Journal of Health, Population, and Nutrition最新文献

Background: It has been well documented that Indigenous people in northern remote communities in Canada continue to experience a disproportionate burden of health disparities due to complex interactions of multiple determinants of health, including food insecurity, colonialism, barriers in accessing primary healthcare, and disrupted socioeconomic and political structures. Health promotion programs are essential in building preventive measures and empowering communities to take control over their health by helping them make informed health choices. This study described Indigenous-led nutrition-related health programs, the Healthy Babies, Healthy Children Program (HBHCP) and the Diabetes Prevention Program (DPP), which respond to food insecurity drivers and support community needs in Moose Cree First Nation (MCFN). It also documented the on-the-ground realities of program delivery and highlighted community-informed priorities for improved programming.

Methods: Grounded in community-based participatory research (CBPR) principles, our approach emphasized the importance of community engagement in supporting the healing process within this cultural context. Data collection included first-hand participation in program delivery alongside program coordinators, participant feedback, and semi-structured interviews from community members (n = 6) and Health Center staff (n = 3). Thematic analysis was used to identify themes across interview data, field notes, and community feedback.

Results: High food costs, limited access and availability, and poor food quality remain the primary food-related challenges experienced in the community. Health programs serve as frontline responders to community needs and address these challenges through culturally grounded and family-oriented nutrition education activities. Community members valued the programs' knowledge-sharing approaches, tangible support, and social connections. However, systemic barriers significantly constrain program delivery, including inadequate funding, limited resources, staffing shortages, and the impact of COVID-19. These barriers limited the programs' capacity to reach their full potential, despite strong community resilience.

Conclusion: Indigenous-led nutrition programs are vital in addressing food insecurity and promoting health in northern communities. The findings underscore the need for sustainable funding and stronger policy support that reflects the true cost of service delivery in remote Indigenous communities. The findings emphasize the need for policy changes that move beyond top-down approaches toward community-informed policies and Indigenous-led health programming.

Background: HPV infection is a major risk factor for cervical cancer. HPV vaccine coverage remains low. Early identification of high-risk individuals with some characteristics is crucial for those with limited vaccination access.

Objective: To estimate the impact of different HPV infection statuses on subsequent infection, infection type, and coinfection. Influencing factors of long-term HPV infection status and clearance were also explored.

Methods: Data from Wuxi's cervical cancer screening (2013-2022) was used. Multivariate and multinomial logistic regression models were used to evaluate the relationship between different HPV infection statuses in the first four rounds and subsequent (the fifth round) infection, infection type, and coinfection, and the influencing factors on different HPV infection statuses during the five rounds, respectively. Survival analysis was applied to explore the HPV clearance.

Results: A total of 20,817 females were included. Those experienced two or more HPV infections had the highest likelihood of being subsequent infection (Two or more vs. One: OR = 2.11, 95%CI: 1.61 ~ 2.76, P < 0.001). The risk of subsequent infection increases progressively (versus sustained infection-free) in one classification of HPV infection: a single transient infection (OR = 5.72, 95%CI: 4.66 ~ 7.01, P < 0.001), persistent infection (positivity in ≥ 2 consecutive rounds; OR = 10.78, 95%CI: 8.04 ~ 14.44, P < 0.001), reinfection (reversion to positivity after prior clearance; OR = 18.51, 95%CI: 11.58 ~ 29.57, P < 0.001), and lowest among those who cleared infection with no recurrence (OR = 2.99, 95%CI: 2.32 ~ 3.84, P < 0.001), highest among those with unsolved infection (OR = 23.21, 95%CI: 18.29 ~ 29.45, P < 0.001) or reinfection (OR = 18.79, 95%CI: 11.51 ~ 30.04, P < 0.001) in another classification. HPV infection status seemed not to associate with subsequent infection types and coinfection. Baseline age, at least one coinfections and HPV 16/18 infection may influence long-term HPV infection status. The median duration for HPV clearance is 1.98 years (95%CI:1.96 ~ 2.00), which significantly affected by baseline age (HR = 0.99, 95%CI: 0.98 ~ 0.99, P < 0.001) and history of coinfection (HR = 0.50, 95%CI: 0.80 ~ 1.02, P < 0.001).

Conclusions: When HPV vaccination coverage remains suboptimal, early identification of high-risk cervical cancer populations should prioritize characteristics including multiple/persistent/recurrence infection, coinfection, high-risk types infection, advanced age, and prolonged viral clearance time.

Background: Despite global efforts to improve maternal health outcomes, many regions, including Uganda, continue to face challenges in achieving optimal maternal healthcare utilization. This study aims to investigate how restricted autonomy in household decision-making by significant others affects inadequate use of maternal healthcare services among married women in Uganda. Inadequate use of maternal healthcare services refers to not meeting all four WHO-recommended standards for ANC timing, ANC visits, place of delivery, and PNC timing.

Methods: Secondary data from the latest 2016 Uganda Demographic and Health Survey (UDHS 2016) were used for this study. Data from 7906 married women of childbearing age were analyzed using a multilevel binary logistic regression approach.

Results: The inadequate use of maternal healthcare services was estimated to be 39.1%. The odds of inadequate use were 17% higher among women with moderate restricted autonomy in household decision-making by significant others compared to women with low restrictions [Adjusted Odds Ratio (AOR) = 1.17, 95% Confidence Interval (CI) = 1.02-1.34]. Inadequate use of MHCS decreases with an increase in the household wealth index. Women from the richest household [(AOR) = 0.52, 95% CI = 0.39,0.70] were less likely to report Inadequate use of maternal healthcare services compared to the poorest. Employed women were less likely [AOR = 0.73, 95% CI = 0.62-0.84] to report inadequate use of maternal healthcare services. Women who reside in the northern region of Uganda were significantly less likely [AOR = 0.72, 95% CI = 0.52-0.99] to report inadequate use of maternal healthcare services compared to those who reside in the central region.

Conclusion: The study concluded that the restricted autonomy in household decision-making by significant others plays a crucial role in the use of maternal healthcare services among married women in Uganda. Factors such as maternal age, household wealth index, employment status, and region of residence were also associated with inadequate use of maternal healthcare services. Therefore, to achieve Sustainable Development Goal (SDG) 3.1, the government and policymakers should engage significant others in maternal health programs, promote regional equity, female labor force participation, education, and autonomy in health decision-making.

Background: Despite advancements in the use of maternity care services, certain nations in sub-Saharan Africa continue to record unacceptable rates of maternal and perinatal morbidity and mortality, particularly in the postnatal period. This study aimed to assess the level of postnatal care service utilisation and associated factors among multiparous women in Buyamba County, Rakai District, Uganda.

Method: A community-based cross-sectional study involving women who had two or more children was conducted in four sub-counties of Buyamba County. Study participants were recruited using a systematic sampling technique. A structured and pre-tested questionnaire was used to gather data. Descriptive, bivariate and modified poisson regressions were computed using STATA version 14. Statistical significance was considered at p < 0.05 and the strength of statistical association was assessed by prevalence ratios with 95% confidence intervals.

Result: Out of 321 women who participated in the study, (81.9%) were married, (30.8%) were aged 35-44 years, (71.0%) attended antenatal care (ANC) during their previous pregnancy, (94.7%) delivered normally, and (94.4%) utilised postnatal care (PNC) services of which (67.2%) received immunisation for the children, (26.2%) acquired family planning counseling and (70.3%) had four or more PNC visits. Attending antenatal care (aPR = 1.750; 95% CI: 1.029-2.981), being aware of PNC services (aPR = 1.380; 95% CI: 1.016-1.875), receiving PNC education (aPR = 1.421; 95% CI: 1.048-1.923), having a normal delivery (aPR = 1.538; 95% CI: 1.055-2.241), and residing within 5 km of a health facility (aPR = 1.282; 95% CI: 1.006-1.632) were significantly associated with a higher likelihood of utilising postnatal care services. In contrast, being younger in age (aPR = 0.511; 95% CI: 0.347-0.752) and having a husband without formal education (aPR = 0.622; 95% CI: 0.454-0.853) were significantly associated with a lower likelihood of postnatal care services utilisation.

Conclusion: The study identified several maternal, spousal, and accessibility factors influencing postnatal care utilisation. Enhancing maternal health education, improving facility access, involving partners, and strengthening antenatal counseling and community sensitisation can increase PNC utilisation and improve maternal and neonatal health outcomes.

Aim: A community-based cross-sectional study was conducted to explore the association between Ultra-Processed Foods (UPFs) intake and the risk of frailty among community-dwelling older adults.

Methods: The current study was conducted on 368 community-dwelling older adults (with a mean age of 67.11 ± 6.21 years, of whom 55.2% were women) at health centers of Maragheh city in Iran. Body composition was measured by a body composition analyzer and physical activity by the short-form physical activity questionnaire. The UPFs intake were determined using NOVA classification, based on a self-administered 147-item semi-quantitative FFQ. Blood samples were derived for the evaluation of blood parameters. Raw and adjusted logistic regression models were used to examine the relationship between UPFs intake tertiles and the risk of frailty.

Results: Outcomes showed that the overall prevalence of frailty was 96 (26.1%). Results from the multivariable adjusted logistic regression model indicated that higher UPFs intake was significantly associated with higher odds of frailty (OR = 2.15, 95% CI: 1.13-4.09, P = 0.019). Subgroup analysis also indicated that among men, higher UPF intake was significantly related to higher odds of frailty (OR = 3.55, 95% CI: 1.20-10.51, P = 0.022), but not for women (P > 0.05). Additionally, the results revealed that higher UPF intake was significantly associated with the risk of exhaustion (OR = 3.97, 95% CI: 1.89-8.34, P < 0.001), especially among men (OR = 9.89, 95% CI: 3.10-31.60, P < 0.001), unlike women (P > 0.05). However, there were no significant associations between UPFs intake and other components of frailty, including the risk of weight loss, slowness, dominant hand grip strength and low physical activity.

Conclusions: The results highlighted that higher UPFs intake was significantly associated with the risk of frailty and exhaustion among community-dwelling older adults, especially for men. Future large-scale prospective and interventional studies are warranted to validate these associations and elucidate underlying biological mechanisms.

Malnutrition is a significant public health concern affecting many populations, particularly in developing countries such as India and its neighboring economies. It can lead to adverse health outcomes, including stunted growth, impaired cognition, and increased susceptibility to disease. This review attempts to summarize the problems associated with malnutrition in different age groups in India and its neighboring countries, and the accompanying factors contributing to it. We also summarize the different biofortification techniques, which, when appropriately implemented, can alleviate these problems and potentially increase the availability and accessibility of crucial micronutrients such as vitamins and minerals in the diets of vulnerable populations. Government schemes and policies for scaling up biofortification interventions, as well as increasing public awareness and acceptance of biofortified crops, have also been delineated. In conclusion, while significant challenges remain, biofortification represents a promising approach for combating malnutrition, although further research and evaluations are needed to realize its potential impact fully.

Background: Multivitamin and mineral (MVM) supplements have been shown to provide various health benefits, including enhanced energy, skin health, metabolism, and immune function. This study explored the impact of MVM supplements based on users' experience in Taiwan.

Methods: This retrospective, real-world, cross-sectional study included 400 respondents, aged 35-60 years, residing in Taiwan. Data were collected via an online survey. Respondents self-reported perceived benefits across six youthful vitality benefits: energy, metabolism, sleep, mental alertness, skin health and complexion, and spirit. Additional assessments covered perceived immunity, general health, quality-of-life (QoL), well-being, user attitude and perception. Subgroup analyses was performed post hoc based on gender (male vs. female), age (< 50 vs. ≥50 years) and frequency of use (daily vs. occasional) to explore potential subgroup differences in perceived benefits.

Results: A total of 93% of users agreed that MVM supplements support at least one out of six youthful vitality benefits. Users reported several perceived benefits: energy support (59.00%), improved metabolism (59.75%), improved complexion (53.25%), normal immune functioning (66.25%), confident in maintaining overall health (63.25%). Satisfaction levels were notably high, with 74.50% expressing satisfaction with product use, 72.50% trusting the product, and 79.00% showed willingness to repurchase. Subgroup analyses suggested that males, daily users, and users aged ≥ 50 years experienced more favorable outcomes across several parameters as compared to their respective counterparts.

Conclusion: This study provides real-world evidence that MVM supplements are widely perceived to support youthful vitality, immunity, general health, and QoL. These user-reported outcomes complement existing clinical research by highlighting benefits experienced in everyday settings, especially among daily users and those aged 50 and above. The high satisfaction and trust levels observed further reinforce the relevance of MVM supplements as a self-care strategy. By bridging the gap between controlled trials and consumer experience, this study adds valuable context to the science and recommendation of micronutrient supplementation.

Background: Sustainable food literacy, healthy life awareness, and adherence to sustainable dietary models such as the Mediterranean diet are critical for promoting both public health and environmental well-being. While sociodemographic influences have been examined in previous research, the potential role of social media addiction as a behavioral factor in shaping sustainable dietary practices remains underexplored.

Objectives: This study aimed to investigate how sustainable food literacy, healthy life awareness, and social media addiction relate to Mediterranean diet adherence and nutritional sustainability in adults, while also accounting for key sociodemographic characteristics.

Methods: This cross-sectional online study included 2,263 adults (60.5% female; mean age, 29.4 ± 11.7 years; mean BMI, 24.54 ± 6.8 kg/m²). Data were collected using the Sustainable Food Literacy Scale (SFLS), Social Media Addiction Scale (SMAS), Adherence to the Mediterranean Diet and Nutritional Sustainability Questionnaire Turkish Version (MedQ-Sus-Tr), and Healthy Life Awareness Scale (HLAS). Pearson correlation and multiple linear regression analyses were performed.

Results: Based on the MedQ-Sus-Tr, 91.0% of participants were classified as having low adherence to the Mediterranean diet, and 70.1% were classified as having low nutritional sustainability. Mediterranean diet adherence showed the strongest correlation with nutritional sustainability (r = 0.728, p < 0.001). Predictors of Mediterranean diet adherence included marital status, income, SFLS, and HLAS (R² = 0.365), while nutritional sustainability was predicted by marital status, income, SFLS, and HLAS (R² = 0.301). SFLS was associated with sex, education level, marital status, income, social media addiction, HLAS, Mediterranean diet adherence, and nutritional sustainability (R² = 0.704). HLAS was predicted by sex, age, SFLS, social media addiction, Mediterranean diet adherence, and nutritional sustainability (R² = 0.696).

Conclusions: Our findings highlight that higher sustainable food literacy and healthy life awareness significantly predict greater adherence to the Mediterranean diet and improved nutritional sustainability, regardless of sociodemographic characteristics. Social media addiction was positively associated with both literacy and awareness, though it did not directly predict dietary adherence or sustainability. These results suggest that while social media use may enhance exposure to nutrition-related information, its impact on actual dietary behaviors is less direct. Targeted interventions should therefore leverage the informational potential of digital platforms, while also fostering translation of awareness into healthier and more sustainable eating practices.