Context: Dietary assessment in minority ethnic groups is critical for surveillance programs and for implementing effective interventions. A major challenge is the accurate estimation of portion sizes for traditional foods and dishes. Objective: The aim of this systematic review was to assess records published up to 2014 describing a portion-size estimation element (PSEE) applicable to the dietary assessment of UK-residing ethnic minorities. Data sources, selection, and extraction: Electronic databases, internet sites, and theses repositories were searched, generating 5683 titles, from which 57 eligible full-text records were reviewed. Data analysis: Forty-two publications about minority ethnic groups (n = 20) or autochthonous populations (n = 22) were included. The most common PSEEs (47%) were combination tools (eg, food models and portion-size lists), followed by portion-size lists in questionnaires/guides (19%) and image-based and volumetric tools (17% each). Only 17% of PSEEs had been validated against weighed data. Conclusions: When developing ethnic-specific dietary assessment tools, it is important to consider customary portion sizes by sex and age, traditional household utensil usage, and population literacy levels. Combining multiple PSEEs may increase accuracy, but such methods require validation.
South Asian women living in the UK are particularly at high risk of obesity-related complications, such as type 2 diabetes and cardiovascular disease. Exposure to large portion sizes is a risk factor for obesity. Specifically designed tableware helps individuals to manage weight by controlling food portion sizes. Thirty-one (n = 31) overweight or obese South Asian adult women participated in a randomised cross-over trial aimed to assess the efficacy, acceptance, and weight change of two guided/calibrated commercially available portion control tools (Utensil set and Crockery Set) used in free-living conditions. Data on acceptance, perceived changes in portion size, frequency, and meal type was collected using paper questionnaires and 3-day diet diaries. Scores describing acceptance, ease of use, and perceived effectiveness were derived from five-point Likert scales from which binary indicators (high/low) were analysed for significance using multivariate variance analysis for repeated measurements. A reduction in BMI was observed at each point of measurement (p = 0.007). For overall tool use, the crockery set scored higher in all areas of acceptance, ease of use, and perceived efficacy for all comparisons. Self-selected portion sizes increased for salads and decreased for cooking oil and breakfast cereals with both tools. Further research to scale up and evaluate similar weight management interventions for this group is warranted.
According to the World Health Organisation (2013) non-communicable diseases (NCD) account for 65% of global deaths. Disproportionally 80% of NCD related mortality occurs in low to middle income countries, including Ghana, and is projected to increase (1) . Adequate consumption of fruit and vegetables (FV) is a key modifiable risk factor for NCDs however, World Health Survey data (2) indicates Ghana's prevalence of low FV consumption, based on <400 g a day, (3) is 37% for women and 38% for men. On average Ghanaians consume FV between 2-6 days per week and of these the majority consume 0-2 servings (4) Street food traders/vendors, (SFVs) contribute to employment and the Ghanaian economy, providing a range of food and non-food items to the masses using "push" strategies for selling. The present study examined the feasibility of SFVs as a possible vehicle for optimising FV consumption by raising awareness of the value of FV in relation to health and supplying products to meet the needs of the population.A cross sectional survey administered by trained thirteen student environment health officers was used to seek SFV views (n = 699). Data were analysed after inputting into SPSS (version 19). Focus groups (n = 12) were undertaken with SFVs to explore the issues in depth and analysed using thematic analysis.The majority of SFV were female, (87·3%) aged between 20-50 years and had a low level of education reflecting other data (5) . Sixty-nine percent (69%) of the participants responded that increased consumption of FV results in a lower risk of CHD and 52·4% acknowledged reduced cancer risk. Notably less than 3% of SFV were aware of the recommended daily amount of FV to be consumed (i.e. 5 servings). Fifty-eight percent didn't know, followed by 17% who suggested 3. Thirty-two percent (n = 225) of SFVs sold FV (solely 23%; combined 9%), 68% of those questioned did not sell FV; the main reason for selling FV was due to high demand for these foods (80·4%, n = 563). FV was sold significantly by SFV that are mobile (p = < 0·001), self-employed (p = < 0·001) and male (p = < 0·001). Thirty percent were willing to develop and sell more FV, 68% of the 'willing to change' group did not currently sell FV. Focus group findings revealed employment, better wage and income as key themes for why SFV sold their current goods. SFV were positive about increasing supply (and thus sales) of FV to promote health improvement should the market demand more availability and access.Knowledge and consumption data supports earlier research findings (2,4) . SFVs are an important platform to supply FV to the masses. Using them as a vehicle to promote FV consumption in Ghana has possibilities and they are a proven trainable group, having been trained on food hygiene courses in the past. A pilot intervention would be a useful way forward.
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