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PubMed2000

Browning indicators in bread.

Bread is the most important food in the Spanish household and represents the largest proportion of products produced by commercial bakeries. The browning indicators furosine, hydroxymethylfurfural (HMF), and color were determined to evaluate heat effects induced during manufacture of these foods. The breads analyzed were common, special, sliced toasted, and snack breads. Identical sample preparation and HPLC conditions were used to determine HMF in all breads. The precision tested at high and low HMF concentration in breads was 2.60% and 1.57%, respectively. Recovery of HMF was 96.2%. The HMF values ranged from 2.2 to 68.8 mg/kg. Color index (100 - L) ranged from 17.0 to 38.2. The linear correlations (r(2)) between 100 - L/HMF were above 0.70 for common, special, and snack breads. Similar correlation was obtained between 100 - L/HMF in a dough baking at different times. The furosine content in common bread ranged between 125 and 208 mg/100 g of protein. No linear correlation was found between furosine and HMF. Moreover, HMF and furosine were also determined in crumb and crust. Levels of HMF had a wide range (0.9-1.76 mg/kg) and furosine was between 43 and 221 mg/100 g of protein.

Bread↗

PubMed1997

Occurrence of fumonisin B1 and B2 in corn-based foodstuffs in Taiwan market.

Corn-based human foodstuffs purchased in Taiwan were analyzed for fumonisin B1 (FB1) and fumonisin B2 (FB2) using high-performance liquid chromatography. Fifty-two (33.9%) and 32 (20.9%) of 153 samples were found to contain FB1 (73-2395 ng/g) and FB2 (120-715 ng/g), respectively. The highest frequency of detection and also the highest FB1 concentrations were found in sweetcorn (50%, 1089 ng/g) and cornflour (50%, 608 ng/g), followed by corn snacks (33.3%, 2395 ng/g), miscellaneous corn products (33.3%, 73 ng/g), popcorn (31.8%, 1003 ng/g) and cornflakes (23.5%, 1281 ng/g). 16 corn snacks (= approximately 20.5% of the samples) had an average FB1 and FB2 content of 456 and 145 ng/g, respectively, while six sweetcorn (= 25%) samples were contaminated with an average of 400 ng/g of FB1 and 65 ng/g of FB2. Of the 22 pop-corn samples examined, 7 had an average of 347 ng/g and 116 ng/g of FB1 and FB2, respectively. During an analysis of the distribution pattern for the combined fumonisin levels of FB1 and FB2, it became apparent that more than 69% of tested samples had fumonisin concentrations below 100 ng/g, while 11.1% (or 17 samples) contained in excess of 600 ng toxins per g. These results clearly illustrated that commercially available corn-based foodstuffs for human consumption in Taiwan are frequently contaminated with FB1 and FB2.

Carboxylic Acids↗

PubMed1999

Relationship between lifestyle and serum lipid and lipoprotein levels in middle-aged Japanese men.

Cross-sectional associations between lifestyle factors [cigarette smoking, alcohol intake, overall obesity indicated by body mass index (BMI), eating breakfast, snacking between meals, considering nutritional balance, coffee drinking, physical exercise, and hours of work and sleep] and serum lipid and lipoprotein levels were examined in 1580 middle-aged Japanese men in Osaka, Japan. From stepwise regression analyses, significant correlates with low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and Log triglyceride levels were, in the order of relative importance: BMI, alcohol intake (negative), and age for LDL cholesterol level; BMI (negative), cigarette smoking (negative), alcohol intake, considering nutritional balance, and physical exercise for HDL cholesterol level; and BMI, cigarette smoking, working hours (negative), considering nutritional balance (negative), alcohol intake, and coffee drinking (negative) for Log triglyceride level. The cumulative percentages of variation for LDL cholesterol, HDL cholesterol and Log triglyceride levels were 4.2%, 15.4% and 14.7%, respectively. From stepwise regression analyses, excluding BMI as a factor in the model, snacking between meals emerged as a significant factor for LDL cholesterol level and HDL cholesterol level (negative). The cumulative percentage of variation for each serum lipid and lipoprotein level was decreased (1.5% for LDL cholesterol, 6.8% for HDL cholesterol, and 3.1% for Log triglyceride). These results suggest that BMI has the strongest association with serum lipid and lipoprotein levels and that good daily lifestyles may have an anti-atherogenic effect by altering serum lipid and lipoprotein levels in middle-aged Japanese men.

Body Mass Index↗

PubMed2002

Increased risk of early-stage breast cancer related to consumption of sweet foods among women less than age 45 in the United States.

OBJECTIVES: To evaluate the associations of dietary macronutrients, food groups, and eating patterns with risk of breast cancer in a population-based case-control study. METHODS: In this study among women 20-44 years of age, 568 cases with breast cancer and 1451 population-based controls were included. They completed a detailed in-person interview, a self-administered food-frequency questionnaire and were measured for anthropometric indices. Logistic regression was used to estimate odds ratios (OR) and their 95% confidence intervals (CI) of breast cancer, adjusted for age, study site, race, education, alcohol consumption, oral contraceptive usage, smoking status, and body mass index. RESULTS: There was no association between breast cancer risk and intake of calories, macronutrients, or types of fat. Risk of breast cancer was unrelated to intakes of a variety of food groups, including red meats, dairy, high-fat snacks and desserts, or foods high in animal fat. Increased risk was observed for high intake of a food group composed of sweet items, particularly sodas and desserts. Risk increased linearly with percent of calories from sweets and frequency of sweets intake. Consumption of sweets 9.8 or more times per week compared with <2.8 times per week was associated with an adjusted OR of 1.32 (95% CI = 1.0-1.8). This association did not appear to be due to the high-fat foods or carbonated beverages that comprised the food group. Compared with women reporting one or two meals and snacks per day, reduced risks were noted for women reporting six or more (OR = 0.69, 95% CI = 0.4-1.1). CONCLUSIONS: These data suggest a modest relationship between intakes of sweet items with risk of in-situ and localized breast cancer in young women. This relation is consistent with the hypothesized link of high insulin exposure and risk of breast cancer. There was some suggestion that women who ate many times during the day were at reduced risk of disease, which is also consistent with an insulin-related mechanism.

Adult↗

PubMed1987

"Eating lightly" and the self-presentation of femininity.

In Experiment 1, male and female subjects were given an opportunity to snack as they participated in a "get-acquainted study" with a same-sex or opposite-sex partner (confederate) whose social desirability was manipulated. Consistent with the hypothesis that women may eat less when motivated to present themselves in a feminine light, female subjects ate significantly less with a desirable male partner than in the remaining three conditions. In contrast, male subjects did not eat more (or less) with a desirable woman, although they did show an overall tendency to eat less with female (vs. male) partners. In Experiment 2, female subjects snacked as they got acquainted with a desirable male partner (confederate). Before this interaction, subjects received feedback indicating that they had either very masculine or very feminine interests. In addition, subjects believed either that their male partner was aware of their gender feedback or that he was unaware. Consistent with predictions derived from Schlenker's (1982) analytic-identity theory of social conduct, subjects in the partner-aware conditions ate less when they had received masculine (vs. feminine) feedback, whereas subjects in the partner-unaware conditions ate less when they had received feminine (vs. masculine) feedback. Implications for understanding eating disorders such as anorexia and bulimia are discussed.

Adult↗

PubMed2004

Mothers' behavior modifications during pretense and their possible signal value for toddlers.

An important issue for understanding early cognition is why very young children's real-world representations do not get confused by pretense events. One possible source of information for children is the pretender's behaviors. Pretender behaviors may vary systematically across real and pretend scenarios, perhaps signaling to toddlers to interpret certain events as not real. Pretender behaviors were examined in 2 experiments in which mothers were asked both to pretend to have a snack and really to have a snack with their 18-month-olds. Episodes were analyzed for condition differences in verbal and nonverbal behaviors, including smiling, looking, laughter, and functional movements. Reliable differences were found across conditions for several variables. In a 3rd experiment, children's apparent understanding of pretense in relation to their mothers' behaviors was examined, and significant associations were found with some of the mothers' behavioral changes but not others. This work provides a first inroad into the issue of how children learn to interpret pretense acts as pretense.

Attention↗

PubMed2003

Stress and dietary practices in adolescents.

Baseline data from the Health and Behavior in Teenagers Study (HABITS) were used to investigate associations between stress and dietary practices in a socioeconomically and ethnically diverse sample of 4,320 schoolchildren (mean age = 11.83 years). Male (n = 2,578) and female (n = 1,742) pupils completed questionnaire measures of stress and 4 aspects of dietary practice (fatty food intake, fruit and vegetable intake, snacking, and breakfast consumption) and also provided demographic and anthropometric data. Multivariate analyses revealed that greater stress was associated with more fatty food intake, less fruit and vegetable intake, more snacking, and a reduced likelihood of daily breakfast consumption. These effects were independent of individual (gender, weight) and social (socioeconomic status, ethnicity) factors. Stress may contribute to long-term disease risk by steering the diet in a more unhealthy direction.

Adolescent↗

PubMed1997

Eating habits, food and health related attitudes and beliefs reported by French students.

OBJECTIVES: To assess eating habits and some food related behaviours, beliefs and knowledge in educated young French adults. DESIGN: A standardized questionnaire administered in university classes. SETTING: University or 'Grandes Ecoles' of Paris and Dijon. SUBJECTS: 660 male and female French students. INTERVENTIONS: International survey; questionnaire composed of three major sections: (1) Health-related attitudes such as substances used, dieting, health practices; (2) Beliefs concerning behaviour and health, including eating habits; (3) Knowledge, namely relevance of factors to diseases such as cancer or cardiovascular diseases. RESULTS: Gender, self-perception of body size, BMI and attempts to lose weight affected a number of behaviours. Average BMI corresponded to standard values. 'Healthy' behaviours were often reported such as: avoiding fat and cholesterol, efforts to eat fruit and fiber. The French students showed a low frequency of snacking and a high regularity in having breakfast, especially respondents with lower BMI (females < or = 23 and males < or = 24.5 kg/m2). Beliefs about the importance of behaviours were closely associated with the performance of the behaviours. Awareness of the role of eating factors in cardiovascular diseases was observed. CONCLUSION: The meal and snack pattern in French students is very close to the traditional model. More food- and health-related behaviours and attitudes are reported by women than men. Some of them could be due to a genuine motivation for prevention and health in females or else to a greater wish to be thin. 'Desire to lose weight' is often reported although BMI values are normally low in this young population. Beliefs in the importance of a behaviour for health are correlated with the reported performance of the behaviours.

Adult↗

PubMed1997

Fat preferences, dietary fat intake and body composition in children.

OBJECTIVE: To examine the relationship between fat preference, dietary intake data and body composition in children. SUBJECT AND METHODS: Subjects studied were 88 children aged 9-12 y from two elementary schools in Ohio. Measures for dietary intake and body composition were obtained by 3 day diet records, anthropometrics, triceps and subscapular skinfolds. Fat preference data was assessed by hedonic rating of high and low fat snack foods. RESULTS: Data indicate that children who preferred the high fat snack items had high dietary fat intakes (r = 0.57, P < 0.05). Tricep skinfold measurement and BMI correlated positively with high fat food preferences (r = 0.51 and r = 0.46 P < 0.05). CONCLUSIONS: These data suggest preference for high fat foods may occur due to diet composition and that increased adiposity may be associated with higher relative fat intakes.

Body Composition↗

PubMed2003

Estimated energy intake, macronutrient intake and meal pattern of Flemish adolescents.

OBJECTIVE: To describe the energy and macronutrient intake and the meal patterns of Flemish adolescents, aged 13-18 y. METHODS: A 7 day estimated food record was administered to the whole sample. SETTING: Secondary schools in the city of Ghent, Belgium. SUBJECTS: A total of 341 adolescents (13-18 y) selected by a multistage clustered sampling (participation: 72.7%). MAIN RESULTS: A significant increase with age was observed in total energy intake in adolescent boys (P<0.01), but not in girls. The energy distribution over the macronutrients showed no significant difference between boys and girls. On average, 35.7% (s.d. 4.81%) of energy came from total fat and 15.4% (s.d. 2.46%) from saturated fatty acids; 49.0% (s.d. 5.28%) from total carbohydrates with 25.1% (s.d. 4.49%) from complex carbohydrates and 23.9% (s.d. 5.86%) from free sugars. The energy contribution of alcohol in the 16-18 y-old-group was significantly higher as compared with the 13-15 y-old-group, for both boys and girls. Snacks between meals accounted for almost 20% of the total energy intake. Lunch and dinner were characterized by high total fat content. CONCLUSION: These students consumed a diet high in total fat and in saturated fatty acids and also high in mono- and disaccharides. Observed mean intakes deviate considerably from the Belgian dietary guidelines. A low energy intake at breakfast was observed, while a higher proportion of energy was derived from snacks.

Adolescent↗

PubMed2005

Young adolescents' nutrition assessment on computer (YANA-C).

OBJECTIVE: To assess the relative validity and acceptability of the computerised 24-h recall 'Young Adolescent's Nutrition Assessment on Computer (YANA-C)'. DESIGN: Food and nutrient intakes assessed with YANA-C were compared with food records (study 1) and 24-h dietary recall interviews (study 2). MAIN OUTCOME MEASURES: Intakes of food groups (fruit, fruit juice, vegetables, potatoes, bread, cereals, milk, cheese, other milk products, soft drinks, diet soft drinks, sugar/sweets, pastry/cookies, savoury snacks, butter/sauces, eggs, fish, meat) and nutrients (energy, carbohydrates, protein, fat, fiber, calcium, vitamin C and iron). SUBJECTS AND SETTING: A total of 237 pupils (11-14 y) from two primary and four secondary schools (study 1: n = 136; study 2: n = 101) in Belgium-Flanders. RESULTS: YANA-C proved to agree well with both standard methods in categorizing subjects in consumers and nonconsumers (kappa(study 1) = 0.48-0.92; kappa(study 2) = 0.38-0.90). Spearman's correlations for energy and nutrient intakes ranged between 0.44 and 0.79 for study 1 and between 0.44 and 0.86 for study 2. Nutrient and energy intakes were in general (excluding calcium) significantly higher in YANA-C in comparison with the food record, but not in comparison with the interview (only fiber). Statistics used to investigate whether YANA-C agreed with the other methods in ranking portions/amounts in consumers only were fair to moderate for most of the food groups (weighted kappa study 1 = 0.11-0.55; study 2 = 0.04-0.73); amounts in consumers only, were significantly lower in YANA-C against both standards for cereals; amounts were significantly higher in YANA-C against the food record for milk, soft drinks, sugar/sweets and savoury snacks and against the interview for potatoes. Only a few pupils evaluated the program negatively. CONCLUSION: YANA-C is a promising method to collect detailed dietary information from young adolescents with relatively low staff resources, useful in many nutrition research applications.

Adolescent↗

PubMed2005

Lunchbox contents of Australian school children: room for improvement.

OBJECTIVE: In light of the increasing prevalence of obesity in children and the potential of schools as a setting for intervention, we aimed to identify the main foods and beverages consumed at primary school and to determine differences in consumption patterns between children who used the school canteen and those who did not. DESIGN: Cross-sectional survey of school foods in 1681 5-12 y old children, 2003-2004. SETTING: Barwon South-Western region of Victoria, Australia. RESULTS: The school food provided an average (+/-s.e.m.) of 3087+/-26 kJ. Bread was the most frequently consumed food and contributed 20% of total energy at school, biscuits 13%, fruit 10%, muesli/fruit bars 8%, packaged snacks 7%, and fruit juice/cordial 6%. About 10% of children used the school canteen and these children obtained more total energy and more energy from cakes, fast foods and soft drink than noncanteen users (P<0.001). In all, 68% of children had fruit in their lunchboxes, however, over 90% of children had energy-dense, micronutrient-poor snacks ('junk food'). CONCLUSIONS: Fruit intake in primary schools seems reasonably high but could be targeted for further increase as part of promoting a healthy diet. Of concern, however, are the excessive amounts of energy-dense foods in school lunchboxes. These should be considered a priority for health promotion efforts along with reducing the consumption of sweetened drinks. These measures are urgently needed to improve the school-based diets of Australian children and attempt to curb the increasing prevalence of childhood obesity.

Age Factors↗

PubMed2006

Meal glycaemic load of normal-weight and overweight Hong Kong children.

OBJECTIVE: To describe the pattern of meal glycaemic load of children in Hong Kong and to determine whether the meal glycaemic load is associated with childhood overweight. METHOD: Dietary records (3-day) of 316 Hong Kong children aged 6-7 years were collected. Glycaemic load was calculated from the estimated weight (WT), carbohydrate content (%CHO) and glycaemic index (GI) of each food taken using the equation: (% CHO x GI x WT/100). The meal glycaemic load was then the sum of the glycaemic loads of all food taken in each meal. Logistic regression analyses were used to compare the average meal glycaemic load (of breakfast, lunch and dinner) and other dietary parameters between overweight children and normal-weight children. RESULTS: Breakfast, lunch, dinner and snacks provided, respectively, 17, 29, 29 and 25% of the total glycaemic load in a day. White rice (excluding congee (rice porridge) and glutinous rice) contributed almost half of the total glycaemic load. Adjusted logistic regression showed that the meal glycaemic load was not significantly associated with childhood overweight after adjusting for parental obesity, birth weight, sleeping duration, mean energy intake and paternal smoking. CONCLUSION: Meal glycaemic load calculated from current diet was not an independent factor associated with childhood overweight in children aged 6-7 years. Our data suggested that modifying the type of rice/staple consumed and choosing low-GI snacks could have a major influence on the total meal glycaemic load of young Hong Kong children.

Case-Control Studies↗

PubMed2004

The freshman weight gain: a model for the study of the epidemic of obesity.

OBJECTIVE: The objective of this study was to quantify the weight gain of freshmen during their first 12 weeks at Cornell University. In addition, students completed questionnaires that revealed particular behaviors and activities that were associated with weight gain. DESIGN: Serial, correlational study. SUBJECTS: A total of 68 freshmen from Cornell University. MEASUREMENT: A total of 60 students were weighed during the first week of the semester, then again 12 weeks later. They were also given a questionnaire to complete concerning their behavior during the previous 12 weeks. RESULTS: After adjusting for clothing weights, the mean weight gain of the freshmen was 1.9+/-2.4 kg, a value significantly different from 0. Two regression models generated from the questionnaire were fitted to the weight gain. The first linear regression model (Model 1) accounted for 58% of the variance and indicated that eating in the 'all-you-can-eat' dining halls accounted for 20% of the variance in weight gain. Snacking and eating high-fat 'junk food' accounted for anther 20%. When initial weight was used as a covariate (Model 2), the consumption of junk foods, meal frequency and number of snacks accounted for 47% of the variance. CONCLUSION: The study clearly demonstrated that significant weight gain during first semester college is a real phenomenon and can be attributed to tangible environmental stimuli. The weight gain is considerably greater than that observed in the population and may be useful as a model to test various techniques that may reduce or reverse the 'epidemic' of obesity observed in the general population.

Adolescent↗

PubMed2005

Associations between BMI, social strata and the estimated energy content of foods.

OBJECTIVE: Many studies have shown that the prevalence of obesity is greater in lower social classes. The reasons for this effect however are unclear. Since there is also a link between education and social class, and an association between education and prevalence of obesity, one hypothesis is that lack of education about energy contents of foods may contribute to the effects of social class on obesity. SUBJECTS: We tested the hypothesis that knowledge of food energy contents is associated with differences in body mass index (BMI) in a sample of 346 people of both genders, aged between 18 and 45 y, of variable body mass index and drawn from different social strata. RESULTS: Estimates of food energy contents were on average well correlated with the actual energy contents, but individual estimates were very poor in all subpopulations of this sample. We found that subjects of different BMIs did not differentially estimate the energy contents of foods high in carbohydrate, but low in fat and protein (fruit and bread). However, foods that contained high fat contents, independent of the other macronutrients present, were generally perceived to have significantly lower energy contents by obese people than nonobese subjects (although this was not observed for all high-fat foods). Overall, this difference interacted with social class, such that the difference between the BMI groups was exaggerated in the lower social stratum but abolished in the higher social class. Binary logistic regressions revealed that the probability of being obese (BMI>30 kg/m2) in the lower social class group was significantly negatively associated with the estimated food energy content of most high-fat foods. Such an association was not found in the higher social class group. In the lower social class group, overall food knowledge appeared superior in the leaner subject group (BMI<30 kg/m2), but obese subjects were actually better at estimating the energy contents of snacks and alcoholic beverages. The leaner group significantly overestimated the energy contents of these items. CONCLUSION: Differences between individuals in estimates of food energy contents may contribute to the development of obesity in lower social strata. Whether this is driven by a protective effect in lean subjects of overestimating the energy contents of certain foods (snacks and alcoholic beverages) or a susceptibility in the obese because they underestimate the energy contents of other foods is not certain. Knowing which of these alternatives is true is important and may help design public health education programmes directed at these people to help alleviate the obesity epidemic.

Adolescent↗

PubMed1998

Review article: olestra and its gastrointestinal safety.

Olestra is a fat substitute made from sucrose and vegetable oil. Olestra is neither digested nor absorbed, and therefore adds no calories or fat to the diet. Because the gut is the only organ that is exposed to olestra, the potential for olestra to affect gastrointestinal structure and function, and the absorption of nutrients from the gut, has been investigated. Histological evaluations performed after long-term feeding studies have shown no indications that olestra causes injury to the gastrointestinal mucosa. Olestra is not metabolized by the colonic microflora, and has no meaningful effects on the metabolic function of these organisms. Studies of gastrointestinal transit have shown that the consumption of olestra with food does not affect gastric emptying, or small or large bowel transit times. Olestra does not affect the absorption of macronutrients, water-soluble vitamins or minerals. It causes a dose-responsive decrease in the availability of the fat-soluble vitamins A, D, E and K; however, this potentially adverse effect is offset by the addition of vitamins to olestra-containing foods. Olestra has no consistent effect on the amount of total bile acids excreted in the faeces, and therefore probably has no significant effect on bile acid absorption. The occurrence of gastrointestinal symptoms, including diarrhoea, loose stools, gas and abdominal cramping, after consumption of olestra under ordinary snacking conditions is comparable to that following consumption of triglyceride-containing snacks.

Animals↗

PubMed2002

Is there a relationship between the food intakes of Scottish 5(1/2)-8(1/2)-year-olds and those of their mothers?

BACKGROUND: Recent reports have highlighted certain aspects of the diets of children and adults in Scotland today that are a cause for concern. If there are significant associations between family members in food choice and thus in nutrient intakes, this may be important in the aetiology and prevention of diseases relating to dietary risk factors. AIM: To compare the food intake of Scottish children aged 5(1/2)-8(1/2) years with that of their mothers. METHODS: As part of a larger study, data on food intakes were obtained from 4-day weighed food records for 36 Scottish children (12 boys and 24 girls), aged 5(1/2)-8(1/2) years, who had participated in the 1992/1993 National Diet and Nutrition Survey (NDNS), and their mothers. RESULTS: Compared with their mothers, children had higher median densities [weight (g) of foods per 4.2 MJ (1000 kcal)] of snack foods including fruit, bread and confectionery and lower median densities of meat and meat products, fish, potatoes and vegetables. Positive, significant correlations between children and mothers were found for median densities of bread (r = 0.360, P < 0.05), fruit (r = 0.735, P < 0.001) and potatoes (r = 0.572, P < 0.001) and also for chips (r = 0.651, P < 0.001) and chocolate confectionery (r = 0.368, P < 0.05), the latter two being foods that should be reduced in the average Scottish diet. CONCLUSIONS: Children's intakes of snack foods were correlated with that of their mothers emphasizing the need for change at a family level if current guidelines on diet are to be implemented.

Adult↗

PubMed2000

Meal pattern and risk factor evaluation in one-year completers of a weight reduction program for obese men - the 'Gustaf' study.

OBJECTIVES: To evaluate changes in meal patterns and in obesity related risk factors after 1 year of treatment in obese men. DESIGN: Data from two 24-h dietary recalls, performed at base-line and after 1 year of treatment, were related to changes in medical risk factors. SETTING: Academic obesity unit. SUBJECTS: Sixty-three men, aged 44 (eight) years (mean [SD]) and Base-line Body Mass Index (BMI) 37.4 (4.6) kg m-2, who had completed 1 year of treatment. The men were subdivided by tertiles according to weight change: tertile I (n = 21), mean +0.3 kg, tertile II (n = 21), mean -5.8 kg and tertile III (n = 21), mean -14.2 kg. MAIN OUTCOME MEASURES: Weight loss, changes in meal patterns and in obesity related medical risk factors. RESULTS: The reported mean energy intake decreased after treatment in tertiles II and III by 700 (1300) kcal (P < 0.05) and 700 (900) kcal (P = 0.001), respectively. In tertile III the energy-% from fat decreased (P < 0.05) with a reciprocal increase in energy-% from protein (P < 0.05). The frequency of snacks of a low nutritional quality decreased (P < 0.01) in tertile III together with an increase in energy-% from 'hot meals of good quality' (P < 0.05). Obesity related risk factors (anthropometry, blood pressure, serum lipid concentrations, blood glucose and plasma insulin) improved in a beneficial way only in tertile III. CONCLUSIONS: The weight loss in the successful tertile III men was to a great extent explained by fewer low quality snacks but more energy from high quality meals. These changes reflected the behaviour modification strategy recommended.

Adult↗