It is recognised that eating habits established in early childhood may track into adult life. Developing effective interventions to promote healthier patterns of eating throughout the life course requires a greater understanding of the diets of young children and the factors that influence early dietary patterns. In a longitudinal UK cohort study, we assessed the diets of 1640 children at age 3 years using an interviewer-administered FFQ and examined the influence of maternal and family factors on the quality of the children's diets. To describe dietary quality, we used a principal components analysis-defined pattern of foods that is consistent with healthy eating recommendations. This was termed a 'prudent' diet pattern and was characterised by high intakes of fruit, vegetables and wholemeal bread, but by low intakes of white bread, confectionery, chips and roast potatoes. The key influence on the quality of the children's diets was the quality of their mother's diets; alone it accounted for almost a third of the variance in child's dietary quality. Mothers who had better-quality diets, which complied with dietary recommendations, were more likely to have children with comparable diets. This relationship remained strong even after adjustment for all other factors considered, including maternal educational attainment, BMI and smoking, and the child's birth order and the time spent watching television. Our data provide strong evidence of shared family patterns of diet and suggest that interventions to improve the quality of young women's diets could be effective in improving the quality of their children's diets.

A number of studies in developed countries suggest that breastfeeding protects against infections in infancy. However, the choice to breastfeed is often related to maternal characteristics, and many of these studies are limited in the extent to which they can take account of confounding influences. In a prospective birth cohort study, we assessed the relationship between the duration of breastfeeding and the prevalence of lower respiratory tract infections, ear infections and gastrointestinal morbidity during the first year of life in 1764 infants. We considered the duration of all breastfeeding, including mixed feeding. Eighty-one per cent of the infants were breastfed initially, and 25% were breastfed up to 6 months. There were graded decreases in the prevalence of respiratory and gastrointestinal symptoms between birth and 6 months as breastfeeding duration increased; these were robust to adjustment for a number of confounding factors. The adjusted relative risks (95% confidence interval) for infants breastfed for six or more months compared with infants who were never breastfed were 0.72 (0.58-0.89), 0.43 (0.30-0.61) and 0.60 (0.39-0.92) for general respiratory morbidity, diarrhoea and vomiting, respectively. Duration of breastfeeding in the second half of infancy was less strongly related to diagnosed respiratory tract infections and gastrointestinal morbidity, although important benefits of breastfeeding were still seen. Our data provide strong support for a protective role of breastfeeding against respiratory and gastrointestinal infections in infancy. The graded inverse associations with breastfeeding duration suggest that current efforts to promote breastfeeding and increase duration will have important effects in reducing morbidity in infancy.

Uncertainty remains regarding the efficacy of low intakes of ergocalciferol (vitamin D2 or D2) and cholecalciferol (vitamin D3 or D3) provided in food to increase serum 25-hydroxy-vitamin D (25-OH-D) metabolite concentrations when UV-B exposure is low. We recruited 40 healthy men and women into a double-blind, parallel design, randomized controlled trial. Participants received placebo or 1 of 4 experimental treatments (D2 or D3 at 5 or 10 μg/d) supplied as a malted milk drink for 4 wk during a period of minimal UV-B exposure in the UK. The primary outcome was a change in serum 25-OH-D2 and 25-OH-D3 concentrations measured by ultra-performance liquid chromatography tandem MS. The secondary outcomes were changes in concentrations of plasma parathyroid hormone and serum calcium (Ca(2+)). Baseline concentrations (geometric mean ± SD) of 25-OH-D2, 25-OH-D3, and total 25-OH-D were 3 ± 4, 32 ± 22, and 37 ± 22 nmol/L, respectively. Both D2- and D3-fortified drinks resulted in dose-dependent increases (P < 0.001) in their respective 25-OH metabolites that did not significantly differ in size. Increments from baseline compared with the placebo group following 5 and 10 μg/d of D2 were (mean ± SEM) 9.4 ± 2.5 and 17.8 ± 2.4 nmol/L for 25-OH-D2 and following 5 and 10 μg/d of D3 were 15.1 ± 4.7 and 22.9 ± 4.6 nmol/L for 25-OH-D3, respectively. There was no difference between D2 and D3 groups in the incremental AUC of their respective metabolites. These findings suggest that D2 and D3 are equipotent in increasing 25-OH-D in healthy men and women with negligible UV-B exposure.

Objective: To evaluate the use of an administered eighty-item FFQ to assess nutrient intake and diet quality in 3-year-old children. Design: Frequency of consumption and portion size of the foods listed on the FFQ during the 3 months preceding the interview were reported by the child's main caregiver; after the interview a 2 d prospective food diary (FD) was completed on behalf of the child. Nutrient intakes from the FFQ and FD were estimated using UK food composition data. Diet quality was assessed from the FFQ and FD according to the child's scores for a principal component analysis-defined dietary pattern ('prudent' pattern), characterised by high consumption of fruit, vegetables, water and wholemeal cereals. Setting: Southampton, UK. Subjects: Children (n 892) aged 3 years in the Southampton Women's Survey. Results: Intakes of all nutrients assessed by the FFQ were higher than FD estimates, but there was reasonable agreement in terms of ranking of children (range of Spearman rank correlations for energy-adjusted nutrient intakes, r s 5 0?41 to 0?59). Prudent diet scores estimated from the FFQ and FD were highly correlated (r 5 0?72). Some family and child characteristics appeared to influence the ability of the FFQ to rank children, most notably the number of child's meals eaten away from home. Conclusions: The FFQ provides useful information to allow ranking of children at this age with respect to nutrient intake and quality of diet, but may overestimate absolute intakes. Dietary studies of young children need to consider family and child characteristics that may impact on reporting error associated with an FFQ.

There has been an increase in the number of studies that use dietary patterns analysis to assess diet as a whole, rather than individual foods or nutrients. Identification of dietary patterns in childhood may prove useful in investigating the relationship between early diet and health in later life. The aim of the present study was to describe the dietary patterns of 3-year-old children using principal component analysis (PCA). Data were collected from children in the Southampton Women's Survey (SWS). The SWS is a large prospective study in which a total of 12 583 non-pregnant women aged 20-34 years and resident in the city of Southampton, UK were recruited between 1998 and 2002. Babies born to women in the SWS are followed up at 6 months, 12 months, 2, 3, 4, 6 and 8 years of age (1) . At age 3 years the children were visited at home where their diet, eating behaviour, physical activity and illnesses were assessed. Diet was assessed using an eighty-item FFQ, administered by trained research nurses, to record the average frequency and quantity of the foods consumed by the child over the preceding 3 months. Between 1998Between and 2003Between , 1981 singleton babies were born to the women in the SWS. Complete dietary data were available for 1640 (83 %) of these children at 3 years of age.PCA identified three distinct dietary components in the 3 year olds that explained 7.5, 4.6 and 3.7% of the total variation in the study sample. The first component was termed a 'prudent' diet pattern and was characterised by a high frequency of consumption of vegetables, fruit and juices, water, wholemeal bread and fish and low consumption of white bread, crisps, chips and processed meat. The second component was termed a 'traditional' pattern and was characterised by a high frequency of consumption of processed and red meat, puddings and green vegetables and low consumption of wholemeal bread, water and fruit juices. The third component was termed a 'convenience vegetarian' pattern and was characterised by a high consumption of vegetable dishes and vegetarian foods, beans and pulses and quiche and pizza and low consumption of meat, boiled potatoes and vegetables.Three clear patterns of foods have been described in the diets of the children in the SWS at 3 years of age. These patterns reflect large differences in dietary choices and food consumption. The 'prudent' dietary pattern that explains the most variation in the study sample is very similar to the 'prudent' pattern that has been described previously for the women in the SWS (2) . Ongoing work is addressing the relationship between the dietary patterns of the mothers in the SWS and their children, and the influence of these patterns on growth and development in early childhood.

Fatty acids have an important role in fetal growth and development, and requirements for long-chain PUFA, particularly the n-3 fatty acid (FA) DHA, are increased in pregnancy (1) . Oily fish is one of the richest sources of n-3 FA, including DHA. Current levels of oily fish and n-3 FA consumption in non-pregnant women in the UK are low compared with recommendations (2) . However, little is known about variations in n-3 FA intake and dietary influences on n-3 FA status in pregnant women in the UK (2) . The aim of this study was to describe variations in oily fish intake, and associations with plasma n-3 FA concentrations in women taking part in the Southampton Women's Survey (SWS). At around 34 weeks gestation, venous blood samples were taken, and the n-3 FA content of plasma phosphatidylcholine (PC) determined using GC. Diet was assessed using an administered food frequency questionnaire that recorded the frequency of consumption of 'oily fish' in the three preceding months. Complete n-3 FA data were available for 1765 (89 %) women who delivered before the end of 2003.The median frequency of consumption of oily fish was once a fortnight; 36 % of the women were consuming oily fish once a week or more. There were strong correlations between oily fish consumption and the percentages of EPA, DHA and total n-3 FA in plasma PC (r = 0.264, r = 0.398 and r = 0.378 respectively, all P < 0.0001) (see Fig.

Dietary sources of vitamin D may only play a minor role in meeting vitamin D requirements compared with ultraviolet exposure (1) . Data from the National Diet and Nutrition Survey suggest that vitamin D insufficiency, defined as serum 25-hydroxyvitamin D (25(OH)D) < 25 nmol/L, is widespread in the UK (2) . Except for oily fish, there are few rich dietary sources of vitamin D. Furthermore, high intakes of unrefined cereals can contribute to low serum 25(OH)D concentrations by increasing the catabolism of vitamin D which is thought to be due to their high phytic acid content interfering with calcium absorption (3) . We report the association between dietary vitamin D intake and 25(OH)D at baseline in subjects recruited into a randomised controlled trial, and the changes in vitamin D intake and 25(OH)D following randomisation to two dietary interventions.The CRESSIDA trial (ISRCTN92382106) randomised 165 healthy non-smoking men and women aged 40-70 y to a cardioprotective (CP) or a control (C) diet for 12 wks. Blood samples and 4-d diet records completed at baseline and follow-up were available for analysis in 162 subjects. The cardioprotective diet included salt < 6 g/d, saturated fatty acids < 10 % of food energy, oily fish intake 1-2 portions/wk and fruit and vegetables 5 portions/d, and supplied at least half of the cereal intake from wholegrains. The control diet was a typical well balanced British diet but contained oily fish less than once a month. All subjects abstained from dietary supplements throughout the study. Table 1 shows vitamin D intakes and plasma concentrations of 25(OH)D determined by immunoassay. Dietary vitamin D intake and 25(OH)D concentrations were correlated at baseline (r = 0.277; P < 0.001). Vitamin D intake increased following the cardioprotective diet compared with the control as a consequence of the increased consumption of oily fish. Serum 25(OH)D concentrations at 12 weeks were 9.2 nmol/L (P < 0.001) greater in the CP diet group compared to the C group when adjusted for baseline 25(OH)D, age, BMI, gender, ethnicity and seasonality. This increase is similar to the increase in 25(OH)D found after supplementation with 5 mg vitamin D3 per day for 4 weeks in the winter months (4) . In conclusion, the consumption of oily fish 1-2 times a week improves vitamin D status, and the inclusion of wholegrain cereals (mainly breakfast cereals and bread) as part of a cardioprotective diet does not have an adverse effect on vitamin D status.