This FFQ was specifically designed for South Asian women in the UK. Despite the diversity of diets, the FFQ had reasonable validity. The role of diet in breast cancer disease aetiology in this population is being assessed with this instrument.

We investigated the relative validity of an interview-administered FFQ to estimate phytoestrogen intake among South Asian women in the UK. A population-based sample of 108 healthy South Asian women completed random repeated monthly 24-h recalls [with a subsample (n = 58) also providing multiple plasma samples] over a period of 1 y followed by administration of the FFQ. The FFQ produced slightly higher estimates of phytoestrogen intake than the 24-h recalls, but the percentage of women classified into the same +/- 1 quartile by the 2 methods was high for all phytoestrogens (from 81 to 94%) with only a small percentage (<5%) being misclassified into extreme opposite quartiles. Energy-adjusted Spearman correlations coefficients between the estimates obtained by the FFQ and the 24-h recalls were 0.55 for genistein, 0.60 for daidzein, 0.70 for secoisolariciresinol, and 0.63 for matairesinol (all P < 0.001). Spearman correlation coefficients between the FFQ estimates and plasma levels were 0.21 (P = 0.12) for genistein, 0.32 (P = 0.02) for daidzein and 0.10 (P = 0.43) for enterolactone; the corresponding values for the 24-h recalls compared with plasma levels were 0.43 (P < 0.001), 0.40 (P = 0.002), and 0.08 (P = 0.50), respectively. The method of triads was used to estimate the validity coefficients (VCs) between the estimates provided by each assessment method and "true intake." The FFQ had the highest VC for lignans (0.91 vs. 0.73 for 24-h recalls and 0.11 for plasma samples) and satisfactory VCs for both genistein (0.46 vs. 0.95 and 0.45, respectively) and daidzein (0.67 vs. 0.83 and 0.45, respectively). This FFQ is thus a relatively valid tool with which to estimate phytoestrogen intake among South Asian women in the UK.

These findings are consistent with the possibility that high phyto-oestrogen intake may protect against breast cancer, but further research is required to confirm this hypothesis.

South Asian women in England have a lower breast cancer risk than their English-native counterparts, but less is known about variations in risk between distinct South Asian ethnic subgroups. We used the data from a population-based case -control study of first-generation South Asian migrants to assess risks by ethnic subgroup. In all, 240 breast cancer cases, identified through cancer registries, were individually matched on age and general practitioner to two controls. Information on the region of origin, religious and linguistic background, and on breast cancer risk factors was obtained from participants. Breast cancer odds varied significantly between the ethnic subgroups (P ¼ 0.008), with risk increasing in the following order: Bangladeshi Muslims (odds ratio (OR) 0.33, 95% confidence interval (CI): 0.10, 1.06), Punjabi Hindu (OR 0.59, 95% CI: 0.33, 1.27), Gujarati Hindu (1 ¼ reference group), Punjabi Sikh (OR 1.23, 95% CI: 0.72, 2.11) and Pakistani/Indian Muslims (OR 1.76, 95% CI: 1.10, 2.81). The statistically significant raised risk in Pakistani/Indian Muslims increased with adjustment for socioeconomic and reproductive risk factors (OR 2.12, 95% CI: 1.25, 3.58), but was attenuated, and no longer significant, with further adjustment for waist circumference and intake of nonstarch polysaccharides and fat (OR 1.49, 95% CI: 0.85, 2.63). These findings reveal differences in breast cancer risk between South Asian ethnic subgroups, which were not fully explained by reproductive differences, but were partly accounted for by diet and body size.

To investigate the role of lifelong vegetarianism on the aetiology of female breast cancer, we conducted a population-based case-control study among South Asian migrant women from the Indian subcontinent resident in England. A total of 240 South Asian breast cancer cases were identified from 2 cancer registries during 1995-1999. For each case, 2 age-matched South Asian controls were randomly selected from the age-sex register of the case practice. Lifelong vegetarians had a slight reduction, although not statistically significant, in the odds of breast cancer relative to lifelong meat-eaters, which persisted after adjustment for socio-demographic and reproductive variables [odds ratio (OR)‫;77.0؍‬ 95% confidence interval (CI)‫05.0؍‬ -1.18]. Analysis by food group revealed no linear trend in the odds of breast cancer with increasing consumption of meat (p‫)01.0؍‬ but the odds were higher for women in the top 75%. In contrast, there were strong inverse trends in the odds of breast cancer with increasing intake of vegetables (p‫,)500.0؍‬ pulses (p‫)700.0؍‬ and fibre [non-starch polysaccharides, NSP (p‫,])20.0؍‬ with women in the highest 25% of intake of these foods having about 50% of the odds of those in the lowest ones. Adjustment for intake of vegetables and pulses reverted the odds of breast cancer in lifelong vegetarians relative to lifelong meateaters (OR‫;40.1؍‬ 95% CI‫)86.1-56.0؍‬ and attenuated the quartile-specific estimates for meat intake, whereas the inverse trends in the odds of breast cancer with intake of vegetables and pulses remained after adjustment for type of diet or meat intake. These findings suggest that lifelong vegetarianism may be associated with a reduction in the risk of breast cancer through its association with a higher intake of vegetables and pulses. Although it is not possible to exclude the possibility that lifelong meat abstention may also play a role, the findings provide evidence that a diet rich in vegetables and pulses, such as those typically found in South Asian diets, may be protective against this cancer. © 2002 Wiley-Liss, Inc. Key words: breast cancer; diet; vegetarianism; migrants; South Asians; EnglandMigrant 1,2 and ecological 3 studies have supported the hypothesis that diet may play a role in the aetiology of female breast cancer. However, results from cohort and case-control studies have been inconsistent. Deficiencies in study design or inaccuracies of dietary assessment methods that introduce non-differential misclassification of exposure leading to relative risk estimates biased towards unity could have contributed to the conflicting results. In addition, a common difficulty in investigating relationships between dietary factors and breast cancer risks with case-control or cohort studies, especially if they are likely to be weak associations, is the relative homogeneity of the diet of Western populations where most such epidemiological studies have been carried out. South Asian populations such as those in India, Pakistan and Bangladesh are characterised by a l...

Phyto-oestrogens, naturally occurring hormone-like chemicals in plant food, may play a protective role against hormone-related chronic diseases. South Asian migrants in the UK have a lower incidence of hormone-related cancer than their hosts but the extent to which this difference may be due to phytoestrogen intake is not known. The aim was to compare habitual phytoestrogen intake in first-generation South Asian migrant women and native British women. South Asian (n 221) and native British women (n 50) were recruited from general practitioner lists and were asked to provide monthly 24 h recalls for a period of 1 year. An enhanced phytoestrogen database was compiled using data from a literature search and unpublished data. A sub-sample of South Asian women (n 100) and the native British women (n 40) also provided blood samples every 3 months during the 1-year period. The median daily intakes (mg/d) of isoflavones (184·2 v. 333·9) and lignans (110·8 v. 148·8) were significantly lower in South Asians than in the native British (P , 0·001, P ¼ 0·04 respectively). There were no significant differences in mean plasma isoflavone levels (nmol/l) but plasma enterolactone was significantly lower in the South Asians (13·9 (SD17·5) v. 28·5 (SD23·3), P , 0·001). The main sources of phytoestrogens were bread and vegetables in both ethnic groups. Habitual phytoestrogen intake in South Asian and native British women was below 1 mg/d and was higher in the native British diet. The present study does not support the hypothesis that differences in phytoestrogen intake, or in circulating levels, could explain differences in hormone-related cancer risks between these two populations.

This abstract was awarded the student prize.Overweight and obesity in UK firefighters are reaching epidemic proportions exceeding that of the UK general population (1) . This compromises physical fitness (2) and concomitant firefighter and public safety (3) . Research has identified specific exposures related to firefighting (4)(5) , which may also contribute to uniquely high rates of coronary heart disease (CHD) and acute myocardial infarctions (MI) seen in this occupational group (6) . These exposures include intense heat which could impair vascular function and increase thrombogenicity (4) , and fire stations as obesogenic environments which perpetuate a culture of over-nutrition alongside increasing sedentary behaviour (5) . Faced with a multitude of exposures, it is imperative that modifiable risk factors for CHD and MI are addressed. This however seems to have been overlooked by UK researchers thus far. We aimed to design, implement and evaluate the efficacy and feasibility of a fire station based dietary and lifestyle weight loss intervention for UK firefighters, factoring in a complex combination of exposures and firefighter specific cultural habits (5) .Forty London firefighters were recruited via staff email in February 2017. Thirty-eight firefighters (35 males, 3 females; mean age = 44·8, SD = 7·2) from 2 London fire stations (Hornchurch: intervention, Harold Hill: control) completed the one-month, clustercontrolled dietary and lifestyle intervention which ran February to March 2017. Hornchurch firefighters received the programme involving a face-to-face personalised information session; general information sheet; midway face-to-face support session; and nutritionist support throughout. Informational components focussed on fire station obesogenic environmental modification alongside nutrition, physical activity and lifestyle education in a low-intensity/low participant burden format. All firefighters were assessed at baseline and post-intervention for Body Mass Index (BMI), Body Fat Percentage (BF%) and Waist Circumference (WC). Dietary assessment was carried out using the EPIC-Norfolk Food Frequency Questionnaire (7) . At baseline, 70 % of the sample were classified overweight or obese by BMI (Harold Hill: 67 %; Hornchurch: 74 %). Post intervention, Hornchurch displayed significant mean reductions in BMI and BF% of 0·4 kg/m 2 (p = 0·01) and 0·9 % (p = 0·04) respectively, and borderline non-significant improvement in WC of 1·4 cm (p = 0·06). Harold Hill displayed a significant mean reduction of 0·8 cm in WC (p = 0·03), but not for BMI or BF%. Hornchurch firefighters reported favourable changes over the one month period for energy intake: With an attrition rate of 5 % the intervention was highly feasible. It was also efficacious, resulting in significant weight loss, reduced body fat and improvements in dietary behaviour. This study represents the first dietary and lifestyle worksite intervention for firefighters in the UK.

The use of food banks is rising in the UK; a leading charity's records show an increase of 163 % from 2013 and 2014 (1) . Whilst research has examined the causes of food insecurity; to date there has been little investigation into the health implications of widespread and on-going food bank use.A typical food parcel should consist of food items that will be sufficient for three days depending on whether they are single, a couple, or an entire family and usually consists of a variety of canned foods: soups, beans, tomatoes, vegetables, meats (often as tinned ravioli or spaghetti), fish, fruit and rice pudding. Other goods such as ultra-heat treated (UHT) milk, juice, a bag of sugar, pasta/rice, coffee, cereals and biscuits are also provided (2) . However, the variety and content of food parcels can vary depending on the volunteer packing the food parcel, the stock available, population demographics, and by the organisation who runs the food banks. Therefore, we decided to collect information from two different food banks in southwest UK (located in Bournemouth and Blandford). The contents of different food parcels (n 126) were analysed and typical meal plans were also constructed using available food items to assess actual nutritional adequacy at the point of consumption.Mean energy and % energy of macronutrient intake of the emergency food parcels met the EAR and DRVs but the constructed meal plans did not meet the requirements for energy and was lower than the mean intake of low income NDNS quintile. Furthermore, both the whole contents and meal plan showed a higher proportion of energy derived from carbohydrate than recommended and the NDNS survey. Similarly, when the meal plans were compared to the EatWell Plate (4) they were deficient in proportions of milk & dairy foods and fruit & vegetables groups; mean values of 5 % and 12 % respectively compared to the recommended proportions of 15 % and 32·5 %. Micronutrients that were also of possible concern were vitamin C, calcium, magnesium, potassium and zinc, where the meal plans did not meet RNIs, although LRNIs were met. We suggest that reformulation of food bank parcels with the addition of a few low-cost key items could address most of the above issues; one litre of UHT milk per person, add potatoes and pulses (not just baked beans) as a distinct categories. Sugar, fruit juice and pasta/bean/pastry meat items should be counted as "added extras" and not as part of the core parcel, and packet sauce mixes and crackers could be added to increase meal plan options. This should be in addition to providing dietary education, basic cooking skills and instilling a concept of a healthy balanced diet amongst the recipients.