1.05 micromol l(-1). Mean SF and serum iron concentrations and TS were significantly lower in anaemic children than in their non-anaemic peers, while TIBC and EP were significantly higher in children with anaemia. Hb was significantly correlated with serum iron and retinol concentrations. Serum retinol and SF concentrations and mean corpuscular volume were significantly correlated with Hb by multiple regression analysis. CONCLUSIONS: Anaemia among school-aged children in rural Kazakhstan appears to be related to iron indices and vitamin A status.  相似文献   

13.
OBJECTIVE: To assess the effectiveness of a behaviour change approach, with or without financial support, in improving vitamin A (VA) intake and serum retinol concentration through mango and liver consumption by children. DESIGN: A parallel design (no control area) was used to assess changes in VA intake and serum retinol over a 15-week period. SETTING AND SUBJECTS: A pilot study was implemented in the Department of Kokologho, a rural area in central west Burkina Faso. One hundred and fifty children aged 2-3 years were randomly selected and assigned to two treatment groups: PA$$ (promotional activities and financial support) and PA (promotional activities). RESULTS: The intervention significantly increased (P < 0.001) total VA intake by 56% in PA$$ and by 50% in PA. VA intake from liver increased significantly (P < 0.001) from 12.7 +/- 23.5 to 155.3 +/- 56.3 microg retinol activity equivalents (RAE) in PA$$ and from 21.6 +/- 29.7 to 135.3 +/- 44.9 microg RAE in PA. Changes in VA intake from liver were significantly higher (P = 0.004) in PA$$ compared with PA. Mean serum retinol concentration increased significantly by 26% (P < 0.001) in PA$$ and 30% (P < 0.001) in PA. Changes in serum retinol concentration (0.13 micromol l(-1) in PA$$ vs. 0.17 micromol l(-1) and in PA) did not differ significantly (P = 0.455) between groups over the intervention. CONCLUSION: Promotional activities on mango and liver intake effectively increased VA intake and serum retinol concentrations. Although an additional beneficial effect of financial support on liver intake was observed, this did not translate into a further increase in serum retinol concentration.  相似文献   

14.
OBJECTIVE: To investigate the prevalence of obesity in affluent schoolchildren of Delhi. DESIGN: This was a cross-sectional study covering over 4000 students. Anthropometric measurements and birth weights of all the students were recorded. SETTING AND SUBJECTS: The study was carried out in a school catering to the affluent section of Indian society and included both boys and girls in the age range 4 to 17 years. RESULTS: The heights and weights of the children were almost similar to those of the National Center for Health Statistics standards, and were much above the values reported by the Indian National Nutrition Monitoring Bureau, which largely captures rural children belonging to lower socio-economic strata in India. Of the subjects studied, 22% were overweight and 6% were obese. Only 6% of these children had low birth weight. CONCLUSION: The prevalence of obesity is rising among children because of their change in lifestyle. Children born with a birth weight of > or = 3 kg tended to have higher body mass index in their adolescent years and maybe consequently in their adult years. Nutrition education can play an important part in reducing the incidence of overweight/obesity and its associated complications.  相似文献   

15.
OBJECTIVE: To assess iodine status and its determinants in women of childbearing age in a rural area in the Kayes region, Mali, West Africa. DESIGN: Cross-sectional study where women's iodine status was indicated by urinary iodine concentration (UIC) and level of goitre based on palpation. Salt iodine was assessed semi-quantitatively at household level. Individual characteristics were collected using questionnaires. SETTING: Fifteen villages in a rural area in the Kayes region of Mali. SUBJECTS: Women aged 15-45 years (n=423). RESULTS: Median UIC was 2.7 microg dl(-1), and only 6% of the women had adequate iodine status of UIC >10 microg dl(-1). Most women (60%) had visible goitre, and only 9% were classified as without goitre. Only 39% of the households were using salt with any iodine, and level of knowledge about salt iodisation was low. Main determinants of UIC were breast-feeding and level of salt iodisation; currently breast-feeding women had lower UIC, and UIC increased with increasing level of iodine in household salt. Prevalence of goitre was lower in older women with higher body mass index. CONCLUSION: The study indicates severe iodine deficiency in the study area. Urgent action is needed to improve the situation through enforcing salt iodisation legislation and increasing the level of knowledge about the importance of iodised salt in the population.  相似文献   

16.
OBJECTIVE: To evaluate the effects of a comprehensive physical activity (PA) promotion programme in elementary schools on children's total PA levels, leisure-time PA, physical fitness and psychosocial correlates of PA. DESIGN: A pre-test-post-test design over two school years. SETTING AND SUBJECTS: Sixteen elementary schools (764 children, mean age: 11.2 +/- 0.7 years) were randomly assigned to the intervention condition (n = 8) and the control condition (n = 8). The intervention included a health-related physical education programme, an extracurricular PA promotion programme and classroom-based PA education lessons. In the total sample, leisure-time PA, psychosocial correlates of PA and physical fitness were measured using a PA questionnaire and the Eurofit test battery. In a sub-sample, total PA levels were measured using an accelerometer. RESULTS: According to accelerometer data, children's moderate PA and moderate-to-vigorous PA (MVPA) levels decreased less in the intervention schools than in the control schools (P < 0.01). The average time spent on MVPA decreased by 9 min per day in the intervention schools compared with 33 min per day in the control schools. Children in the intervention schools reported significantly more moderate PA in leisure time than the controls (P < 0.05). No overall improvement of physical fitness and no effects on the psychosocial correlates of PA were found. CONCLUSIONS: The comprehensive PA promotion programme was successful in preventing a decline in children's total activity levels. Furthermore, the intervention increased children's PA engagement in leisure time. Therefore, implementation needs to be encouraged.  相似文献   

17.
OBJECTIVE: To study individual determinants of differential benefit from the Senegal Community Nutrition Project (CNP) by monitoring improvement in children's weight-for-age index (WA) or underweight status (WA < -2 Z-scores) during participation. DESIGN: A follow-up study using the CNP child monitoring data. Linear general models compared variations in WA according to 14 factors describing the beneficiaries and CNP services. SETTING: Poor neighbourhoods of Diourbel, a large city in Senegal, West Africa. Over a 6-month period, the CNP provided underweight or nutritionally at-risk 6-35-month-old children with monthly growth monitoring and promotion and weekly food supplementation, provided that mothers attended weekly nutrition education sessions. SUBJECTS: All the children who participated in the first two years of the project (n=4084). RESULTS: Mean WA varied from -2.13 (standard deviation (SD) 0.82) to -1.58 (SD 0.81) Z-scores between recruitment and the end of the follow-up. The lower the child's initial WA, the greater was their increase in WA but the lower was the probability of recovery from underweight. Only 61% of underweight children recovered. Six months of CNP services may not be sufficient for catch-up growth of severely underweight children. The number of food supplement rations received was not a direct indicator of the probability of recovery. After adjustment for services received and initial WA, probability of recovery was lower in girls, in younger children, in twins and when mothers belonged to a specific ethnic group. CONCLUSIONS: Determinants of benefit from CNP differed from the risk factors for underweight. Identification of participants with a lower probability of recovery can help improve outcome. Moreover, an explanation for the lack of recovery could be that many underweight children are stunted but not necessarily wasted.  相似文献   

18.
OBJECTIVES: To explore how time spent watching television (TV) is associated with the dietary behaviours of New Zealand children and young adolescents. DESIGN: Secondary data analysis of a nationally representative, cross-sectional survey. SETTING: In homes or schools of New Zealand school students. PARTICIPANTS: In total, 3275 children aged 5 to 14 years. RESULTS: The odds of being overweight or obese increased with duration of TV viewing for children and adolescents when controlling for age, sex, ethnicity, socio-economic status and physical activity. Children and adolescents who watched the most TV were significantly more likely to be higher consumers of foods most commonly advertised on TV: soft drinks and fruit drinks, some sweets and snacks, and some fast foods. Both children and adolescents watching two or more hours of TV a day were more than twice as likely to drink soft drinks five times a week or more (P = 0.03 and P = 0.04, respectively), eat hamburgers at least once a week (both P = 0.02), and eat French fries at least once a week (both P < 0.01). CONCLUSIONS: These findings suggest that longer duration of TV watching (thus, more frequent exposure to advertising) influences the frequency of consumption of soft drinks, some sweets and snacks, and some fast foods among children and young adolescents. Efforts to curtail the amount of time children spend watching TV may result in better dietary habits and weight control for children and adolescents. Future studies examining the impact of advertising on children's diets through interventions and international comparisons of legislation would provide more definitive evidence of the role of advertising in child and adolescent obesity.  相似文献   

19.
BACKGROUND: A national survey found that micronutrient deficiencies are prevalent in South African children, particularly calcium, iron, zinc, riboflavin, niacin, vitamin B6, folate, vitamin A, E and C. Mandatory fortification of maize meal and wheat flour were introduced in 2003 to combat some of the deficiencies found in children. To date however, there has not been a national survey on dietary intake in adults. OBJECTIVES: The main objectives of this study were to evaluate the micronutrient intake of the diet consumed by the average adult South African by means of secondary data analyses and secondly to evaluate the effects of fortification on selected nutrient intakes. STUDY DESIGN: Secondary data analysis was carried out with numerous dietary surveys on adults to create a database that included sampling (and weighting) according to ethnic/urban-rural residence in line with the population census, of which 79% were black Africans and the majority resided in rural areas. The effect of fortification was evaluated by substituting fortified foods in the diet for the unfortified products. SUBJECTS: The combined database used in this study comprised 3229 adults. RESULTS: Mean calcium, iron, folate and vitamin B6 intakes were very low particularly in women. Mean intakes of most micronutrients were lower in rural areas. Fortification of maize meal and wheat flour (bread) raised mean levels of thiamine, riboflavin, niacin, vitamin B6 and folate above the recommended nutrient intakes (RNIs). In women, despite fortification, mean iron intakes remained below the RNIs, as did calcium since it was not in the fortification mix. CONCLUSION: The average dietary intake of adults was of poor nutrient density, particularly in rural areas. Fortification of maize meal and wheat flour (bread) considerably improved mean vitamin B6, thiamine, riboflavin, niacin, folate and iron intakes as well as the overall mean adequacy ratio of the diet.  相似文献   

20.
OBJECTIVE: To determine the nutrient composition of complementary foods consumed by 6-12-month-old South African infants. DESIGN: Nutrient intake was determined for infants who were recruited to participate in a randomised controlled trial using a single 24-hour dietary recall. SETTING/SUBJECTS: Infants aged 6-12 months (n=475) residing in The Valley of a Thousand Hills, a rural area in KwaZulu-Natal, South Africa. RESULTS: Energy and protein intakes from complementary foods were adequate. Infants who consumed infant products (commercially available fortified infant cereals/ready-to-eat canned baby foods/formula milk powder) had significantly higher intakes of calcium, iron, zinc, vitamin A, thiamine, riboflavin, niacin, vitamin B6, vitamin B12 and vitamin C than infants who did not consume any infant products. For infants who consumed infant cereals (n=142), these cereals provided 51% of total iron intake. Infant cereals provided more than 25% of total intake for magnesium, thiamine, niacin and vitamin B12. For infants consuming ready-to-eat canned baby foods (n=77), these products contributed less than 15% of total intake for all the micronutrients. The nutrient density of the complementary diet was less than half the desired density for calcium, iron and zinc. Animal products were consumed by 17% of infants, 26% consumed dairy products and 18% consumed vitamin-A-rich fruit and vegetables during the 24-hour recall period. CONCLUSION: The nutrient composition of complementary foods among rural South African infants was inadequate, especially for iron, zinc and calcium. Strategies should be developed to improve the nutritional quality of their diets.  相似文献   

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