Tony Sheehy

Ethiopia is the second-most populous country in Africa. Although most people still live in rural areas, the urban population is increasing. Generally, urbanisation is associated with a nutrition transition and an increase in risk factors for non-communicable diseases (NCDs). The objective of this study was to determine how the nutritional composition of the Ethiopian food supply has changed over the last 50 years and whether there is evidence of a nutrition transition. Food balance sheets for Ethiopia from 1961 to 2011 were downloaded from the FAOSTAT database and daily per capita supply for 17 commodity groupings was calculated. After appropriate coding, per capita energy and nutrient supplies were determined. Per capita energy supply was 1710 kcal/d in 1961, fell to 1403 kcal/d by 1973, and increased to 2111 kcal/d in 2011. Carbohydrate was by far the greatest energy source throughout the period, ranging from 72% of energy in 1968 to 79% in 1998; however, this was mostly provided by complex carbohydrates as the contribution of sugars to energy only varied between 4.7% in 1994 and 6.7% in 2011. Energy from fat was low, ranging from 14% of energy in 1970 to 10% in 1998. Energy from protein ranged from 14% in 1962 to 11% in 1994. Per capita supplies of calcium, vitamin A, C, D, folate and other B-vitamins were insufficient and there was a low supply of animal foods. The Ethiopian food supply is still remarkably high in complex carbohydrates and low in sugars, fat, protein, and micronutrients. There is little evidence yet of changes that are usually associated with a nutrition transition.

Background: To determine the portion sizes of traditional and non-traditional foods being consumed by Inuit adults in three remote communities in Nunavut, Canada.Methods: A cross-sectional study was carried out between June and October, 2008. Trained field workers collected dietary data using a culturally appropriate, validated quantitative food frequency questionnaire (QFFQ) developed specifically for the study population.Results: Caribou, muktuk (whale blubber and skin) and Arctic char (salmon family), were the most commonly consumed traditional foods; mean portion sizes for traditional foods ranged from 10 g for fermented seal fat to 424 g for fried caribou. Fried bannock and white bread were consumed by >85% of participants; mean portion sizes for these foods were 189 g and 70 g, respectively. Sugar-sweetened beverages and energy-dense, nutrient-poor foods were also widely consumed. Mean portion sizes for regular pop and sweetened juices with added sugar were 663 g and 572 g, respectively. Mean portion sizes for potato chips, pilot biscuits, cakes, chocolate and cookies were 59 g, 59 g, 106 g, 59 g, and 46 g, respectively.Conclusions: The present study provides further evidence of the nutrition transition that is occurring among Inuit in the Canadian Arctic. It also highlights a number of foods and beverages that could be targeted in future nutritional intervention programs aimed at obesity and diet-related chronic disease prevention in these and other Inuit communities.

Research indicates that a diet rich in whole grains may reduce the risk of prevalent chronic diseases, including cardiovascular disease, diabetes, and some cancers, and that risk for these diseases varies by ethnicity. The objective of the current study was to identify major dietary sources of grains and describe their contribution to B vitamins in five ethnic groups. A cross-sectional mail survey was used to collect data from participants in the Multiethnic Cohort Study in Hawaii and Los Angeles County, United States, from 1993 to 1996. Dietary intake data collected using a quantitative food frequency questionnaire was available for 186,916 participants representing five ethnic groups (African American, Latino, Japanese American, Native Hawaiian and Caucasian) aged 45–75 years. The top sources of grain foods were determined, and their contribution to thiamin, riboflavin, niacin, vitamin B6, and folic acid intakes were analyzed. The top source of whole grains was whole wheat/rye bread for all ethnic-sex groups, followed by popcorn and cooked cereals, except for Native Hawaiian men and Japanese Americans, for whom brown/wild rice was the second top source; major contributors of refined grains were white rice and white bread, except for Latinos. Refined grain foods contributed more to grain consumption (27.1-55.6%) than whole grain foods (7.4-30.8%) among all ethnic-sex groups, except African American women. Grain foods made an important contribution to the intakes of thiamin (30.2-45.9%), riboflavin (23.1-29.2%), niacin (27.1-35.8%), vitamin B6 (22.9-27.5%), and folic acid (23.3-27.7%). This is the first study to document consumption of different grain sources and their contribution to B vitamins in five ethnic groups in the U.S. Findings can be used to assess unhealthful food choices, to guide dietary recommendations, and to help reduce risk of chronic diseases in these populations.

Objective: Trinidad and Tobago has experienced an epidemiological transition over recent decades characterised by reduced rates of communicable diseases but rapidly increasing rates of obesity and non-communicable chronic diseases. The objective of the present study was to investigate the changes in energy and nutrient supply that have taken place in Trinidad and Tobago between 1961 and 2007.Design: Food balance sheets for each year between 1961 and 2007 were downloaded from the FAOSTAT database and daily per capita supply for seventeen food commodity groupings was calculated. After appropriate coding, energy and nutrient supply were determined using dietary analysis software.Setting: FAO food balance sheets for Trinidad and Tobago from 1961 to 2007.Subjects: None.Results: The food supply in 2007 provided an extra 1561 kJ (373 kcal)/capita per d than it did in 1961. Energy from carbohydrate as a percentage of total energy fell from 62 % in 1961 to 57 % in 2007, whereas energy from fat as a percentage of total energy increased from 26 % to over 30 % and now lies at the upper end of WHO recommendations. Sugars increased from 20 % to over 26 % of total energy and are well above WHO recommendations. When expressed on a nutrient density basis, supplies of vitamin A, folate and Ca are lower than WHO recommendations.Conclusions: Nutritional imbalances in the Trinidadian food supply need to be addressed to combat the rise in nutrition-related chronic disease that is projected to cause increased disability and premature death in the country in the coming years.

Over the course of the last 50 years the Republic of Ireland has gone from being one of the poorest countries in Europe to one of the richest; however, it is now experiencing increasing rates of obesity and non-communicable chronic disease. Although several national nutrition surveys have been carried out in Ireland since 1990, there is little information on the Irish diet before then. We analysed the FAO food balance sheets for Ireland from 1961 to 2007 in order to characterise the changes in energy and nutrient supply that took place during that period. Food balance sheets were downloaded from the FAOSTAT database and per capita supply of commodities was analysed using dietary analysis software. Energy from carbohydrate as a percentage of total energy fell from 55 % in 1961 to 46 % in 2007, whereas energy from fat increased from 29 % to 34 %; these values are well outside WHO recommendations for the prevention of chronic disease. Energy from alcohol as a percentage of total energy has doubled within the last 20 years. On a nutrient-density basis, vitamins and minerals met or exceeded WHO recommendations, apart from vitamin D, folate, Ca and Fe. Although there are methodological limitations associated with the use of food balance sheets, the present results demonstrate that the current imbalances in the Irish diet were already evident several decades ago. Because they are so long established, they will be difficult to reverse unless major public health nutrition interventions are implemented.

Objective: European governments have yet to introduce mandatory folic acid fortification of foods for neural tube defect prevention because of uncertainty about the long-term safety of high intake of folic acid. Novel folate-enriched eggs have been proposed as offering a practical way of increasing intake of natural folates, which do not have the same safety concerns as synthetic folic acid. Our objective was to estimate the potential increase in folate supply that could occur in European Union (EU) countries if normal eggs were replaced by folate-enriched eggs. Design: FAOSTAT data on daily per capita availability of eggs were linked to mean folate concentrations of un-enriched and folate-enriched eggs from three representative feeding trials from the recent literature. Setting: Data were collated in Microsoft Excel. Subjects: The study used food balance sheets for Europe for 1961–2003 and for twenty-six individual EU countries for 2003. Results: There has been little variation in egg supply in Europe over the past 40 years, with eggs providing only about 1·3–1·6 % of total energy. In 2003, the average per capita egg supply across twenty-six EU countries was 32·8 g/d, equivalent to a little over half an egg. Even if the folate concentrations of all eggs across the EU were increased two- to threefold, per capita folate supply would increase only by about 25 μg/d. Conclusions: At current enrichment levels, the availability of novel folate-enriched eggs will have little impact on folate supply in EU countries. In the absence of mandatory fortification, additional natural folate sources are needed urgently.

Barbados has been experiencing increasing rates of obesity and chronic non-communicable diseases characteristic of a country in nutrition transition. However, few studies have been carried out on how precisely the diet has changed in recent decades. Our aim was to analyse the FAO food balance sheets for Barbados from 1961 to 2003 in order to characterise the changes that have taken place in the macronutrient supply of the country during that period. Annual food balance sheets were downloaded from the FAOSTAT database, and per capita supply for twelve commodity groupings was analysed for energy and macronutrient levels using WISP dietary analysis software (Tinuviel Software, Llanfechell, Anglesey, UK). The food supply in 2003 provided over 2500 kJ (about 600 kcal) more energy per capita per d than it did in 1961. Energy from carbohydrate as a percentage of total energy has fallen from 70 % in 1961 to 57 % in 2003 and is now at the lower end of WHO recommendations. Energy from fat as a percentage of total energy increased from 19 % to 28 % and now lies at the upper end of WHO recommendations. Sugars, at over 17 % of dietary energy, are well above the upper limit set by the WHO. Despite having methodological limitations associated with the use of food balance statistics, our data suggest that these imbalances need to be addressed as a matter of priority in order to try to reverse the incidence of nutrition-related chronic diseases that are projected to cause increasing disability and premature death in the country in the coming years.