nation of deaths in the population under the age of 65 (by using husband's or father's occupation for analysis of women and children), though the longitudinal study has managed to extend analysis to older age groups' and to cancer registration data" and the general household survey annual report also provide analysis of health measures by socioeconomic group. These difficulties have led to proposals for alternative measures of social stratification'" and to the adoption of an area based method of analysis." The near universal use of postcodes as a basis for area classification means that most events can be allocated geographically, thus overcoming many of the limitations described. In addition, compared with social class deprivation measures show distinct discrimination between populations. Classification of the population on the basis of the area in which it lives could therefore provide a valuable alternative strategy for analysis of data in relation to socioeconomic lowest third of outdoor activity compared with the highest was 4-3 (0.7 to 26.8), and that for grip strength was 3-9 (0.7 to 23.0). Conclusions-Reduced intake of dietary calcium does not seem to be a risk factor for hip fracture. Further evidence is provided that physical activity in the elderly protects against hip fracture.

In a national survey in Britain, 983 elderly people randomly selected from eight areas were asked about falls they had had in the past. The independent association of social and physical variables with a history of one or more falls was analysed by multiple logistic regression. Those who had fallen one or more times had reduced grip strength and were less mobile than those who had not fallen. More of them used non-phenothiazine tranquilizers, lived alone, had recently lost weight or were physically disabled. Independent of these influences, a history of having fallen was strongly related to place of residence. Part of this relationship was explained by differences in housing, in particular the percentage of houses without indoor lavatories.

Objective: To describe the relationship of the mother's physical activity to the birth size of her baby in a rural Indian population. Design: Prospective observational study. Setting: Six villages near Pune, Maharashtra, India. Subjects: A total of 797 women were studied after excluding abortions and termination of pregnancies (112), foetal anomalies (8), multiple pregnancies (3), incomplete pre-pregnancy anthropometry (14) and pregnancies detected later than 21 weeks of gestation (168). Method: An activity questionnaire was developed after focus group discussions and incorporated community-specific activities. It was validated against an observer-maintained diary. Activity scores were derived using published data on energy costs to weight the contributions of various activities. It was then administered to assess physical activity at 18 ( AE 2) and 28 ( AE 2) weeks of gestation. Outcome measures: Birth outcome, maternal weight gain and neonatal anthropometry. Results: The activity questionnaire was used to classify women into light, moderate and heavy activity categories. Maternal activity did not influence the incidence of prematurity or stillbirth, or the duration of gestation. It was inversely related to maternal weight gain up to 28 weeks of gestation (P ¼ 0.002). Higher maternal activity in early, as well as mid gestation, was associated with lower mean birth weight (P ¼ 0.05 and 0.02, respectively ), and smaller neonatal head circumference (P ¼ 0.005 and 0.009) and mid-arm circumference (P ¼ 0.03 and 0.01) after adjusting for the effect of major confounding factors. Conclusions: The Findings suggest that excessive maternal activity during pregnancy is associated with smaller foetal size in rural India, The approach described for developing an activity questionnaire has potential for adoption in other settings.

We studied links between human malnutrition and wild meat availability within the Rainforest Biotic Zone in central Africa. We distinguished two distinct hunted mammalian diversity distributions, one in the rainforest areas (Deep Rainforest Diversity, DRD) containing taxa of lower hunting sustainability, the other in the northern rainforest-savanna mosaic, with species of greater hunting potential (Marginal Rainforest Diversity, MRD). Wild meat availability, assessed by standing crop mammalian biomass, was greater in MRD than in DRD areas. Predicted bushmeat extraction was also higher in MRD areas. Despite this, stunting of children, a measure of human malnutrition, was greater in MRD areas. Structural equation modeling identified that, in MRD areas, mammal diversity fell away from urban areas, but proximity to these positively influenced higher stunting incidence. In DRD areas, remoteness and distance from dense human settlements and infrastructures explained lower stunting levels. Moreover, stunting was higher away from protected areas. Our results suggest that in MRD areas, forest wildlife rational use for better human nutrition is possible. By contrast, the relatively low human populations in DRD areas currently offer abundant opportunities for the continued protection of more vulnerable mammals and allow dietary needs of local populations to be met.

Mesiodistal and buccolingual crown diameters were measured from dental casts representing the deciduous dentitions of 197 Aboriginal children from the Northern Territory of Australia. Double determination analysis indicated that the semi-automatic recording procedure used was reliable leading to observer errors of no practical significance. Tooth-size was greater in the male subjects but the sexual dimorphism was less marked than in the permanent teeth of the same subjects. The mandibular teeth were more uniform than maxillary with respect to buccolingual size relative to mesiodistal. Extremes of general tooth-size were more marked in the deciduous dentition than in the permanent as a consequence of the relatively large deciduous second molar which in Aboriginals approximates in size the permanent first molar of many other ethnic groups.

Objective: Women of lower educational attainment have less balanced and varied diets than women of higher educational attainment. The diets of women are vital to the long-term health of their offspring. The present study aimed to identify factors that influence the food choices of women with lower educational attainment and how women could be helped to improve those choices. Design: We conducted eight focus group discussions with women of lower educational attainment to identify these factors. We contrasted the results of these discussions with those from three focus group discussions with women of higher educational attainment. Setting: Southampton, UK. Subjects: Forty-two white Caucasian women of lower educational attainment and fourteen of higher educational attainment aged 18 to 44 years. Results: The dominant theme in discussions with women of lower educational attainment was their sense that they lacked control over food choices for themselves and their families. Partners and children exerted a high degree of control over which foods were bought and prepared. Women's perceptions of the cost of healthy food, the need to avoid waste, being trapped at home surrounded by opportunities to snack, and having limited skill and experience with food, all contributed to their sense they lacked control over their own and their family's food choices. Conclusions: An intervention to improve the food choices of women with lower educational attainment needs to increase their sense of control over their diet and the foods they buy. This might include increasing their skills in food preparation. Keywords Food choice Health benefits Education Focus groups UKStudies from across Europe have identified a relationship between educational attainment and diet. Education level was the most important social variable in explaining differences in vegetable and fat intake in a random sample of Danish men and women (1) , and having no qualifications was a significant predictor of low healthy eating scores in 7434 men and women in the Scottish Health Survey (2) . In a group of 6125 women who took part in the Southampton Women's Survey, it was found that women who leave school with few or no qualifications eat a less balanced or 'prudent' diet than women with qualifications (3) . A 'prudent' diet in this survey was characterised by high intakes of fruit and vegetables, wholemeal bread, rice, pasta, yoghurt and breakfast cereals. An 'imprudent' diet was characterised by high intakes of chips and roast potatoes, sugar, white bread, red and processed meats, full-fat dairy products, crisps, sweets, tinned vegetables, cakes and biscuits. More than half of the women who left school with no qualifications were in the lowest quarter of the 'prudent' diet score. This proportion fell progressively with increasing qualifications, so that only 3 % of women with university degrees had scores in the lowest quarter. This relationship was not explained by social class. Women's diets are important not only for their own health but also for that of...

Healthy normotensive volunteers aged 20 to 59 yr were randomly allocated either to a control group or to one of two experimental groups. The control group ate a low P/S ratio diet for 12 wk while the first experimental group ate a high P/S ratio diet for 6 wk followed by a low P/S ratio diet for the next 6 wk. The second experimental group ate a low P/S ratio diet in the first 6 wk followed by a high P/S ratio diet for the next 6 wk. Dietary P/S ratio, plasma linoleic acid (18:2), and cheek cell phospholipid 18:2 levels were compared in each dietary group at the end of the 1st and 2nd 6 wk. On change from a low to a high P/S ratio diet, there was a 36% increase in the proportion of 18:2 in the cheek cell phospholipids in comparison with the proportion existing before the change. This was associated with an increase in the proportion of 18:2 in the plasma lipids of this group. No reduction in the proportion of 18:2 in the cheek cell phospholipids was apparent in the control group or the group which changed from a high to a low P/S ratio diet, although in the latter group there was a reduction in the proportion of 18:2 in the plasma lipids. As the phospholipid fatty acid composition of human cheek cells reflects dietary lipid status under certain conditions, this observation may be useful in dietary and nutritional studies, particularly as human cheek cells can be obtained in a noninvasive manner.

Diet records from 2402 middle-aged men and women in three English towns have been used to derive food lists which indicate the percentage contribution each food, or group of foods, makes to the intake of specific nutrients. Comparison of these food lists with those based on the American diet show differences in sources of nutrients; for example, brussels sprouts provide 5% of the vitamin C intake in our English towns, whereas in the US they provide only 0.3%. It would not be appropriate, therefore, to use American food lists in English populations, since important sources of the nutrient may be omitted or non-important sources included. These food lists can be used for English populations as a basis for food frequency questionnaires.