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An investigation was carried out to determine whether there were significant changes in nutrient intake over 17 years of adult life. The Medical Research Council National Survey of Health and Development is a longitudinal study of a nationally representative cohort of singleton births in the UK in 1946. Of this cohort, 1253 survey members provided information on diet recorded in a 5 d diary at age 36 years in 1982, 43 years in 1989 and 53 years in 1999. The outcome measures were mean intakes of energy, macronutrients, minerals and vitamins. There were significant changes in the intake of most nutrients in 1999 compared with previous years. Intakes of fat, Na, Fe and Cu have fallen, but there was a rising trend in the intakes of Ca, P, carotene, thiamin, pyridoxine, folic acid and vitamins C, D and E in both men and women. Additionally, intakes of K, Mg and vitamin K1 have risen in women. There were significant gender differences, women showing a higher percentage rise in the intakes of carotene, riboflavin, folic acid, vitamin C and vitamin E. These changes were related to changes in the consumption of certain key foods, such as the increased consumption of fruit and vegetables and a shift away from whole milk, butter and red meat. Most of these trends are in line with accepted nutritional guidelines. How far these changes are due to consumer choice and real changes in food composition or are due to artefacts inherent in the methodology is discussed.

Objective: To evaluate whether there was food and nutrient equality across occupational social classes and geographical region for members of the 1946 British birth cohort at age 4 years., Design: Cross-sectional analysis of selected food groups, energy and nutrients from one-day recall diet records., Setting: England, Scotland and Wales in 1950., Subjects: Nationally representative sample of 4419 children aged 4 years in 1950 from the MRC National Survey of Health and Development (NSHD) (1946 Birth Cohort)., Results: Significant food and nutrient inequalities occurred by region and occupational social class of the father. Disparity in fruit and vegetable consumption primarily led to the nutrient differences, especially with respect to lower vitamin C and carotene intakes in children from Scotland and from a manual social class background. Lower energy intake in Scottish children was attributable to inequality in the consumption of foods providing fat, and also to the retention of the traditional Scottish diet that included porridge and soups. Consumption of some rationed foods -- bacon, orange juice and tea -- was inequitably distributed by father's social class, but others, in particular meat and spreading fats, were consumed more uniformly. In contrast to fruits and vegetables, which showed marked sociodemographic disparities, other non-rationed foods such as bread and potatoes were consumed universally., Conclusion: Local cultural norms may have played as strong a part in sociodemographic differences in the diet of children in the early 1950s as did the strict, post-war food rationing that prevailed. In consequence, nutritional equality was not achieved, and the relatively low intake of antioxidant vitamins during early childhood in certain population groups may have compromised health in the long term.

The Ca and P intakes of 148 pregnant and lactating women in a rural village in The Gambia, West Africa, have been estimated by direct weighing of food on a total of 4188 d. The Ca and P contents of local foods were determined by analysis of raw ingredients, snack foods and prepared dishes. Information about the contribution of mineral-rich seasonings was obtained. Efforts were made to discover unusual sources of Ca that might not be perceived as food by subject or observer. The main contributors to daily Ca intake were shown to be leaves, fish, cereals, groundnuts and local salt. Cow's milk accounted for only 5% of Ca intake. Unusual sources of Ca were discovered, namely baobab (Adansonia digitata) fruit and selected earths, but these were consumed infrequently and their contributions to Ca intakes were small. Cereals and groundnuts were the main sources of P. Ca and P intakes (mg/d) were shown to average 404 (SD 110) and 887 (SD 219) respectively. Seasonal changes in the availability of leaves, cereals and groundnuts resulted in variations in Ca and P intakes. The rainy season was associated with increased Ca intakes (by 16%) but decreased P consumption (by 15%). No difference was observed in Ca intake between pregnant and lactating women but P intake in lactation was 11% higher than that in pregnancy during the post-harvest season. The implications of these low Ca intakes require investigation.

In order to test whether lactational capacity can be improved by dietary interventions, a nutritionally balanced supplement was provided under carefully controlled conditions to 130 nursing mothers in Keneba, The Gambia over 12 months. Maternal mean energy intake (+/- s.e.) increased from 1568 +/- 15 kcal/d (6.56 +/- 0.06 MJ/d) to 2291 +/- 14 kcal/d (9.59 +/- 0.06 MJ/d). Protein intake was in excess of the WHO/FAO recommended intake after supplementation and serious deficits of riboflavin, vitamin A, vitamin C and calcium were rectified. The supplement had no effect on breast-milk volume, compared with retrospective controls, at any stage of lactation or in any season of the year. There was no selective effect on women with poor milk outputs. The average milk protein concentration was slightly improved over the entire period of lactation (+ 6.6 per cent, P less than 0.01), but the total energy content was unchanged since an increase in breast-milk fat concentration (+ 7.9 per cent, n.s.) was offset by a decrease in the milk lactose concentration (- 7.6 per cent, P less than 0.01). Breast milk vitamin content was improved for those vitamins for which the supplement provided a significant proportion of the recommended dietary intake.

The energy intake of 143 pregnant and lactating Gambian women was measured prospectively each week for a year. Anthropometric, birth weight, and breast milk output measurements were also obtained. The average energy intakes (+/- SE) during the dry and wet seasons respectively were: pregnancy, 1483 +/- 22 and 1417 +/- 41 kcal/day; lactation (1st trimester), 1773 +/- 31 and 1474 +/- 42 kcal/day; lactation (subsequent trimesters), 1662 +/- 16 and 1413 +/- 37 kcal/day. Pregnant women gained 1.4 kg body weight per month in the dry season, but only 0.4 kg in the wet season. Lactating women gained weight in the dry season and lost weight in the wet season. Maternal nutritional status did not deteriorate with increasing parity. Mean birth weights (+/- SE) were: 2.94 +/- 0.07 and 2.78 +/- 0.11 kg in dry and wet seasons, respectively. Breast milk output and quality and early infant growth were close to values from well-nourished communities during the dry season, but deteriorated markedly during the wet season. Wet season energy intakes were clearly inadequate, but these results indicate that, despite being low by international standards, the dry season intake was compatible with a good lactational performance. Except for a somewhat low birth weight, which is partly explained by small maternal stature, progress during pregnancy was also remarkably normal during the dry season.

An examination of published reports of measured energy intakes of infants and young children reveals that during the first year of life the pattern of change in food energy intake differs fundamentally from the WHO/FAO (1973) Recommendations. In contrast to the progressive linear decline in intake per kg body weight that has previously been assumed, measured intakes are not only substantially lower, but fall much more rapidly up to six months. In even greater contrast, they then rise again, to coincide with the recommendations, reaching a peak at around two years. These findings enable a more realistic assessment to be made of the adequacy of breast milk as the sole source of food in the early months of life.

1. Long-term clinical and biochemical riboflavin status and dietary intake of riboflavin were monitored for 18 months in a group of twenty-three relatively-healthy elderly subjects living at home in the north of England. 2. Both dietary intake and biochemical status, as measured by the activation coefficient (stimulated:basal activity) of NAD(P)H2:glutathione oxidoreductase (EC 1.6.4.2), remained fairly constant for each individual and for most subjects the usual intake and biochemical status were characterized quite accurately by a single week's intake dietary record and a single measurement of the activation coefficient. 3. The expected relationship between biochemical status and dietary intake was present, but not strongly evident. There was a significant within-subject correlation between alpha values and the immediately preceding dietary intake; however the between-subject correlation between alpha values and dietary intake approached zero if the two subjects receiving long-term riboflavin supplements were omitted. Over the limited range of intakes observed in unsupplemented subjects, non-dietary factors evidently obscure the relationship. 4. Although eight subjects had average values above 1.2 for the activation coefficient, no excessively high values were observed, and no subject showed any clear-cut clinical deficiency symptoms.

Riboflavin status by the erythrocyte glutathione reductase (NAD(P)H2:glutathione oxidoreductase EC1.6.4.2) test, and dietary riboflavin intake, were measured in 156 pregnant and lactating women in Keneba, a rural Gambian village, and in 59 pregnant and lactating women in Cambridge, England. The Keneba women were studied longitudinally, for up to 19 months. In Keneba, where the mean daily riboflavin intake was 0.5 mg, the mean erythrocyte glutathione reductase activation coefficient was 1.78 and there was a marked deterioration of biochemical status near parturition. In Cambridge, where the mean intake was 2.3 mg/day, the mean activation coefficient was 1.19. A vitamin fortified diet supplement, given to lactating women in Keneba for 8 months, raised their mean riboflavin intake for 0.5 to 1.5 mg/day and reduced the mean activation coefficient to 1.42. It is therefore likely that an intake even greater than the current United Kingdom or United States recommended daily amounts would be needed to achieve biochemical 'normality' in these women.

In a dietary study of 112 Cambridge families, 191 primary and secondary school children kept 7-day records of measured food consumption. Of 955 weekday lunches recorded, 533 (56 per cent) were school dinners. School dinners provided less than one quarter of the recommended daily amount (RDA) for energy, iron and riboflavin, and less than one third of the RDA for protein, calcium, thiamin and ascorbic acid. School dinners provided a smaller proportion of a day's nutrient intake than did other mid-day meals. Total energy intakes were lower on school-dinner days than on other week-days. Children from lower income families had larger school dinners and obtained a larger proportion of their daily nutrient intake from school dinners than did children from higher income families. School dinners played their most important nutritional role in the lower income families.

In winter the vitamin D state of elderly people may reach levels associated with osteomalacia, although the disease may not be clinically apparent. A statistical correlation was observed in a group of elderly subjects during the winter between dietary vitamin D intake and vitamin D state, but the intake was generally too low to make a biologically important contribution to maintaining vitamin D concentrations. Ultraviolet light (UVL) is the primary determinant of vitamin D state in summer and winter, in winter owing to the pools of vitamin D built up during the previous summer. Plasma concentrations of 25-hydroxy vitamin D (25-OHD) in winter of 15.0-22.5 nmol/l (6-9 ng/ml) require that the concentration in the previous summer was over 40 nmol/l (16 ng/ml). To maintain plasma concentrations in the elderly above those associated with osteomalacia a mean dietary vitamin D intake of over 5 microgram/day is required. A more physiological approach, however, would be to increase exposure to UVL.

Vitamin C intakes from mangoes and oranges, and plasma and breast milk ascorbic acid concentrations were measured at regular intervals in a cohort of pregnant and lactating women in Keneba and Manduar, two neighbouring rural Gambian villages. Extremely wide seasonal variations in plasma ascorbic acid levels were observed, the peak during the mango season in May and June attaining mean levels of 1.4 mg/dl, while the lowest levels, averaging only 0.2 mg/dl, were observed during the rainy season, during September and October. Parallel, but less pronounced variations were observed in breast milk ascorbate levels. A vitamin-fortified milk and biscuit supplement, given first to the lactating, and later to the pregnant, mothers in Keneba, which provided about 35 mg ascorbic acid per day, failed to produce any major improvement in plasma ascorbic acid levels during the rainy season, although there was some evidence for an improvement in breast milk levels. It is therefore likely that considerably greater intakes are required to maintain satisfactory maternal circulating levels and biochemical status during this critical period.

In McCance & Widdowson's 'The composition of foods' many items lack information on the content of the lesser B vitamins, and dietary intakes can therefore be underestimated. The degree of this underestimation was assessed using data from a longitudinal study of the food intake of 63 pregnant and lactating mothers in Cambridge, UK, with a total of 3185 days of weighed diet records. The extra mean daily additional intake of each vitamin contributed by foods eaten by the mothers but lacking data in the food tables was estimated to be: vitamin B12, 0.1 micrograms, (1.5 per cent of total intake); vitamin B6, 0.04 mg (3.3 per cent); total folate, 10 micrograms (5.3 per cent); pantothenic acid, 0.6 mg (11.5 per cent); and biotin, 5 mg (14.3 per cent). Although many items in the tables lack data, most were eaten infrequently and made little contribution to vitamin intake. It was estimated that, if data were added for a limited number of frequently-eaten foods, namely, white toast, baked beans, biscuits, breakfast cereals and 'chicken with skin', then intakes of all five vitamins would be underestimated by less than 4 per cent.

The quantitative relationships between dietary energy intake and weight gain in pregnancy, birthweight and lactation performance during the first three months of infancy have been studied in such a way as to take account of major differences in the patterns of heavy manual labour at different times of the year in a subsistence farming community. Maternal weight gain and the accumulation of subcutaneous fat were significantly lower when the last trimester of pregnancy fell during the time of heaviest farm work and lowest energy intakes. The birth-weight of babies was also significantly correlated with differences in energy intake throughout the year. During early lactation breast milk yields were significantly related to concomitant alterations in the subcutaneous fat stores. Evidence has been produced which suggests that in undernourished nursing women there could be a competition for dietary energy between the repleting maternal subcutaneous fat organs and the mammary glands at the expense of milk production.

Background: This is a study of the associations of adult leg and trunk length with early life height and weight, diet, socioeconomic circumstances, and health, and parental height, divorce and death.Method: The data used were collected in a longitudinal study of the health, development and ageing of a British national birth cohort (N = 2879 in this analysis) studied since birth in 1946. Multiple regression models were used to investigate the relationships.Results: Adult leg and trunk length were each positively associated with parental height, birthweight, and weight at 4 years. Leg length was associated positively with breastfeeding and energy intake at 4 years. Trunk length was associated negatively with serious illness in childhood and possibly also parental divorce, but not with the dietary data.Conclusion: Adult leg length is particularly sensitive to environmental factors and diet in early childhood because that is the period of most rapid leg growth. Trunk growth is faster than leg growth after infancy and before puberty, and may be associated with the effects of serious illness and parental separation because of the child's growing sensitivity to stressful circumstances, as well as the result of the biological effects of illness. [ABSTRACT FROM AUTHOR]