Despite its significant usefulness in adolescent health studies, the single-item “body size perception” question, developed within the Health Behaviour in School-aged Children (HBSC) survey, has yet to undergo multidimensional validation.
To assess the convergent, divergent and concurrent validity of the HBSC body size perception question among adolescents.
The single-item HBSC body size perception question is as follows: “Do you think your body is…?,” with answers ranging from “much too thin” to “much too fat.” Fifteen-year-old participants included in the analysis were 72,086 from 45 HBSC countries in 2017/18 (concurrent validity), and 595, 127, and 615 in 2021/22 in French-speaking Belgium, Ireland, and Poland, respectively. The convergent, divergent, and concurrent validity was assessed with body dissatisfaction, social desirability, and selfesteem, respectively. The concurrent validity was also examined with body mass index (BMI) from the 2017/18 HBSC data. All analyses were sex-stratified.
Cohen’s Kappa values were 0.67 [confidence interval (CI): 95%: 0.62, 0.72] and 0.64 (0.59, 0.69) for boys and girls, respectively, in all 3 countries together. Body size perception was associated with social desirability, selfesteem, and BMI, with a stronger association in girls than that in boys. For instance, girls with higher social desirability were less likely to perceive themselves as “too thin” [Relative Risk Ratio (RRR) = 0.78 (0.69, 0.89)] rather than as the “right size.” Boys with higher selfesteem were less likely to perceive themselves as “too fat” [0.93 (0.90, 0.97)] rather than the “right size.” Girls with underweight were less likely to perceive themselves as “too fat” [0.38 (0.34, 043)] rather than “right size” and girls with overweight/obesity were more likely to perceive themselves as such [8.19 (7.49, 8.95)].
The single-item HBSC body size perception question demonstrated good convergent, divergent, and concurrent validity. It reflects adolescents’ own perception of body size, possibly influenced by societal norms and ideals.
Social expectations play a crucial role in shaping dietary practices among women and children. However, despite significant attention to promoting social and behavioral change in nutrition-focused programs and research, the influence of social norms on women’s agency in enhancing nutrition practices is often overlooked. In this perspective, we advocate for a paradigm shift by incorporating a “norms aware” approach. This underscores the importance of recognizing, measuring, and addressing the societal constraints and barriers that women and children encounter in their journey to improved nutrition. Drawing on insights from the United States Agency for International Development-funded Kulawa project in Niger, we highlight the implications of using social norms diagnosis tools to understand the contextual dynamics within child-feeding practices, informing intervention design, and targeted populations. Integrating a norms perspective into nutrition programming and research does not require an overhaul, but rather a nuanced application of understanding of contextual drivers, such as social norms and agency, that have been underemphasized. We delve into the role of the socio-ecologic system, underscore the importance of addressing power imbalances related to gender and social hierarchy, and emphasize that programs targeting norms should aim for community rather than individual-level change. We provide guidance for programs and research integrating a norms perspective, as well as examples of how tools, such as the Social Norms Exploration Tool and Social Norms Analysis Plot framework, can be applied to identify and prioritize social norms, facilitating the design of “norms aware” programs. Additionally, we highlight the critical role of community engagement and discuss the value of using qualitative and quantitative approaches to document the process and outcomes of social norms research, program design, and implementation. When we recognize the role of social norms in nutrition as a missing ingredient in nutrition research, programming, and social and behavior change strategies, we create opportunities for more effective and contextually relevant research and interventions that address the complexities of enhancing nutrition practices among women and children.
Milk provides essential crucial public health nutrients, including 3–4 nutrients of public health concern, yet dairy consumption has declined over time, leading most Americans to fall short of meeting Dietary Guidelines recommendations.
To investigate milk and beverage consumption trends in preschool-age children, along with nutrient intakes from beverages, and to analyze the potential impact of replacing nondairy beverages with milk through isocaloric substitution.
Data from the National Health and Nutrition Examination Survey 2001–2018 for children aged 1–5 y (n = 4696) were used, and milk and other beverages intakes were estimated from the first 24-h in-person dietary recall. Nutrient intakes were determined using the United States Department of Agriculture’s food and nutrient database for dietary studies. Changes in nutrient intakes of children aged 2–5 y were modeled assuming isocaloric substitution with milk of all nondairy beverages consumed during lunch and dinner combined. Sample-weighted analyses were performed using SAS 9.4, and significance was set at P < 0.01.
With the increasing age of children, the intake of milk decreased, whereas the intake of energy, caloric beverages excluding milk, and sugar-sweetened beverages increased. Daily intakes of energy, protein, fat, saturated fatty acids (SFA), calcium, magnesium, potassium, sodium, vitamin A, folate, vitamin B-12, and vitamin D from caloric beverages including milk decreased with age, whereas the daily intake of fiber and added sugar increased with age. With the isocaloric replacement of nondairy caloric beverages with milk at lunch and dinner among children aged 2–5 y, intake of protein, fat, SFAs, calcium, magnesium, potassium, sodium, vitamin A, folate, vitamin B-12, and vitamin D increased, whereas for intake of carbohydrate, fiber, total sugar, and added sugar decreased.
The current findings indicate that increased efforts are needed to reverse the decrease in milk intake over time and as preschool children age and provide additional evidence to support specific dietary recommendations for milk.
Propolis, a natural resin produced by bees, has been studied for its potential effects on liver enzymes and obesity indices. However, a meta-analysis is necessary to comprehensively understand the impact of propolis on obesity and liver function.
This meta-analysis of randomized controlled trials (RCTs) sought to evaluate the effects of propolis consumption on liver enzymes and obesity indices in adults.
A systematic literature search up to December 2023 was completed in PubMed/Medline, Scopus, and Web of Science, to identify eligible RCTs. Heterogeneity tests of the selected trials were performed using the I2 statistic. Random-effects models were assessed on the basis of the heterogeneity tests, and pooled data were determined as weighted mean differences (WMDs) with a 95% confidence interval (CI).
A pooled analysis of 24 trials showed that propolis consumption led to a significant reduction in alanine aminotransferase (ALT) (WMD: −2.58; 95% CI: −4.64, −0.52; P = 0.01), aspartate aminotransferase (AST) (WMD: −1.84; 95% CI: −3.01, −0.67; P = 0.002), and alkaline phosphatase (ALP) (WMD: −24.90; 95% CI: −42.13, −7.67; P = 0.005) in comparison with the control group. However, there were no significant effects on gamma-glutamyl transferase (GGT), body weight, BMI (in kg/m2), fat mass, body fat percentage, fat-free mass, adiponectin, waist circumference, hip circumference, and waist–hip ratio in comparison with the control group.
We discovered that consuming propolis can lead to a significant decrease in ALT, AST, and ALP levels, without causing significant changes in GGT, anthropometric indices, and adiponectin levels. However, future well-designed RCTs with large numbers of participants and extended durations, focusing on precise propolis dosage and ingredients, are necessary.
A risk haplotype in SLC16A11 characterized by alterations in fatty acid metabolism emerged as a genetic risk factor associated with increased susceptibility to type 2 diabetes (T2D) in Mexican population. Its role on treatment responses is not well understood.
We aimed to determine the impact of the risk haplotype on the metabolomic profile during a lifestyle intervention (LSI).
We recruited Mexican-mestizo individuals with ≥1 prediabetes criteria according to the American Diabetes Association with a body mass index between 25 and 45 kg/m2. We conducted a 24-wk quasiexperimental LSI study for diabetes prevention. Here, we compared longitudinal plasma liquid chromatography/mass spectrometry metabolomic changes between carriers and noncarriers. We analyzed the association of risk haplotype with metabolites leveraging repeated assessments using multivariable-adjusted linear mixed models.
Before the intervention, carriers (N = 21) showed higher concentrations of hippurate, C16 carnitine, glycine, and cinnamoylglycine. After 24 wk of LSI, carriers exhibited a deleterious metabolomic profile. This profile was characterized by increased concentrations of hippurate, cinnamoglycine, xanthosine, N-acetylputrescine, L-acetylcarnitine, ceramide (d18:1/24:1), and decreased concentrations of citrulline and phosphatidylethanolamine. These metabolites were associated with higher concentrations of total cholesterol, triglycerides, and low density lipoprotein cholesterol. The effect of LSI on the risk haplotype was notably more pronounced in its impact on 2 metabolites: methylmalonylcarnitine (β: −0.56; P-interaction = 0.014) and betaine (β: −0.64; P-interaction = 0.017). Interestingly, lower consumption across visits of polyunsaturated (β: −0.038; P = 0.017) fatty acids were associated with higher concentrations of methylmalonylcarnitine. Covariates for adjustment across models included age, sex, genetic ancestry principal components, and body mass index.
Our study highlights the persistence of deleterious metabolomic patterns associated with the risk haplotype before and during a 24-wk LSI. We also emphasize the potential regulatory role of polyunsaturated fatty acids on methylmalonylcarnitine concentrations suggesting a route for improving interventions for individuals with high-genetic risk.
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