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BACKGROUND Longitudinal data investigating tracking of children's lifestyle behaviors and predictors of childhood obesity are limited. OBJECTIVES We examined changes in children's lifestyle behaviors (dietary, physical activity, and screen time) from ages 2-5 y to determine if maternal sociodemographic factors and BMI predict child obesity at 3.5 y and 5 y. METHODS Data were obtained from 667 first-time mothers who were recruited into the Healthy Beginnings Trial at 24-34 weeks of gestation in Sydney, Australia. Child lifestyle behaviors were assessed using face-to-face questionnaire interviews with mothers. To measure child and maternal anthropometry, BMI (in kg/m2) was calculated using measured height and weight. Children were categorized as overweight or obese based on the International Obesity Task Force criteria. We used 1-factor repeated-measures ANOVA to track preschoolers' lifestyle behaviors and multiple logistic regression to determine obesity predictors. RESULTS In children aged 2-5 y, consumption of vegetables (ηp2 = 0.06; P

Background The obesity-cataract association has been inconsistently reported. The fat mass and obesity-related (FTO) single-nucleotide polymorphism (SNP) rs9939609 is a major SNP associated with obesity and has been used as an instrumental variable for obesity in a Mendelian randomization (MR) approach. An interaction between the FTO SNP and macronutrient intake for obesity was suggested previously. Objective The aim of this study was to assess the associations between obesity and cataract, using FTO SNP rs9939609 as an instrumental variable in an MR approach, and explore interactions of this SNP with macronutrient intake in relation to risk of cataract in a population-based cohort. Methods The Blue Mountains Eye Study (BMES) is a longitudinal population-based study of common eye disease. Of 3654 baseline participants of the BMES (1992-1994), 2334 (75.8% of survivors) and 1952 (76.7% of survivors) were followed 5 and 10 y later. During the 5-y follow-up, 1174 new participants were examined. Cumulative cataract was defined as the presence of cortical, nuclear, or posterior subcapsular (PSC) cataract at any visit, following the Wisconsin Cataract Grading System. Imputed dosage of the FTO SNP rs9939609 was used. Quintiles of macronutrient intake (carbohydrates, protein, fats) were derived from an FFQ. ORs and 95% CIs were estimated using multivariable-adjusted logistic regression models. Results After multivariable adjustment, there were no associations between BMI and any cataract types in MR models using rs9939609 as an instrumental variable. However, an interaction between rs9939609 and protein intake for PSC cataract risk was suggested (P = 0.03). In analyses stratified by quintiles of protein intake, each minor allele of rs9939609 was associated with increased odds of PSC (OR: 2.14; 95% CI: 1.27, 3.60) in the lowest quintile subgroup only. Conclusions Obesity was not causally associated with age-related cataract. However, among persons in the lowest quintile of protein intake, obesity may be associated with PSC cataract.

Background The majority of research performed to date has examined the effects of commonly known antioxidants such as vitamins C, E, and A and carotenoids on age-related macular degeneration (AMD) risk and progression. To date, there is limited research on promising phytochemicals with antioxidant and anti-inflammatory properties, including flavonoids. Objective In this exploratory study, we aimed to assess the independent associations between dietary intake of total flavonoids and common flavonoid classes with the prevalence and 15-y incidence of AMD. Design In this population-based cohort study, 2856 adults aged ≥49 y at baseline and 2037 followed up 15 y later were included in prevalence and incidence analyses, respectively. Dietary intake was assessed by using a semiquantitative food-frequency questionnaire (FFQ). Estimates of the flavonoid content of foods in the FFQ were assessed by using the USDA Flavonoid, Isoflavone, and Proanthocyanidin databases. AMD was assessed from retinal photographs. Results In cross-sectional analysis, each 1-SD increase in total overall flavonoid intake was associated with a reduced likelihood of any AMD (multivariable-adjusted OR: 0.76; 95% CI: 0.58, 0.99). Each 1-SD increase in dietary intake of total flavonols and total flavanones was associated with reduced odds of the prevalence of any AMD [multivariable-adjusted OR (95% CI): 0.75 (0.58, 0.97) and 0.77 (0.60, 0.99), respectively]. A marginally significant trend (P = 0.05) was observed between increasing the intake of total flavanone and hesperidin (from the first to the fourth quartile) and reduced likelihood of incident late AMD, after multivariable adjustment. Participants who reported ≥1 serving of oranges/d compared with those who never consumed oranges at baseline had a reduced risk of late AMD 15 y later (multivariable-adjusted OR: 0.39; 95% CI: 0.18, 0.85). Conclusions Our findings suggest an independent and protective association between dietary intake of flavonoids and the likelihood of having AMD. Additional prospective cohort studies are needed to validate these findings.

Purpose To assess joint effects of genetic and modifiable factors on the 10-year progression of age-related macular degeneration (AMD). Design Individual and pooled data analyses of 2 population-based cohorts. Participants Blue Mountains Eye Study (BMES) and Rotterdam Study (RS) participants (n = 835). Methods Participants of the BMES and RS were followed up over 10 years or more. At baseline and follow-up visits, interviews using questionnaires and eye examinations with retinal photography were performed. Age-related macular degeneration was assessed by trained photographic graders and verified by retinal specialists. Genetic susceptibility to AMD meant carrying 2 or more risk alleles of the CFH or ARMS2 SNPs, or both (rs1061170 and rs10490924), relative to 0 or 1 risk allele. Discrete logistic regression models were used to investigate the joint associations of genetic susceptibility and either smoking, fish consumption, dietary intake of lutein–zeaxanthin, or combined environmental risk scores from the 3 modifiable factors with the risk of AMD progression. Odds ratios (ORs) with 95% confidence intervals (CIs) and synergy indexes are reported. Main Outcome Measure Ten-year progression of AMD, categorized as any (≥1 step) or 2-step (≥2 steps) progression on the Three Continent AMD Consortium 5-step severity scale. Results Older age, the presence of AMD genetic susceptibility, and baseline AMD status were associated strongly with AMD progression (P Conclusions Among persons with AMD genetic susceptibility and pre-existing early AMD lesions, presenting with high environmental risk scores from 3 modifiable factors (smoking, infrequent consumption of fish, low lutein–zeaxanthin intake) were associated with an increased risk of 2-step progression over 10 years.

Background Observational studies of the Mediterranean diet suggest cognitive benefits, potentially reducing dementia risk. Objective We performed the first published review to our knowledge of randomized controlled trials (RCTs) investigating Mediterranean diet effects on cognition or brain morphology and function, with an additional focus on intervention diet quality and its relation to "traditional" Mediterranean dietary patterns. Design We searched 9 databases from inception (final update December 2017) for RCTs testing a Mediterranean compared with alternate diet for cognitive or brain morphology and function outcomes. Results Analyses were based on 66 cognitive tests and 1 brain function outcome from 5 included studies (n = 1888 participants). The prescribed Mediterranean diets varied considerably between studies, particularly with regards to quantitative food advice. Only 8/66 (12.1%) of individual cognitive outcomes at trial level significantly favored a Mediterranean diet for cognitive performance, with effect sizes (ESs) ranging from small (0.32) to large (1.66), whereas 2 outcomes favored controls. Data limitations precluded a meta-analysis. Of 8 domain composite cognitive scores from 2 studies, the 3 (Memory, Frontal, and Global function) from PREDIMED (PREvencion con DIeta MEDiterranea) were significant, with ESs ranging from 0.39 to 1.29. A posttest comparison at a second PREDIMED site found that the Mediterranean diet modulates the effect of several genotypes associated with dementia risk for some cognitive outcomes, with mixed results. Finally, the risk of low-plasma brain-derived neurotrophic factor was reduced by 78% (OR = 0.22; 95% CI: 0.05, 0.90) in those who consumed a Mediterranean diet compared to control diet at 3 y in this trial. There was no benefit of the Mediterranean diet for incident cognitive impairment or dementia. Conclusions Five RCTs of the Mediterranean diet and cognition have been published to date. The data are mostly nonsignificant, with small ESs. However, the significant improvements in cognitive domain composites in the most robustly designed study warrant additional research.

We aimed to produce an updated Australian glycaemic index (GI) database based on a systematic method. GI values were assigned to the 3871 unique foods in an Australian food composition database. Following the method, 1124 (29%) foods had less than 2.5 g of available carbohydrates per 100 g and were assigned a GI of 0, and 416 (11%) foods had a direct match in one of the three data tables used. The GI value of a ‘closely related’ food was assigned to 1793 (46%) foods; 135 foods (3%) had their GI values calculated using the weighted average GI method; 391 (10%) foods were assigned the median GI of their corresponding food subgroup, and 12 (

Background and aims The relationship between dairy food consumption and dietary calcium intake, and vascular risk factors during adolescence remains unclear. We aimed to prospectively assess whether dairy food consumption (milk, cheese, yoghurt) is associated with blood pressure (BP) and retinal microvascular signs among adolescents. Methods and results As many as 2353 and 1216 participants aged 12 and 17, respectively, were examined. Longitudinal analyses involved 888 subjects with complete baseline and follow-up data. Dairy consumption was assessed from validated semi-quantitative food frequency questionnaires. BP information was collected and retinal vessel caliber was quantified from digital photographs using computer software. In girls, after multivariable adjustment, each serve/day increase in total dairy intake was concurrently associated with 1.04 ( p = 0.03) and 1.10 mm Hg ( p = 0.02) decreases in mean diastolic and arterial BP, respectively. Also in girls, each serve/day increase in cheese intake over 5 years was concurrently related to 7.18 ( p = 0.001), 5.28 ( p = 0.002) and 5.79 mm Hg ( p = 0.001) decrease in mean systolic, diastolic and arterial BP, respectively. Among girls, each 100 mg/day increase in dietary calcium intake was associated with a concurrent 0.5 ( p = 0.01) and 0.3 mm Hg ( p = 0.02) decrease in mean systolic and arterial BP, respectively. Cross-sectionally, adolescents in the highest versus lowest tertile of yoghurt intake had ∼1.3 μm wider retinal arterioles ( p = 0.05) and ∼2.0 μm narrower venules ( p = 0.04). Conclusions Consumption of dairy products, particularly cheese, could have a beneficial effect on BP, particularly among girls.

Background and aims: Higher consumption of dairy products and calcium is likely to play a role in maintaining optimal vascular health. In this study, we aimed to explore the as- sociations between consumption of total-, regular- and low-fat dairy foods, and total calcium intake with retinal vascular caliber. Methods and results: 2813 Blue Mountains Eye Study participants aged 50þ years had dietary data collected using a semi-quantitative food frequency questionnaire, and serves of dairy consumption were calculated. Fundus photographs were taken and retinal vascular caliber measured using computer-assisted techniques and summarized. After adjusting for age, sex, body mass index, smoking, mean arterial blood pressure, serum glucose, white cell count, his- tory of diagnosed hypertension, stroke and coronary heart disease, plus retinal arteriolar caliber, participants in the lowest quintile of total dairy consumption compared to those in the remaining highest 4 quintiles had significantly wider retinal venular caliber, 227.2 versus 224.7 mm, respectively (multivariable-adjusted p Z 0.002). Also, subjects in the lowest quin- tile of low-fat dairy product consumption versus those in the remaining quintiles of low-fat dairy intake had wider retinal venules (w1.7 mm, p Z 0.03) and narrower retinal arterioles (w1.4 mm, p Z 0.04). Participants in the lowest quintile versus highest quintile of total dietary calcium intake had w2.3 mm wider retinal venules (multivariable-adjusted p-trend Z 0.02). Conclusions: A significant association was observed between lower intake of dairy products or calcium and adverse retinal vascular signs. We cannot discount the possibility of confounding from unmeasured risk factors; hence, further studies are warranted to confirm these findings. a 2013 Published by Elsevier B.V.

Background Nutritional parameters could influence self-perceived health and functional status of older adults. Objective We prospectively determined the association between diet quality and quality of life and activities of daily living. Design This was an observational cohort study in which total diet scores, reflecting adherence to dietary guidelines, were determined. Dietary intakes were assessed using a food frequency questionnaire at baseline. Total diet scores were allocated for intake of selected food groups and nutrients for each participant as described in the Australian Guide to Healthy Eating. Higher scores indicated closer adherence to dietary guidelines. Participants/setting In Sydney, Australia, 1,305 and 895 participants (aged ≥55 years) with complete data were examined over 5 and 10 years, respectively. Main outcome variables The 36-Item Short-Form Survey assesses quality of life and has eight subscales representing dimensions of health and well-being; higher scores reflect better quality of life. Functional status was determined once at the 10-year follow-up by the Older Americans Resources and Services activities of daily living scale. This scale has 14 items: seven items assess basic activities of daily living (eg, eating and walking) and seven items assess instrumental activities of daily living (eg, shopping or housework). Statistical analyses performed Normalized 36-Item Short-Form Survey component scores were used in analysis of covariance to calculate multivariable adjusted mean scores. Logistic regression analysis was used to calculate adjusted odds ratios and 95% CIs to demonstrate the association between total diet score with the 5-year incidence of impaired activities of daily living. Results Participants in the highest vs lowest quartile of baseline total diet scores had adjusted mean scores 5.6, 4.0, 5.3, and 2.6 units higher in these 36-Item Short-Form Survey domains 5 years later: physical function ( P trend =0.003), general health ( P trend =0.02), vitality ( P trend =0.001), and physical composite score ( P trend =0.003), respectively. Participants in the highest vs lowest quartile of baseline total diet scores had 50% reduced risk of impaired instrumental activites of daily living at follow-up (multivariable-adjusted P trend =0.03). Conclusions Higher diet quality was prospectively associated with better quality of life and functional ability.

Parenting style may have a role in the development of young children's dietary behaviour, and a better understanding of parenting style may lead to better-targeted childhood obesity prevention interventions. This study aimed to investigate the association of parental self-efficacy, parenting style and dietary behaviour of young children. A cross-sectional study with 242 first-time mothers and their children was conducted using the data from the Healthy Beginnings Trial undertaken in one of the most socially and economically disadvantaged areas of south-western Sydney, in 2007-2010. Parental self-efficacy, parenting style (warmth and hostility) and children's dietary behaviours (consumption of vegetables, fruit, soft-drink and snacks) were assessed by face-to-face interviews with participating mothers in the control group when their children were 2 years old. Logistic regression analysis was conducted to exam- ine the association between parenting style and the child's dietary behaviour. Mothers with higher levels of global parental self-efficacy and self-efficacy for an infant were more likely to report their children had 2 serves of vegetables per day, with odds ratio (OR) 2.40 (95%CI 1.35-4.27, P = 0.003) and OR 1.88 (95%CI 1.06-3.36, P = 0.03), respectively. A higher level of global parental self-efficacy or self-efficacy for an infant was significantly associated with having 2 serves of fruit per day with adjusted odds ratio (AOR) 2.46 (95%CI 1.35-4.48, P = 0.003) and AOR 1.85 (95%CI 1.00-3.41, P = 0.048), respectively, after adjusting for annual household income. Mothers with a higher level of parental warmth were more likely to report their children had 2 serves of vegetable per day with OR 1.85 (95%CI 1.06-3.25, P = 0.03). Parental self- efficacy and parenting style were associated, cross-sectionally, with important children's dietary behav- iours. Interventions which target parental self-efficacy and parenting style may improve eating habits of young children, and contribute to childhood obesity prevention.

Background: Epidemiologic evidence of a relation between serum total homocysteine (tHcy), vitamin B-12, and folate and age-related macular degeneration (AMD) is inconsistent and unresolved. Objective: In this cohort study, we aimed to investigate associations between intakes and serum concentrations of folate and vitamin B-12 or serum tHcy and 10-y AMD incidence. Design: Serum folate, vitamin B-12, and tHcy were determined from blood samples drawn in 1997–1999 from cohort members aged $55 y. AMD was assessed in 1760 survivors from retinal photographs taken in 2002–2004 and 2007–2009. Total intakes of folate and vitamin B-12 were assessed by using a food-frequency questionnaire. Results: After adjustment for age, sex, current smoking, white blood cell count, and fish consumption, each 1-SD increase in serum tHcy was associated with increased risk of incident early and any AMD [ORs (95% CIs): 1.33 (1.09, 1.63) and 1.33 (1.11, 1.60), respectively]. Participants with a serum vitamin B-12 deficiency (,185 pmol/L) had higher risk of incident early and late AMD [ORs (95% CIs): 1.58 (1.06, 2.36) and 2.56 (1.38, 4.73), respectively]. Folate deficiency (,11 nmol/L) was associated with 75% and 89% increased risk of incident early and any AMD, respectively, 10 y later. Participants who reported supplementary vitamin B-12 intake had 47% reduced risk of incident any AMD (OR: 0.53; 95% CI: 0.33, 0.85). Conclusion: Elevated serum tHcy and folate and vitamin B-12 deficiencies predicted increased risk of incident AMD, which suggests a potential role for vitamin B-12 and folate in reducing AMD risk. Am J Clin Nutr 2013;98:129–35.

Background: Higher intake of carbohydrates and high–glycemic index (high-GI) diets could lead to small vessel dysfunction. Objectives: We aimed to assess the associations between intakes of high-GI and high–glycemic load (high-GL) diets, carbohydrate, and the main carbohydrate-containing food groups and retinal microvascular changes in preadolescents. Design: Students aged 12 y (n = 2353) from a random cluster sample of 21 schools underwent detailed eye examinations. Retinal vessel caliber and fractal dimension were measured from digital retinal images. A validated semiquantitative food-frequency questionnaire was administered. Results: After multivariable adjustment, children who consumed soft drinks once or more per day had significantly narrower mean retinal arterioles (;1.9 lm) than did those who never or rarely consumed soft drinks (P-trend = 0.03). When the highest to lowest tertiles of carbohydrate consumption were compared, girls had significantly narrower retinal arterioles (;1.4 lm; P-trend = 0.03), and boys had wider venules (;2.3 lm; P-trend = 0.02). In girls only, a higher-GI diet was associated with narrower retinal arterioles (0.98-lm narrowing of retinal arteriolar caliber per SD increase in GI, P = 0.01). Carbohydrate intake and a high-GL diet were associated with greater retinal fractal dimension in girls (highest compared with lowest tertiles: P-trend = 0.003 and 0.01, respectively). Conclusions: Greater consumption of carbohydrates and soft drinks was associated with retinal arteriolar narrowing and venular widening. Because these microvascular signs have been shown to be markers of future cardiovascular disease risk, the presence of this risk factor in children could support the need for healthy dietary patterns that include lower consumption of high-GI foods and soft drinks. Am J Clin Nutr 2012;95:1215–22.

Reliable and valid measures of local food environments are needed to more fully understand the relationship between these environments and health and identify potential intervention points to improve access to, and the availability of, healthy foods. These measures also inform policy making, including the zoning of food outlets and food labelling/information requirements. A literature review was undertaken using health, behavioural and social sciences, nutrition and public health databases and grey literature, to determine available information on the measurement of local food environments. Included articles were those measuring aspects of food environments published from 2000 to 2010. A range of tools and methods are available to measure different components of food environments. Those focusing on community nutrition environments record the number, type and location of food outlets. The tools that focus on the consumer nutrition environment incorporate other factors, such as available food and beverage products, their price and quality, and any promotions or information to prompt consumers to make purchasing decisions. A summary and critique of these measures are provided.

Background: n–3 (omega-3) Polyunsaturated fatty acids (PUFAs), fish, and nuts can regulate inflammatory processes and responses. Objective: We investigated whether dietary intakes of PUFAs [n23, n–6 (omega-6), and a-linolenic acid], fish, and nuts were associated with 15-y mortality attributed to noncardiovascular, noncancer inflammatory diseases. Design: The analyses involved 2514 participants aged 49 y at baseline. Dietary data were collected by using a semiquantitative food-frequency questionnaire, and PUFA, fish, and nut intakes were calculated. Inflammatory disease mortality was confirmed from the Australian National Death Index. Results: Over 15 y, 214 subjects died of inflammatory diseases. Women in the highest tertiles of total n23 PUFA intake, compared with those in the lowest tertile of intake at baseline, had a 44% reduced risk of inflammatory disease mortality (P for trend = 0.03). This association was not observed in men. In both men and women, each 1-SD increase in energy-adjusted intake of a-linolenic acid was inversely associated with inflammatory mortality (hazard ratio: 0.83; 95% CI: 0.71, 0.98). Subjects in the second and third tertiles of nut consumption had a 51% and 32% reduced risk of inflammatory disease mortality, respectively, compared with those in the first tertile (reference). Dietary intakes of long-chain n23 and n26 PUFAs and fish were not associated with inflammatory disease mortality. Conclusions: We report on a novel link between dietary intake of total n23 PUFA and risk of inflammatory disease mortality in older women. Furthermore, our data indicate a protective role of nuts, but not fish, against inflammatory disease mortality. Am J Clin Nutr doi: 10.3945/ajcn.110.009977.

It has been shown that dietary glycemic index (GI) and fiber could have a role in the development of chronic diseases; however, the link between carbohydrate nutrition and development of chronic kidney disease (CKD) is unclear. We aimed to determine whether cross-sectional and longitudinal associations exist between carbohydrate nutrition (mean dietary GI, dietary intakes of carbohydrate, sugar, starch, and fiber) and CKD. Data included 2600 Blue Mountains Eye Study (1997-1999) participants aged ≥50 y. Baseline biochemistry including serum creatinine was measured. Moderate CKD was defined as estimated glomerular filtration rate (eGFR) < 60 mL·min(-1)·1.73 m(-2). Dietary data were collected in a semiquantitative FFQ. Cross-sectionally, participants in the 4th quartile of mean dietary GI intake compared with those in the first quartile (reference) had a 55% increased likelihood of having eGFR < 60 mL·min(-1)·1.73 m(-2) [multivariable-adjusted OR = 1.55 (95% CI = 1.07-2.26); P-trend = 0.01]. After multivariable adjustment, participants in the 4th quartile of dietary cereal fiber intake compared with those in the first quartile (reference) had a 50% reduced risk of incident moderate CKD (P-trend = 0.03). Higher baseline consumption of energy-dense, nutrient-poor sources of carbohydrate (e.g. cookies) yielded a 3-fold higher risk of incident CKD (P-trend = 0.01). In summary, we observed a novel link between high cereal fiber intake and reduced incidence of moderate CKD and this was supported by the cross-sectional association with dietary GI. Conversely, our data suggest that higher intake of energy-dense, nutrient-poor sources of carbohydrate, potentially through acute hyperglycemia, could impair renal function.

Folate, vitamin B(12), iron, and zinc are particularly important nutrients for women of childbearing age. We tested the hypothesis that an electronic, 235-item, semiquantitative food frequency questionnaire (FFQ) is a valid measure of dietary intake when compared with repeat dietary 24-hour recalls. Biomarkers of folate, vitamin B(12), iron, and zinc were determined because their measurement errors are unrelated to errors in dietary questionnaires. Female adults (N = 256) aged 18 to 35 years completed the FFQ, and a representative subset (n = 53) completed repeat dietary 24-hour recalls. The FFQ estimates (mean ± SD) were 315 ± 132 μg for folate, 3.1 ± 2.1 μg for vitamin B(12), 15.4 ± 5.6 mg for iron, and 15.1 ± 6.4 mg for zinc. The percentage of women classified within the same ±1 quartile for energy intake by the 2 methods was 77.3%. There was moderate agreement between the 2 dietary methods, and no systematic bias was noted for energy, folate, vitamin B(12), and zinc. The deattenuated energy-adjusted correlation coefficients ranged from 0.41 (dietary folate equivalents) to 0.60 (folate). Significant correlations between biomarker and nutrient intakes were found for folate (r = 0.37, P.01) and vitamin B(12) (r = 0.27, P.01). The electronic FFQ developed in the present study is a relatively valid tool that was able to adequately assess and rank individuals according to their nutrient intakes.

Summary Objective To examine the consumption patterns of energy-dense, nutrient-poor ‘extra' foods among Australian children and to determine any changes in consumption since the 1995 National Nutrition Survey (1995 NNS). Methods ‘Extra' food consumption was analysed by age group and gender using 24-h recall data from the 2007 Australian National Children's Nutrition and Physical Activity Survey (2007 Survey; n =4380) and the 1995 NNS ( n =2435). Differences in percent consuming, amounts consumed and percent energy contribution were assessed. Results ‘Extra' foods contributed 35% to daily energy intake in the 2007 survey, ranging from 24% in the 2–3 year olds to 38% in the 9–13 and 14–16 year olds. The foods contributing most to energy intake included ‘fried potatoes' (2.9%), ‘cakes, muffins, slices' (2.9%) and ‘potato crisps and similar snacks' (2.6%). Compared to the 1995 NNS, total energy intake was significantly lower in the 2007 Survey (8621kJ in 1995 versus 8330kJ in 2007), as was the consumption of ‘extra' foods (both in terms of weight and energy) (3645kJ in 1995 versus 3049kJ in 2007). All age groups reported a decline in energy intake from ‘extra' foods of approximately 600kJ. Conclusion The overall consumption of ‘extra' foods seems to have decreased from 1995 to 2007. However, ‘extra' foods continue to be over-consumed by Australian children and continuous monitoring of ‘extra' foods consumption is highly warranted.

Background: Identification of modifiable risk factors that could prevent or slow the development of age-related hearing loss (presbycusis) would be valuable. Dietary polyunsaturated fatty acid (PUFA) intake may be related to age-related hearing loss. Objective: We aimed to determine the association between dietary intakes of omega-3 (n23) PUFAs and fish and the risk of presbycusis. Design: The Blue Mountains Hearing Study is a population-based survey of age-related hearing loss (1997‐1999 to 2002‐2004). We collected dietary data by using a semiquantitative food-frequency questionnaire and calculated PUFA and fish intakes. In 2956 participants (aged 50 y), we measured presbycusis, which we defined as the pure-tone average of frequencies 0.5, 1.0, 2.0, and 4.0 kHz .25 decibels of hearing loss. Results: There was an inverse association between total n23 PUFA intake and prevalent hearing loss [odds ratio (OR) per SD increase in energy-adjusted n23 PUFAs: 0.89; 95% CI: 0.81, 0.99]. There was an inverse association between long-chain n23 PUFAs and incident hearing loss (OR per SD increase in long-chain n23 PUFAs: 0.76; 95% CI: 0.60, 0.97). Participants who had 2 servings of fish/wk compared with participants who had ,1 serving of fish/wk had a significantly reduced risk (42%) of developing presbycusis at follow-up (multivariate-adjusted OR: 0.58; 95% CI: 0.35, 0.95). There was an association between consumption of 1t o,2 servings/wk of fish and a reduced risk of a progression of hearing loss (OR: 0.53; 95% CI: 0.32, 0.88). Conclusions: There was an inverse association between higher intakes of long-chain n23 PUFAs and regular weekly consumption of fish and hearing loss. Dietary intervention with n23 PUFAs could prevent or delay the development of age-related hearing loss. Am J Clin Nutr doi: 10.3945/ajcn.2010.29370.

Objective: The aim of this study was to model children’s potential exposure to television food advertisements under different regulatory scenarios to demonstrate the policy implications of regulatory change in Australia. Methods: Television advertising data was collected from Sydney commercial television channels from 14-20 May 2006. Extrapolating from these data, the patterns of food advertising under four regulatory scenarios were examined, including arrangements restricting the content, volume and timing of advertisements. Results: Each scenario resulted in a reduction of total and non-core food advertisements. The scenario to restrict non-core food advertisements during the major viewing period (7:00-20:30) led to the largest reduction in total and non-core food advertisements (79.2% reduction), with no change in the frequency of core food advertisements. Conclusions: The results illustrate the potential for reducing children’s exposure to food advertising through simple regulatory restrictions. Implications: This research contributes to future debates on the regulation of television food advertising. It is particularly relevant as Australian regulations will be under review in 2007.

Objective To investigate associations between dietary intake, including modest supplement intake, of antioxidant vitamins and zinc at baseline and the 5-year incidence of early age-related maculopathy (ARM). Design Population-based cohort study. Participants From 1992 through 1994, 3654 persons aged 49 years or more (82% of those eligible) living in two postcode areas west of Sydney, Australia, were examined for the Blue Mountains Eye Study baseline. Five years later, 2335 persons (75% of known survivors) were reexamined. Methods A 145-item Food Frequency Questionnaire (FFQ) was used to assess nutrient intakes. Of the 2335 people who attended a follow-up visit, 1989 (85%) had completed a FFQ at baseline. The nutrients examined in this study included: α-carotene, β-carotene, β-cryptoxanthin, lutein and zeaxanthin, lycopene, retinol, vitamin A, vitamin C, and zinc. Main outcome measures Early ARM was assessed by masked grading of stereo retinal photographs. Definitions for incidence closely followed those used in the Beaver Dam Eye Study. Results Early ARM developed in 192 persons (8.7% 5-year incidence) who did not have either late or early ARM at baseline. Of these, 159 persons completed the FFQ at baseline. After adjusting for age, gender, family history of ARM, and smoking status at baseline, no associations, or any trends suggesting possible association, were found between baseline intake of the nutrients examined, apart from vitamin C, and the 5-year incidence of early ARM. Compared with the lowest quintile, increasing baseline intakes of vitamin C, from diet and supplements, was associated with an increased risk of incident early ARM (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.0–3.0; and OR, 2.3; 95% CI, 1.3–4.0 for the fourth and fifth quintiles, respectively). Conclusions Our cohort study of an older population could not find evidence of protection associated with usual dietary antioxidant or zinc intakes (including use of supplements) on the 5-year incidence of early ARM.

PURPOSE: To investigate relationships between use of vitamin supplements and the three principal cataract types in a population-based sample. METHODS: We studied 2873 of the 3654 participants (79%) aged 49 to 97 years attending the cross-sectional Blue Mountains Eye Study who completed a detailed food frequency questionnaire, which included type, dose, and duration of vitamin supplement use. Masked grading of nuclear, cortical, and posterior subcapsular opacities from lens photographs was performed, using the Wisconsin method. RESULTS: Use of multivitamin supplements was associated with reduced prevalence of nuclear cataract, odds ratio 0.6, 95% confidence interval 0.4 to 1.0, P = .05. For both nuclear and cortical cataract, longer duration of multivitamin use was associated with reduced cataract prevalence (nuclear cataract, trend P = .02; cortical cataract, trend P = .03). Use of thiamin supplements was associated with reduced prevalence of nuclear (odds ratio 0.6, confidence interval 0.4 to 1.0, P = .03, dose trend P = .03) and cortical cataract (odds ratio 0.7, confidence interval 0.5 to 0.9, P = .01, dose trend P = .02). Riboflavin (odds ratio 0.8, confidence interval 0.6 to 1.0, P = .05) and niacin (odds ratio 0.7, confidence interval 0.6 to 1.0, P = .04) supplements exerted a weaker protective influence on cortical cataract. Vitamin A supplements were protective against nuclear cataract (odds ratio 0.4, confidence interval 0.2 to 0.8, P = .01, dose trend P = .01). Folate (odds ratio 0.4, confidence interval 0.2 to 0.9, P = .03) appeared protective for nuclear cataract, whereas both folate (odds ratio 0.6, confidence interval 0.3 to 0.9, P = .01, dose trend P = .04) and vitamin B12 supplements (odds ratio 0.7, confidence interval 0.5 to 1.0, P = .03, dose trend P = .02) were strongly protective against cortical cataract. CONCLUSIONS: Long-term use of multivitamins, B group and vitamin A supplements was associated with reduced prevalence of either nuclear or cortical cataract. A strong protective influence on cortical cataract, from use of folate or vitamin B12 supplements, is a new finding.

Overweight and obesity represents a significant health issue, with 50% of women entering pregnancy with a body mass index > 25 kg/m2. Obesity is associated with a well-documented increase in risk of complications during pregnancy and childbirth, for both women and their infants. Increasingly, events that occur during pregnancy are recognised to have a critical impact on an individual’s subsequent health and risk of disease, including obesity. This presentation will focus on in-utero factors associated with risk of subsequent obesity, and consider the available evidence for preventive strategies targeting this early-life period.

Purpose To investigate the relationships between dietary macronutrient intake at baseline and the five-year incidence of the three main types of cataract in older people. Design Population-based cohort study. Methods settings: An urban community near Sydney, Australia. study population: The Blue Mountains Eye Study (BMES) examined 3,654 predominantly Caucasian participants aged 49+ years during 1992 to 1994, and then 2,335 survivors (71.5%) after five years. Of these 2,335 subjects, 1988 (85%) completed a Willett-derived food frequency questionnaire (FFQ) at baseline. observation procedures: A 145-item FFQ was used to assess nutrient intakes and lens photography was used to assess the presence of cataract at both time points. main outcome measures: Incidence of cortical, nuclear, and posterior subcapsular (PSC) cataract was assessed via lens photographic grading following the Wisconsin cataract grading method. Results After adjusting for multiple known cataract risk factors, higher dietary intakes of omega-3 polyunsaturated fatty acids (n-3 PUFA) were associated with a reduced incidence of nuclear cataract. The odds ratio (OR) for subjects in the highest quintile of intake compared to those in the lowest quintile was 0.58 (95% confidence interval [CI] 0.35 to 0.97), Ptrend = .027. Similarly, for PSC cataract, higher dietary intakes of protein were protective (OR 0.28; 95% CI 0.10 to 0.76), Ptrend = .015. Dietary macronutrient intake was not associated with incident cortical cataract. Conclusions Higher dietary intakes of n-3 PUFA may decrease the five-year risk of nuclear cataract, whereas higher dietary intakes of protein may decrease risk for PSC cataract.

There has been much recent debate about how to combat Australia’s childhood obesity epidemic and, in particular, considerable controversy about regulations relating to food advertising to children on television. Three separate research studies on food advertising in Australia, conducted in 2002,1 20052 and 2006,3 including those by the authors, describe the frequency and proportion of television advertisements for fruit and vegetables, as well as for high-fat/high-sugar foods.