Adolescence is a critical period for development of depression and understanding of behavioural risk factors is needed to support appropriate preventive strategies. We examined associations between adolescent diet quality and depressive symptoms, cross-sectionally and prospectively, in a large community cohort, adjusting for behavioural and psychosocial covariates.

Prospective community-based cohort study (ROOTS).

Secondary schools in Cambridgeshire and Suffolk, UK.

Study participants (n 603) who completed 4 d diet diaries at age 14 years and reported depressive symptoms (Moods and Feelings Questionnaire (MFQ)) at 14 and 17 years of age.

Diet data were processed to derive a Mediterranean diet score (MDS) and daily servings of fruit and vegetables, and fish. At age 14 years, a negative association between fruit and vegetable intake and MFQ score was seen in the unadjusted cross-sectional regression model (β=−0·40; 95 % CI −0·71,−0·10), but adjustment for behavioural covariates, including smoking and alcohol consumption, attenuated this association. Fish intake and MDS were not cross-sectionally associated with MFQ score. No prospective associations were found between MDS, fruit and vegetable intake or fish intake and later MFQ score.

Diet quality was not associated with depressive symptoms in mid-adolescence. Previously reported associations in this age range may be due to confounding. Further longitudinal studies are needed that investigate associations between adolescent diet and depression across different time frames and populations, ensuring appropriate adjustment for covariates.

To assess the quality of nutrition content and the integration of user quality components and behaviour change theory relevant to food purchasing behaviour in a sample of existing mobile apps.

Descriptive comparative analysis of eleven mobile apps comprising an assessment of their alignment with existing evidence on nutrition, behaviour change and user quality, and their potential ability to support healthier food purchasing behaviour.

Mobile apps freely available for public use in GoogePlay were assessed and scored according to agreed criteria to assess nutrition content quality and integration of behaviour change theory and user quality components.

A sample of eleven mobile apps that met predefined inclusion criteria to ensure relevance and good quality.

The quality of the nutrition content varied. Improvements to the accuracy and appropriateness of nutrition content are needed to ensure mobile apps support a healthy behaviour change process and are accessible to a wider population. There appears to be a narrow focus towards behaviour change with an overemphasis on behavioural outcomes and a small number of behaviour change techniques, which may limit effectiveness. A significant effort from the user was required to use the mobile apps appropriately which may negatively influence user acceptability and subsequent utilisation.

Existing mobile apps may offer a potentially effective approach to supporting healthier food purchasing behaviour but improvements in mobile app design are required to maximise their potential effectiveness. Engagement of mobile app users and nutrition professionals is recommended to support effective design.

To evaluate the sociodemographic and lifestyle factors associated with insufficient and excessive use of folic acid supplements (FAS) among pregnant women.

A pregnancy cohort to which multinomial logistic regression models were applied to identify factors associated with duration and dose of FAS use.

The Growing Up in New Zealand child study, which enrolled pregnant women whose children were born in 2009–2010.

Pregnant women (n 6822) enrolled into a nationally generalizable cohort.

Ninety-two per cent of pregnant women were not taking FAS according to the national recommendation (4 weeks before until 12 weeks after conception), with 69 % taking insufficient FAS and 57 % extending FAS use past 13 weeks’ gestation. The factors associated with extended use differed from those associated with insufficient use. Consistent with published literature, the relative risks of insufficient use were increased for younger women, those with less education, of non-European ethnicities, unemployed, who smoked cigarettes, whose pregnancy was unplanned or who had older children, or were living in more deprived households. In contrast, the relative risks of extended use were increased for women of higher socio-economic status or for whom this was their first pregnancy and decreased for women of Pacific v. European ethnicity.

In New Zealand, current use of FAS during pregnancy potentially exposes pregnant women and their unborn children to too little or too much folic acid. Further policy development is necessary to reduce current socio-economic inequities in the use of FAS.

To compare the performance of the commonly used 24 h recall (24hR) with the more distinct duplicate portion (DP) as reference method for validation of fatty acid intake estimated with an FFQ.

Intakes of SFA, MUFA, n-3 fatty acids and linoleic acid (LA) were estimated by chemical analysis of two DP and by on average five 24hR and two FFQ. Plasma n-3 fatty acids and LA were used to objectively compare ranking of individuals based on DP and 24hR. Multivariate measurement error models were used to estimate validity coefficients and attenuation factors for the FFQ with the DP and 24hR as reference methods.

Wageningen, the Netherlands.

Ninety-two men and 106 women (aged 20–70 years).

Validity coefficients for the fatty acid estimates by the FFQ tended to be lower when using the DP as reference method compared with the 24hR. Attenuation factors for the FFQ tended to be slightly higher based on the DP than those based on the 24hR as reference method. Furthermore, when using plasma fatty acids as reference, the DP showed comparable to slightly better ranking of participants according to their intake of n-3 fatty acids (0·33) and n-3:LA (0·34) than the 24hR (0·22 and 0·24, respectively).

The 24hR gives only slightly different results compared with the distinctive but less feasible DP, therefore use of the 24hR seems appropriate as the reference method for FFQ validation of fatty acid intake.

To test the hypothesis that more frequent consumption of sugar-sweetened soft drinks would be associated with increased risk of obesity-related cancers. Associations for artificially sweetened soft drinks were assessed for comparison.

Prospective cohort study with cancers identified by linkage to cancer registries. At baseline, participants completed a 121-item FFQ including separate questions about the number of times in the past year they had consumed sugar-sweetened or artificially sweetened soft drinks. Anthropometric measurements, including waist circumference, were taken and questions about smoking, leisure-time physical activity and intake of alcoholic beverages were completed.

The Melbourne Collaborative Cohort Study (MCCS) is a prospective cohort study which recruited 41 514 men and women aged 40–69 years between 1990 and 1994. A second wave of data collection occurred in 2003–2007.

Data for 35 593 participants who developed 3283 incident obesity-related cancers were included in the main analysis.

Increasing frequency of consumption of both sugar-sweetened and artificially sweetened soft drinks was associated with greater waist circumference at baseline. For sugar-sweetened soft drinks, the hazard ratio (HR) for obesity-related cancers increased as frequency of consumption increased (HR for consumption >1/d v. <1/month=1·18; 95 % CI 0·97, 1·45; P-trend=0·007). For artificially sweetened soft drinks, the HR for obesity-related cancers was not associated with consumption (HR for consumption >1/d v. <1/month=1·00; 95 % CI 0·79, 1·27; P-trend=0·61).

Our results add to the justification to minimise intake of sugar-sweetened soft drinks.

The present study aimed to assess the: (i) internal structure of the Spanish Child Food Security Survey Module (CFSSM-S) with exploratory and confirmatory factor analysis (EFA and CFA); (ii) measurement invariance by gender, grade, weight status, socio-economic status (SES) and family affluence; and (iii) relationships with these external variables.

A cross-sectional study was conducted. The CFSSM-S and other tools were employed to assess food insecurity, weight status, SES and family affluence, respectively.

A secondary school (grades 7–10) in the city of Terrassa in Catalonia, Spain.

Participants included adolescent boys and girls (n 426) aged 12–17 years.

The cross-validation design with EFA and CFA captured a single factor, ‘food insecurity’. The goodness-of-fit for the one-factor model with CFA (root-mean-square error of approximation=0·038, comparative fit index=0·984, Tucker–Lewis index=0·979) and internal consistency (ω=0·95) were excellent. The measurement invariance indicated that CFSSM-S could be used across genders, grades, weight status, SES and family affluence. Only mean differences for SES and family affluence were found which showed a linear trend, indicating higher CFSSM-S scores for participants with lower SES and family affluence. Of participants, 1·9 % experienced very low food security, 16·4 % low food security and 81·7 % were food secure.

The CFSSM-S is the first validated instrument to assess food insecurity with psychometric guarantees in Spanish adolescents. Researchers and health practitioners in Spain could use this self-reported questionnaire to gain more information about adolescent health in relation to food insecurity.

To study the associations between home food availability and dietary patterns among pre-school children.

Cross-sectional study in which parents of the participating children filled in an FFQ and reported how often they had certain foods in their homes. We derived dietary pattern scores using principal component analysis, and composite scores describing the availability of fruits and vegetables as well as sugar-enriched foods in the home were created for each participant. We used multilevel models to investigate the associations between availability and dietary pattern scores.

The DAGIS study, Finland.

The participants were 864 Finnish 3–6-year-old children recruited from sixty-six pre-schools. The analyses included 711 children with sufficient data.

We identified three dietary patterns explaining 16·7 % of the variance. The patterns were named ‘sweets-and-treats’ (high loadings of e.g. sweet biscuits, chocolate, ice cream), ‘health-conscious’ (high loadings of e.g. nuts, natural yoghurt, berries) and ‘vegetables-and-processed meats’ (high loadings of e.g. vegetables, cold cuts, fruit). In multivariate models, the availability of fruits and vegetables was inversely associated with the sweets-and-treats pattern (β=−0·05, P<0·01) and positively associated with the health-conscious (β=0·07, P<0·01) and vegetables-and-processed meats patterns (β=0·06, P<0·01). The availability of sugar-enriched foods was positively associated with the sweets-and-treats pattern (β=0·10, P<0·01) and inversely associated with the health-conscious pattern (β=−0·03, P<0·01).

Considering dietary patterns, the availability of sugar-enriched foods in the home seems to have a stronger role than that of fruits and vegetables. Parents should restrict the availability of unhealthy foods in the home.

To assess the daily intake of polychlorinated biphenyls not similar to dioxins (NDL-PCB) derived from fish consumption in Spain and compare it with tolerance limits in order to establish a safe threshold so that the nutritional benefits derived from fish consumption may be optimized.

Analysis of NDL-PCB in fish samples and ecological study of the estimated intake of NDL-PCB from fish consumption in different Spanish population groups.

National representative sample of the Spanish population.

The intake of NDL-PCB was estimated in two different scenarios: upper bound (UB) and lower bound (LB). Estimating intake using the average concentration of NDL-PCB found in the fish samples, the intake for ‘other children’ is estimated as: 1·80 (UB) and 5·33 (LB) ng/kg per d at the 50th percentile (P50); 7·39 (UB) and 21·94 (LB) ng/kg per d at the 95th percentile (P95) of fish consumption. Estimated NDL-PCB intake shoots up in the toddler group, reaching values of 30·43 (UB) and 90·37 (LB) ng/kg per d at P95. Estimated intake values are lower than those previously estimated in Europe, something expected since in previous studies intake was estimated through total diet. In adults, our estimated values are 1·59 (UB) and 4·72 (LB) ng/kg per d at P50; 4·95 (UB) and 14·72 (LB) ng/kg per d at P95.

NDL-PCB concentration in fish is under the tolerance limits in most samples. However, daily intake in consumers of large quantities of fish should be monitored and special attention should be given to the youngest age groups due to their special vulnerability and higher exposure.

To estimate the determinants of stunting using rich data from a birth cohort study from urban South Africa and to examine the various mechanisms, both proximate and distal, through which maternal education affects stunting.

Multivariate regression analysis using birth cohort data, where the outcome variable was stunting at age 2 years, and multiple mediator analysis to identify pathways from maternal education to stunting.

South Africa’s largest metropolitan area, Soweto-Johannesburg.

Participants of Birth to Twenty Plus, a longitudinal cohort study of children born in 1990 (n 691).

In multivariate analysis, the birth weight Z-score (−0·084; P<0·001; 95 % CI −0·11, −0·06), the mother’s openness towards modern health care, captured by a vaccination score (−0·05; P=0·04; 95 % CI −0·10, −0·00), and a better-quality care environment (−0·015; P=0·04; 95 % CI −0·03, −0·00) were found to be negatively associated with stunting. Having experienced symptoms of illness related to ears and eyes increased the risk of stunting (0·038; P=0·01; 95 % CI 0·01, 0·07). Results of the mediation analysis showed that maternal education had an indirect effect on stunting largely through socio-economic status and the antenatal environment (measured by the birth weight Z-score).

Overall, many of the factors that were protective against stunting in the final analysis, whether they operated through maternal education or not, were related to the mother’s contribution to the child’s life. This reinforces the idea that to minimise stunting, enhanced antenatal and postnatal services to better support and empower mothers may be important.

The objective of the present study was to test the effectiveness of financial incentives and traffic-light labels to reduce purchases of sugar-sweetened beverages in a community supermarket.

In this randomized controlled trial, after a 2-month baseline period (February–March 2014), in-store traffic-light labels were posted to indicate healthy (green), less healthy (yellow) or unhealthy (red) beverages. During the subsequent five months (April–August 2014), participants in the intervention arm were eligible to earn a $US 25 in-store gift card each month they refrained from purchasing red-labelled beverages.

Urban supermarket in Chelsea, MA, USA, a low-income Latino community.

Participants were customers of this supermarket who had at least one child living at home. A total of 148 customers (n 77 in the intervention group and n 71 in the control group) were included in the final analyses.

Outcomes were monthly in-store purchases tracked using a store loyalty card and self-reported consumption of red-labelled beverages. Compared with control participants, the proportion of intervention participants who purchased any red-labelled beverages decreased by 9 % more per month (P=0·002). More intervention than control participants reduced their consumption of red-labelled beverages (−23 % v. −2 % for consuming ≥1 red beverage/week, P=0·01).

Overall, financial incentives paired with in-store traffic-light labels modestly reduced purchase and consumption of sugar-sweetened beverages by customers of a community supermarket.

Many studies of food intake have been performed and published in Sweden, but to our knowledge no studies have extensively explored the beverage consumption of the Swedish adult population. The present study aimed to describe the beverage consumption and the contribution of beverage energy (including alcohol energy) to total energy intake according to gender, region of living, meal type and day for a Swedish adult population.

National dietary survey Riksmaten (2010–2011), collected by the Swedish National Food Agency.

Sweden.

A total of 1682 participants (57 % women) reported dietary intake data during four consecutive days, specified by portion size, meal, time point, day of the week and venue. Meals were categorized as breakfast, lunch, dinner and ‘other’.

The beverage reported to be consumed the most was water (ml/d), followed by coffee. Men had a higher consumption of juice, soft drinks, beer, spirits and low-alcohol beer, while the consumption of tea and water was higher for women. For both genders, milk contributed the most to beverage energy intake. Energy percentage from beverages was higher at lunch and dinner during weekends for both genders. Participants from the biggest cities in Sweden had a higher consumption of wine for both genders and tea for men than participants from other regions.

A considerable part of total energy intake was contributed by beverages, especially for men. Beverages can contribute to a more enjoyable diet, but at the same time provide energy, sugar and alcohol in amounts that do not promote optimal health.

Concerns have been raised about the potential health impact of ultra-processed foods (UPF) in the diet. Our objective was to investigate the contribution of UPF in the diet in a large French population and its association with sociodemographic factors and dietary patterns.

Cross-sectional analysis of dietary data from 74 470 participants in the web-based NutriNet-Santé cohort. UPF were identified in repeated 24 h records and the proportion (in weight) of UPF in the total diet (UPFp) was computed for each participant. Associations of sociodemographic characteristics and UPFp in quartiles were assessed using multivariate multinomial logistic regression. Food group consumption and nutrient intakes across quartiles of UPFp were estimated using linear regression adjusted for sociodemographic factors and energy intake.

France.

UPF contributed 18·4 % of the foods consumed in weight and 35·9 % of total energy intake. Higher UPFp consumption was independently associated with male gender, younger age, lower education, smoking, and overweight and obesity (all P<0·0001). Participants in the highest UPFp quartile consumed lower amounts of fruit and vegetables (difference between quartile 4 and quartile 1 of UPFp, Δ=−180·3 g/d) and higher amounts of sweet products (Δ=68·5 g/d) and soft drinks (Δ=98·6 g/d; all P<0·0001). They had higher intakes of energy (Δ=610 kJ/d (145·7 kcal/d)) and added sugar (Δ=17·1 g/d), and lower intakes of fibre (Δ=−4·04 g/d), β-carotene (Δ=−1019·6 μg/d) and Ca (Δ=−87·8 mg/d; all P<0·0001).

UPF represent an important part of the diet in adults from the French general population and are associated with unbalanced nutritional intakes.

China has the largest population of elderly citizens in the world, with 177 million adults aged 60 years or older. However, no national estimate of malnutrition in elderly Chinese adults exists. We estimated the prevalence and predictors of malnutrition in this population.

Data from the second wave of the Chinese Health and Retirement Longitudinal Study (CHARLS) include interview and biomarker data for 6450 subjects aged 60 years or older from 448 different communities in twenty-eight provinces, allowing for nationally representative results. Malnutrition was identified based on the ESPEN (European Society of Parenteral and Enteral Nutrition and Metabolism) criteria. We used multivariable regression to investigate the predictors of malnutrition, including demographic factors, marital status, self-reported health status, self-reported standard of living, health insurance status and education.

China.

Community-dwelling Chinese adults aged 60 years or older.

The prevalence of malnutrition in elderly Chinese adults was 12·6 %. Malnutrition was most common among those who were older (OR=1·09; 95 % CI 1·07, 1·10), male (OR=1·41; 95 % CI 1·10, 1·79), lived in rural areas (v. urban: OR=0·75; 95 % CI 0·57, 1·00) or lacked health insurance (P<0·01).

The burden of malnutrition on elderly Chinese adults is significant. Based on current population estimates, up to 20 million are malnourished. Malnutrition is strongly associated with demographic factors, shows a trend to association with health status and is not strongly associated with standard of living or education. A coordinated effort is needed to address malnutrition in this population.

To determine the association between consumption of snacks and sweetened beverages and risk of overweight among children.

Secondary analysis of the Young Lives cohort study in Peru.

Twenty sentinel sites from a total of 1818 districts available in Peru.

Children in the younger cohort of the Young Lives study in Peru, specifically those included in the third (2009) and the fourth (2013) rounds.

A total of 1813 children were evaluated at baseline; 49·2 % girls and mean age 8·0 (sd 0·3) years. At baseline, 3·3 (95 % CI 2·5, 4·2) % reported daily sweetened beverage consumption, while this proportion was 3·9 (95 % CI 3·1, 4·9) % for snacks. Baseline prevalence of overweight was 22·0 (95 % CI 20·1, 23·9) %. Only 1414 children were followed for 4·0 (sd 0·1) years, with an overweight incidence of 3·6 (95 % CI 3·1, 4·1) per 100 person-years. In multivariable analysis, children who consumed sweetened beverages and snacks daily had an average weight increase of 2·29 (95 % CI 0·62, 3·96) and 2·04 (95 % CI 0·48, 3·60) kg more, respectively, than those who never consumed these products, in approximately 4 years of follow-up. Moreover, there was evidence of an association between daily consumption of sweetened beverages and risk of overweight (relative risk=2·12; 95 % CI 1·05, 4·28).

Daily consumption of sweetened beverages and snacks was associated with increased weight gain v. never consuming these products; and in the case of sweetened beverages, with higher risk of developing overweight.

Studies have shown that the consumption of added sugars may be associated with harmful health effects. The present study investigated the presence and types of added sugars in packaged foods.

Cross-sectional analysis of the presence and types of added sugars in the ingredients lists of packaged foods sold in a major Brazilian supermarket. The nomenclature of ingredients classified as added sugars and their frequency were identified. Data were organised and analysed through descriptive statistics: absolute and relative frequencies of the presence of added sugars categorised by food groups were calculated, and ingredients were analysed by text mining using R statistical environment.

A supermarket in Florianópolis, a metropolis in southern Brazil.

Packaged food products (n 4539) classified into eight groups.

Of the 4539 products, 71 % had some type of added sugar. The group with the highest frequency of added sugars was ‘products in which carbohydrates and fats are the main energy source’ (93 %). Food groups containing predominantly salty foods had a high frequency of added sugars, such as ‘meats and eggs’ (61 %). In total, 179 different terms for added sugars were identified, of which sugar, maltodextrin and glucose syrup were the most frequent.

Most of the packaged foods sold in Brazil contain added sugars, which may hamper adherence to the recommendation of limiting added sugars intake. The data may be useful for monitoring tendencies in the use of added sugars in packaged foods and as supplementary information to support the improvement of food label regulations.

Low iodine intakes are associated with goitre and other iodine-deficiency disorders (IDD) that have affected billions of people worldwide. We aimed to assess total goitre rate (TGR) and urinary iodine concentration (UIC) in schoolchildren between 2007 and 2015, percentage of iodized salt consumption by households, and salt iodine content at production, distribution and household levels in north-west Iran.

UIC assessed among schoolchildren in nine consecutive years; 240 schoolchildren aged 8–10 years selected by systematic random sampling each year in the West Azerbaijan Province.

Median UIC was >100 μg/l in all years. More than 50 % of children had iodine deficiency (UIC≤99 μg/l) in 2010 and 2011, while this rate was approximately 15–35 % in other years. Proportion with UIC below 50 μg/l was <20 % in all years except 2010 and 2011. Excessive UIC (≥300 μg/l) rate was between 5·4 and 27·5 %. TGR decreased from 44 % in 1996 to 7·6 % and 0·4 % in 2001 and 2007, respectively. Regular surveys from 2002 to 2015 showed that 98 % or more of households consumed iodized salt. Iodine level ≥20 ppm was observed in 87·5, 83 and 73 % of salt at production, distribution and household level, respectively (data from national study in 2007). The last national study in 2014 showed that median iodine level in household salt was 27 ppm.

Our focused data suggest that the universal salt iodization programme is improving the iodine status of schoolchildren in the West Azerbaijan Province of Iran. Reduction of TGR to less than 5 % in schoolchildren indicates successful elimination of IDD as a major public health problem.

To examine the relationships between objectively measured sleep patterns(sleep duration, sleep efficiency and bedtime) and sugar-sweetened beverage(SSB) consumption (regular soft drinks, energy drinks, sports drinks andfruit juice) among children from all inhabited continents of the world.

Multinational, cross-sectional study.

The International Study of Childhood Obesity, Lifestyle and the Environment(ISCOLE).

Children (n 5873) 9–11 years of age.

Sleep duration was 12 min per night shorter in children who reportedconsuming regular soft drinks ‘at least once a day’compared with those who reported consuming ‘never’ or‘less than once a week’. Children were more likely tosleep the recommended 9–11 h/night if they reportedlower regular soft drink consumption or higher sports drinks consumption.Children who reported consuming energy drinks ‘once a week ormore’ reported a 25-min earlier bedtime than those who reportednever consuming energy drinks. Children who reported consuming sports drinks‘2–4 d a week or more’ also reported a25-min earlier bedtime compared with those who reported never consumingsports drinks. The associations between sleep efficiency and SSB consumptionwere not significant. Similar associations between sleep patterns and SSBconsumption were observed across all twelve study sites.

Shorter sleep duration was associated with higher intake of regular softdrinks, while earlier bedtimes were associated with lower intake of regularsoft drinks and higher intake of energy drinks and sports drinks in thisinternational study of children. Future work is needed to establishcausality and to investigate underlying mechanisms.

To objectively evaluate voluntary nutrition and health claims and marketing techniques present on packaging of high-market-share ultra-processed foods (UPF) in Australia for their potential impact on public health.

Cross-sectional.

Packaging information from five high-market-share food manufacturers and one retailer were obtained from supermarket and manufacturers’ websites.

Ingredients lists for 215 UPF were examined for presence of added sugar. Packaging information was categorised using a taxonomy of nutrition and health information which included nutrition and health claims and five common food marketing techniques. Compliance of statements and claims with the Australia New Zealand Food Standards Code and with Health Star Ratings (HSR) were assessed for all products.

Almost all UPF (95 %) contained added sugars described in thirty-four different ways; 55 % of UPF displayed a HSR; 56 % had nutrition claims (18 % were compliant with regulations); 25 % had health claims (79 % were compliant); and 97 % employed common food marketing techniques. Packaging of 47 % of UPF was designed to appeal to children. UPF carried a mean of 1·5 health and nutrition claims (range 0–10) and 2·6 marketing techniques (range 0–5), and 45 % had HSR≤3·0/5·0.

Most UPF packaging featured nutrition and health statements or claims despite the high prevalence of added sugars and moderate HSR. The degree of inappropriate or inaccurate statements and claims present is concerning, particularly on packaging designed to appeal to children. Public policies to assist parents to select healthy family foods should address the quality and accuracy of information provided on UPF packaging.

To examine changes in the spatial clustering of malnutrition in children under 5 years of age (under-5s) for the period 1999 to 2011 in Bangladesh.

We used data from four nationally representative Demographic and Health Surveys (DHS) conducted in 1999–2000, 2004, 2007 and 2011 in Bangladesh involving a total of 24 211 under-5s located in 1661 primary sampling units (PSU; geographical unit of analysis) throughout Bangladesh. The prevalence of stunting (height/length-for-age Z-score <−2), underweight (weight-for-age Z-score <−2) and wasting (weight-for-height/length Z-score <−2) at each PSU site and for each survey year were estimated based on the WHO child growth standard. The extent of spatial clustering was quantified using semivariograms.

Whole of Bangladesh.

Children under 5 years of age.

Our results demonstrate that in 1999–2000 most PSU throughout Bangladesh experienced stunting, underweight and wasting prevalence which exceeded the WHO thresholds. By 2011, this situation improved, although in two of the six divisions (Barisal and Sylhet) PSU still exhibited higher levels of malnutrition compared with other divisions of the country. The pattern of spatial clustering for stunting, underweight and wasting also changed between 1999 and 2011 both at national and sub-national (division) levels.

We identified divisions where malnutrition indicators (stunting, underweight and wasting) remain highly clustered and other divisions where they are more widely spread in Bangladesh. This has important implications on how interventions for malnutrition need to be delivered (geographically targeted interventions v. random interventions) within each division of the country.

To retrospectively investigate the association between short stature and increased sitting height ratio (SHR) – indicators of stunting – and obesity markers in adults.

Cross-sectional evaluation of the EPIPorto cohort. Weight, height, sitting height and waist circumference were measured. Obesity was assessed for men and women through BMI and waist-to-height ratio (WHtR). Short stature (women, <152 cm; men, <164 cm) and high SHR (women, ≥54·05 %; men, ≥53·25 %) were taken as stunting measures. OR with 95 % CI were computed using logistic regression models.

Representative sample of adults from EPIPorto, an adult cohort study from Porto, Portugal.

A sample of 1682 adults, aged 18–86 years, was analysed.

Higher obesity prevalence was found among women (BMI≥30·0 kg/m2: 25·5 v. 13·3 %, P<0·001) and a higher proportion of men presented abdominal obesity (WHtR≥0·5: 80·1 v. 71·1 %, P<0·001). A positive association was found between short stature and obesity measures for women (multivariate-adjusted OR; 95 % CI: 1·75; 1·17, 2·62 for BMI≥30·0 kg/m2; 1·89; 1·24, 2·87 for WHtR≥0·5). Increased SHR was associated with higher likelihood of having BMI≥30·0 kg/m2 in both sexes (multivariate-adjusted OR; 95 % CI: 2·10; 1·40, 3·16 for women; 1·92; 1·07, 3·43 for men) but not with WHtR≥0·5.

Different growth markers are associated with obesity in adults. However, this association depends on the population and anthropometric measures used: short stature is associated with a higher risk of presenting excessive weight in women but not in men; SHR is more sensitive to detect this effect in both sexes.