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ObjectiveYoung children lack basic skills related to recognizing the types of foods they consume and dietary surveys often rely on parents’ response. The present study aimed to evaluate how well parents of children aged from 3 months to 10 years perceive images of portions of foods commonly consumed by young children.DesignPre-weighed, actual food portions (n 2314) were shown to the study participants who were asked to indicate the picture that corresponded to the food in view. Mean differences between picture numbers selected and shown were estimated and compared using unpaired t tests or Tukey–Cramer pairwise comparisons.SettingReal-time testing of parents’ perception of food images presenting portion sizes consumed by children up to 10 years old.SubjectsA convenience sample of 138 parents/caregivers of young children (69 % females).ResultsIndividuals selected the correct or adjacent image in about 97 % of the assessments. Images presenting amorphous solids (i.e. pies and pastries with a filling), liquid or semi-liquid dishes (i.e. soups, porridges, fruit and vegetable purées) were more prone to bias. There was no indication that personal characteristics (gender, age, educational background, age, number of offspring) were associated with differences in the way parents/caregivers perceived the food pictures.ConclusionsFood pictures may not be appropriate to quantify the intake of liquid, semi-liquid or amorphous solid foods in surveys addressing young children and studies evaluating their performance as food portion anchors should ensure the inclusion of several and various amorphous foods in the assessment.

ObjectiveTo evaluate how well respondents perceive digital images of food portions commonly consumed in Greece.DesignThe picture series was defined on the basis of usual dietary intakes assessed in earlier large-scale studies in Greece. The evaluation included 2218 pre-weighed actual portions shown to participants, who were subsequently asked to link each portion to a food picture. Mean differences between picture numbers selected and portions actually shown were compared using the Wilcoxon paired signed-rank test. The effect of personal characteristics on participants’ selections was evaluated through unpaired t tests (sex and school years) or through Tukey–Kramer pairwise comparisons (age and food groups).SettingTesting of participants’ perception of digital food images used in the Greek national nutrition survey.SubjectsIndividuals (n 103, 61 % females) aged 12 years and over, selected on the basis of the target population of the Greek nutrition survey using convenience sampling.ResultsIndividuals selected the correct or adjacent image in about 90 % of the assessments and tended to overestimate small and underestimate large quantities. Photographs of Greek traditional pies and meat-based pastry dishes led participants to perceive the amounts in the photos larger than they actually were. Adolescents were more prone to underestimating food quantities through the pictures.ConclusionsThe digital food atlas appears generally suitable to be used for the estimation of average food intakes in large-scale dietary surveys in Greece. However, individuals who consistently consume only small or only large food portions may have biased perceptions in relation to others.

ObjectiveTo identify and assess actions by which the catering sector could be engaged in strategies for healthier eating out in Europe.DesignA SWOT analysis was used to assess the participation of the catering sector in actions for healthier eating out. Caterers subsequently shortlisted essential actions to overcome threats and weaknesses the sector may face when engaging in implementing these actions.SettingAnalysis undertaken in the European Union-supported HECTOR project on ‘Eating Out: Habits, Determinants and Recommendations for Consumers and the European Catering Sector’.SubjectsThirty-eight participants from sixteen European countries reflecting a broad multi-stakeholder panel on eating out in Europe.ResultsThe catering sector possesses strengths that allow direct involvement in health promotion strategies and could well capitalise on the opportunities offered. A focus on healthy eating may necessitate business re-orientations. The sector was perceived as being relatively weak in terms of its dependency on the supply of ingredients and lack of financial means, technical capacity, know-how and human resources. To foster participation in strategies for healthier eating out, caterers noted that guidelines should be simple, food-based and tailored to local culture. The focus could be on seasonal foods, traditional options and alternative dishes rather than just on ‘healthy eating’. Small-to-medium-sized enterprises have specific concerns and needs that should be considered in the implementation of such strategies.ConclusionsThe study highlights a number of possible policy actions that could be instrumental in improving dietary intake in Europe through healthier eating out.

Socially-and culturally-patterned differences in food habits exist both between and within European populations. Daily individual food availability data, collected through the national household budget surveys (HBS) and harmonized in the context of the Data Food Networking (DAFNE) project, were used to assess disparities in food habits of seven European populations and to evaluate dietary changes within a 10-year interval. The availability of selected food items was further estimated according to the educational level of the household head and, based only on the Greek HBS data, according to quintiles of the household's food purchasing capacity. Results for overall food availability support the north-south differentiation in food habits. Generally, the availability of most food items, including foods such as vegetable fats, animal lipids and sugar products, has decreased over the 10 years. Households in which the head was in the higher education categories reported lower availability for most food items, with the exception of low-fat milk, fresh fruit, animal lipids and soft drinks; the latter showing a sharp increase even within southern European households. The household's food purchasing capacity can be used as an indicator of socio-economic status, with higher values being associated with lower status. Greek households of lower social class follow a healthier diet in terms of greater availability of vegetable oils, fresh vegetables, legumes, fish and seafood. Data from the DAFNE databank may serve as a tool for identifying and quantifying variation in food habits in Europe, as well as for providing information on the socio-economic determinants of food preferences.

Recasting the role of fruit and vegetables (F&V) in the diet, and planning national and international campaigns to enhance their consumption are major public health service objectives. The present study seeks to describe F&V availability patterns in ten European countries and examine compliance with current recommendations. The mean and median F&V availability (g/person per d) was estimated based on household budget survey data retrieved from the Data Food Networking (DAFNE) databank. Low F&V consumers were identified based on WHO international recommendations (minimum combined F&V intake of about 400 g/person per d) and current conservative guidelines of a minimum daily intake of three portions of vegetables and two portions of fruit. Considerable disparities in F&V availability were found among the surveyed European populations. Only in Mediterranean countries did the mean daily population intake clearly exceed combined F&V recommendations. Dietary patterns were positively skewed in all populations studied, on account of the presence of exceptionally high values among segments of the populations. Moreover, the correlation was unexpectedly weak between the proportion of low fruit and low vegetable consumers (Spearman's correlation coefficient +0·18). More than 50 % of the households in the surveyed populations are likely to consume less than the recommended daily vegetable intake of three portions, and this applies even to the two Mediterranean populations. The efficiency of F&V promoting strategies may be enhanced if F&V are addressed separately; furthermore, interventions that would specifically focus on vegetables are probably needed.

Objective: To assess the short-term (15-d) and long-term (12-month) effects of a school-based health and nutrition education intervention on diet, nutrition intake and BMI. Design: The 12-week teacher-implemented intervention in combination with seminars organized for parents was aimed at improving children’s diet and nutrition knowledge. The intervention took place between September 2007 and January 2008. The participants were randomized to two study groups, the intervention group (IG) and control group (CG), and were examined prior to the intervention on a variety of health knowledge, dietary, behavioural and anthropometric indices. The same measurements were collected 15 d and 1 year after the intervention. Setting: All high schools in Vyronas, a densely populated district of Athens, Greece. Subjects: The sample consisted of 191 students aged 12–13 years. Results: Twelve months after the intervention, the programme was effective in reducing various indices in the IG compared with baseline findings (BMI: 23? 3( SD 2?8) v .2 4? 0( SD 3?1) kg/m 2 , P , 0?001; daily energy intake: 8112? 4( SD 1412?4) v. 8503? 3( SD 1419?3) kJ/d, P , 0?001; total fat intake: 31? 3( SD 4?4) v .3 5? 4( SD 4?7) % of daily energy, P , 0?001). Except for BMI, decreases in the aforementioned indices were also observed 15 d after the intervention. In addition, students of the IG reduced their weekly consumption of red meat and non-home-made meals and increased their frequency of fruit and breakfast cereal consumption. Conclusions: The beneficial effects of this nutrition education intervention among adolescents may highlight the potential of such programmes in the prevention of obesity.