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A prospective cohort study of 1,520 mothers from Zhejiang province of China was undertaken to determine the duration of breastfeeding and associated factors during the first six months postpartum. Most (95.3%) mothers had introduced complementary foods by six months, making them at risk from contaminated infant formula. The mean duration of'any breastfeeding' was greater than 180 days but only 48 days for 'exclusive breastfeeding'. Factors relating to cessation of any breastfeeding were maternal age, timing of the breastfeeding decision, admission of the infant to a special-care nursery, return of the mother to work, the early introduction of water and/or other complementary foods, and their location of residence. The introduction of infant formula before three months was positively associated with the late decision to breastfeed, births in city, and infants being given a prelacteal feed. To combat the melamine disaster, strategies to improve the duration of breastfeeding must be developed taking these factors into account. [ABSTRACT FROM AUTHOR]

Objective: To document the infant feeding practices of Maldivian mothers.Methods: A cross-sectional survey of 251 Maldivian mothers recruited in 2004 from the 'well baby' or 'well child' clinics on the island of Male' and including 75 mothers from three other islands, Hura, Himmafushi and Thulusdhoo.Results: The full breast-feeding rate at hospital discharge was 93% but declined to 41% at 4 months. Any breast-feeding rates were high among Maldivian mothers: 100% at 1 month and 85% were still breast-feeding at 6 months. The median duration of breast-feeding was 24 months.Conclusion: Breast-feeding rates are high and the average duration of breast-feeding is more than 2 years in the Maldives. Health promotion activities should be directed towards maintaining the already high 'any breast-feeding' rates and increasing the proportion of infants exclusively breast-fed to 6 months. [ABSTRACT FROM AUTHOR]

Objective: To investigate the internal validity of a food-frequency questionnaire (FFQ) developed for a case-control study of prostate cancer in southeast China.Design: A comprehensive questionnaire comprising a quantitative FFQ and a short food habit questionnaire (SFHQ) was developed and modified from previous cancer and nutritional studies. The Goldberg formula (ratio of energy intake (EI) to basal metabolic rate (BMR), EI/BMR) was used to assess the validity of the FFQ by making comparisons with physical activity levels. Physical activity levels were measured by the estimated total metabolic equivalents (MET) and the ratio of energy expenditure (EE) to BMR (EE/BMR). Correlation analyses were undertaken to compare the SFHQ variables with those of the quantitative FFQ.Setting: Hangzhou, Zhejiang Province, China.Subjects: A total of 404 men over 45 years old with or without prostate cancer were recruited from eight hospitals.Results: The partial correlation coefficients, controlling for age and family history of prostate cancer, were moderate to high (P<0.05) for preserved foods intake, fat consumption and tea drinking variables between the SFHQ and the quantitative FFQ. The average EI/BMR was 1.72, with 76% of subjects exceeding the Goldberg cut-off value of 1.35. Apart from weight, BMI, EE/BMR and MET, there were no significant differences in characteristics between low (<1.35) and normal EI/BMR groups.Conclusions: The FFQ is demonstrated to be a valid instrument to measure energy and food intake for elderly men in southeast China. [ABSTRACT FROM AUTHOR]

Objective: To investigate the initiation of breast-feeding and exclusive breast-feeding within the first week after delivery for women in rural Vietnam.Design: An interviewer-administered survey was conducted on a sample of rural women who gave birth during August-October 2002.Setting: Quang Xuong District, Thanh Hoa Province of Vietnam.Subjects: Four hundred and sixty-three women participated in the study, of whom 181 delivered at the district hospital (39.1%), 229 at a commune health centre (49.5%) and 53 at home attended by a traditional birth attendant (11.4%).Results: Although the initiation and exclusive breast-feeding rates were relatively high at 98.3% and 83.6% respectively, the premature introduction of complementary food was a great concern. Logistic regression analysis showed that, together with socio-cultural determinants such as feeding preferences of the husband and maternal grandmother, feeding practices of friends, factors relating to delivery methods, delivery locations and health problems could influence the initiation rate and breast-feeding patterns.Conclusions: To promote breast-feeding practices of rural mothers, health education on breast-feeding should take into account local socio-cultural features in addition to improving the counselling skills of health workers. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To report the duration of breastfeeding among a population of Australian women and to identify factors that are associated with the duration of full breastfeeding to 6 months and any breastfeeding to 12 months. METHODS: Participants were 587 women who were recruited from 2 maternity hospitals in Perth and completed a baseline questionnaire just before or shortly after discharge from the hospital. Women were followed up by telephone interview at 4, 10, 16, 22, 32, 40, and 52 weeks postpartum. Data collected included sociodemographic, biomedical, hospital-related, and psychosocial factors associated with the initiation and the duration of breastfeeding. Cox's proportional hazards model was used to identify factors that were associated with the risk for discontinuing full breastfeeding before 6 months and any breastfeeding before 12 months. RESULTS: At 6 months of age, fewer than one half of infants were receiving any breast milk (45.9%), and only 12% were being fully breastfed. By 12 months, only 19.2% of infants were still receiving any breast milk. Breastfeeding duration was independently, positively associated with maternal infant feeding attitudes and negatively associated with breastfeeding difficulties in the first 4 weeks, maternal smoking, introduction of a pacifier, and early return to work. CONCLUSIONS: Relatively few women achieved the international recommendations for duration of full and overall breastfeeding. Women should receive anticipatory guidance while still in the hospital on how to prevent or manage common breastfeeding difficulties and should be discouraged from introducing a pacifier before 10 weeks, if at all. Improved maternity leave provisions and more flexible working conditions may help women to remain at home with their infants longer and/or to combine successfully breastfeeding with employment outside the home. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the relationship between vegetable and fruit consumption and the risk of chronic obstructive pulmonary disease (COPD), a case-control study was conducted in central Japan in 2006. METHODS: A total of 278 referred patients with COPD diagnosed within the past four years and 340 community-based controls undertook spirometric measurements of respiratory function. A structured questionnaire was administered face-to-face to obtain information on demographics, lifestyle and habitual food consumption. RESULTS: The mean vegetable and fruit intakes of cases (155.62 (SD 88.84) and 248.32 (SD 188.17) g/day) were significantly lower (p<0.01) than controls (199.14 (SD 121.41) and 304.09 (SD 253.72) g/day). A substantial reduction in COPD risk was found by increasing daily total vegetable intake, p for trend=0.037. The prevalence of breathlessness also decreased with vegetable consumption, the adjusted odds ratio being 0.49 (95% CI 0.27-0.88) for the highest versus lowest quartile of intake. However, the effects of fruit consumption were not significant. Among the nutrients contained in vegetables and fruits, vitamin A was particularly significant (p=0.008) with an estimated 52% reduction in COPD risk at the highest level of intake. CONCLUSION: The study provided evidence of an inverse association between vegetable consumption and the risk of COPD for Japanese adults.Copyright © 2009 by Elsevier Inc. [ABSTRACT FROM AUTHOR]

This study documented the prevalence and pattern of dietary supplements usage among older adults in Japan. Persons aged 55-75 years residing in middle and southern Japan were recruited and interviewed face-to-face on their use of dietary supplements. Among the 572 (355 male and 217 female) participants from 10 prefectures, 45.8% took supplements on a weekly or daily basis, the prevalence was higher for women (52.5%) than men (41.7%). Many types of miscellaneous supplements were consumed. The most popular supplement was vinegar for both men (11.0%) and women (15.2%), followed by energy drink (8.5%) for men, and multivitamin (8.5%) for men and vitamin C (8.3%) for women. The findings suggested an increasing trend of dietary supplementation by Japanese older adults when compared to previous studies. [ABSTRACT FROM AUTHOR]

Duration of breastfeeding was studied in 556 women delivering at 2 maternity hospitals in Perth, Australia. At discharge 83.8% of women were breastfeeding their infants, including 6% who were giving complementary feeds. At 3 and 6 months, 61.8% and 49.9%, respectively, were still breastfeeding. In a Cox survival analysis of factors associated with duration of breastfeeding a positive association was found with maternal education, age and intended duration of breastfeeding. Male infants were more likely to be weaned before female infants and women whose partners were unemployed, or did not have a preference for breastfeeding, breastfed for shorter duration. There is still a need for programmes which support and encourage breastfeeding, focusing particularly on younger, less well-educated women who intend to breastfeed for less than the recommended 4-6 months. [ABSTRACT FROM AUTHOR]

BACKGROUND: Rates of exclusive breastfeeding in China are relatively low and below national targets. The aim of this study was to document the factors that influence exclusive breastfeeding initiation in Zhejiang, PR China. METHODS: A cohort study of infant feeding practices was undertaken in Zhejiang Province, an eastern coastal region of China. A total of 1520 mothers who delivered in four hospitals located in city, suburb and rural areas during late 2004 to 2005 were enrolled in the study. Multivariate logistic regression analysis was used to explore factors related to exclusive breastfeeding initiation. RESULTS: On discharge from hospital, 50.3% of the mothers were exclusively breastfeeding their infants out of 96.9% of the mothers who had earlier initiated breastfeeding. Exclusive breastfeeding was positively related to vaginal birth, baby's first feed being breast milk, mother living in the suburbs or rural areas, younger age of mother, lower maternal education level and family income. CONCLUSION: The exclusive breastfeeding rate in Zhejiang is only 50.3% on discharge and does not reach Chinese or international targets. A number of behaviours have been identified in the study that could be potentially incorporated into health promotion activities. [ABSTRACT FROM AUTHOR]

Anthropometric assessment is a simple, safe, and cost-efficient method to examine the health status of individuals. The Japanese obesity classification based on the sum of two skin folds (Sigma2SF) was proposed nearly 40 years ago therefore its applicability to Japanese living today is unknown. The current study aimed to determine Sigma2SF cut-off values that correspond to percent body fat (%BF) and BMI values using two datasets from young Japanese adults (233 males and 139 females). Using regression analysis, Sigma2SF and height-corrected Sigma2SF (HtSigma2SF) values that correspond to %BF of 20, 25, and 30% for males and 30, 35, and 40% for females were determined. In addition, cut-off values of both Sigma2SF and HtSigma2SF that correspond to BMI values of 23 kg/m2, 25 kg/m2 and 30 kg/m2 were determined. In comparison with the original Sigma2SF values, the proposed values are smaller by about 10 mm at maximum. The proposed values show an improvement in sensitivity from about 25% to above 90% to identify individuals with >=20% body fat in males and >=30% body fat in females with high specificity of about 95% in both genders. The results indicate that the original Sigma2SF cut-off values to screen obese individuals cannot be applied to young Japanese adults living today and modification is required. Application of the proposed values may assist screening in the clinical setting. [ABSTRACT FROM AUTHOR]

Objective: The Western Australian Health Department's Go for 2&5 campaign aimed to increase adults' awareness of the need to eat more fruit and vegetables and encourage increased consumption of one serving over five years.Design: The multi-strategy fruit and vegetable social marketing campaign, conducted from 2002 to 2005, included mass media advertising (television, radio, press and point-of-sale), public relations events, publications, a website (www.gofor2and5.com), and school and community activities. Campaign development and the evaluation framework were designed using health promotion theory, and assessed values, beliefs, knowledge and behaviour. Two independent telephone surveys evaluated the campaign: the Campaign Tracking Survey interviewed 5032 adults monitoring fruit and vegetable attitudes, beliefs and consumption prior to, during and 12 months after the campaign; and the Health & Wellbeing Surveillance System surveyed 17,993 adults between 2001 and 2006, continuously monitoring consumption.Setting: Population public health intervention-social marketing campaign in Western Australia, population of 2,010,113 in 2005.Subjects: Adults in the Perth metropolitan area.Results: The campaign reached the target audience, increasing awareness of the recommended servings of fruit and vegetables. There was a population net increase of 0.8 in the mean number of servings of fruit and vegetables per day over three years (0.2 for fruit (1.6 in 2002 to 1.8 in 2005) and 0.6 for vegetables (2.6 in 2002 to 3.2 in 2005), significant at P < 0.05).Conclusion: Sustained, well-executed social marketing is effective in improving nutrition knowledge, attitudes and consumption behaviour. The Go for 2&5 campaign provides guidance to future nutrition promotion through social marketing. [ABSTRACT FROM AUTHOR]

Objective: To assess the prevalence of anaemia in rural Vietnam and to determine its risk factors.Design: A cross-sectional survey.Setting: Vietnam, Nghe An Province.Study Population: The total number of participants was 439. Of these participants, one was excluded from the study due to a mental disorder. Forty-seven did not participate in the test for parasites and 68 did not complete at least one of the questions.Results: The prevalence of anaemia (haemoglobin (Hb) <11.0 g dl(-1)) was 43.2% and of severe anaemia (Hb <8.0 g dl(-1)) was 0.5%. Taking iron tablets, the consumption of eggs and the preference for Western medicine significantly and positively correlated with Hb concentration in the pregnant women in a multiple regression analysis. Pregnancy duration and hookworm infestation significantly and negatively correlated with Hb concentration in the pregnant women.Conclusion: The prevalence of anaemia in rural Vietnam has remained as high as that found in the national anaemia survey in 2000. The results of the present study could aid in the development of an iron-deficiency anaemia programme among pregnant women in rural Vietnam that emphasises iron supplementation, parasite control and improved diet, including the consumption of eggs. The programme's focus should be on women who prefer traditional medicine to Western medicine. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to document the infant feeding practices of Chinese-Australian mothers in their home countries and following migration to Australia. The factors that influenced infant feeding practices are also described.Design: A cross-sectional survey.Subjects: A sample of 506 Mandarin-speaking mothers with at least one child, who were born outside of Australia, resident in the Perth area and aged between 23 and 59 years.Setting: Community-based household telephone interviews in Perth, Western Australia.Statistical analysis: Chi square-statistics was used to test the differences in the rates and factors influencing infant feeding practices between mothers' home countries and Australia.Results: There were no significant differences between any breastfeeding rates among Chinese women delivering in either their home countries where breastfeeding initiation was 86.6% or in Australia. Full breastfeeding rates at three and six months for Chinese women were lower than recent Australian rates. Chinese women delivering in Australia received more breastfeeding support and assistance from health professionals. In Australia, 78% stated that they received support form their doctors and nurses for breastfeeding compared with 37.6% in their home countries (P < 0.001). In particular, they were more likely to have put their infant to the breast immediately after birth (47.9%) compared with women delivering in their home countries (4.1%) (P < 0.001). Solid foods were introduced earlier in their home countries.Conclusion: The Chinese-Australian mothers' infant feeding practices in Australia reflected both Western and Eastern influences. The Chinese mothers introduced complementary foods earlier than in other Australian studies, suggesting that culturally specific programs will be needed to encourage exclusive breastfeeding to six months. [ABSTRACT FROM AUTHOR]

Objective: To identify determinants of the initiation and duration of breastfeeding amongst Australian women.Methods: A prospective cohort study of 556 women in Perth, Western Australia and 503 women from the Darling Downs area, Queensland, Australia.Results: Breastfeeding at discharge was most strongly associated with perceived paternal support of breastfeeding with an adjusted odds ratio of 9.13 (95% CI 4.83-17.26), using multivariate logistic regression analysis. Duration of breastfeeding was most strongly associated with the length of time a mother intended to breastfeed with an adjusted relative risk of 4.18 (95% CI 2.81-6.22) for > or = 4 months relative to < 4 months.Conclusions: Interventions which aim to increase the length of time a woman intends to breastfeed, and which highlight the role of the father in successful breastfeeding, are recommended to help achieve recommended targets for breastfeeding initiation and duration. [ABSTRACT FROM AUTHOR]