Public Health Nutrition最新文献

Objective: We examined whether point-of-sale warning posters, compared to control posters, reduced Guatemalan adolescents' purchases of sugar-sweetened beverages (SSBs) at school stores.

Design: We used a difference-in-differences approach (4 weeks baseline, 4 weeks treatment). Our primary analysis compared two schools assigned to an intervention warning poster to one school that displayed a control poster. Based on purchase transaction data, the outcomes were volume of sugar-sweetened beverages, beverage kcal, and sugar purchased per transaction.

Setting: Three private schools in Guatemala City, Guatemala.

Participants: Students between 12 and 18 years of age.

Results: Our primary analysis found that the warning poster decreased the overall volume of sugar-sweetened beverages (in ounces) that adolescents purchased in the warning poster intervention schools (-2.27 oz. 95% CI=[-2.70, -1.85]) compared to the control school. This reduction was driven by a decrease in sugar-sweetened beverage purchases (OR= 0.64 95% CI=[0.49, 0.86]). The warning posters were associated with a significant reduction in likelihood of purchasing a beverage with kilocalories (calories) (OR= 0.68 95% CI=[0.49, 0.92]). These changes were associated with a significant overall decrease of sugar purchased (-5.54g 95% CI=[-6.69, -4.39]). The posters were associated with a significant increase of non-SSB purchases in the intervention schools compared to the control school (OR= 1.53 95% CI=[1.16, 2.02]).

Conclusion: Our results suggest that messages that warn adolescents about the high sugar content in SSBs may be an effective, low-cost way to modestly reduce purchases of these drinks. These findings provide evidence to support national front-of-package labeling, currently being considered in Guatemala.

Objective: The Dutch Children's Food Literacy Questionnaire (DCFLQ) was developed and validated to assess food literacy among children aged 8 to 12 years. The DCFLQ is structured around farm-to-fork principles, including questions on food production, distribution, consumption, waste, and sustainability.

Design: After initial item pool creation, the DCFLQ was developed in collaboration with experts and children. The validation process included assessments of reliability and construct validity, as well as a test-retest evaluation in a subgroup of children.

Setting: The expert panel consisted of domain-related researchers, a pedagogue, a paediatrician, dietitians, and a primary school teacher. Children were recruited via primary schools and a sports club.

Participants: A total of 11 experts and 27 children participated in the development process; 608 children participated in the validation process.

Results: The final questionnaire comprised 29 questions and demonstrated good internal consistency (Cronbach's α = 0.80) and test-retest reliability (ICC = 0.81). DCFLQ scores positively correlated with age, indicating that food literacy is higher in older children.

Conclusions: The DCFLQ is a valuable tool for assessing the effectiveness of nutrition intervention programs and monitoring Dutch children's food literacy over time. International expert consensus on developing food literacy instruments is needed, as diversity in assessment tools impedes cross-cultural comparisons.

Objective: A Body Shape Index (ABSI) is a validated anthropometric measure describing body shape independently of BMI and height. This study aimed to evaluate the association between ABSI and dietary quality and eating behaviours in a Mediterranean clinical population.

Design: We conducted a cross-sectional study analysing associations between ABSI and diet/behaviour using Pearson correlations and multivariable linear regressions adjusted for age, sex and BMI.

Setting: The study took place at a Mediterranean diet-based nutrition clinic in Rome, Italy.

Participants: The sample included 1640 adult patients attending follow-up visits at the clinic. ABSI z-scores were calculated and standardised by age and sex. Weekly food intake was assessed using 7-day food diaries, and behavioural preferences were collected via structured questionnaires.

Results: The Pearson correlation between BMI and internal z-scored ABSI (zABSI) was weak but statistically significant (r = 0·113, P < 0·0001), confirming that ABSI captures body shape independently from BMI. As expected, ABSI strongly correlated with WC (r = 0·78, P < 0·001). Playing a sport was inversely associated with zABSI (β = –0·365, P < 0·001). Nighttime eating (β = 0·237, P = 0·001), snacking between meals (β = 0·133, P = 0·014) and preference for sweet over salty foods (β = 0·025, P = 0·010) were positively associated with higher ABSI values.

Conclusions: In this Mediterranean clinical sample, ABSI identified behavioural and dietary correlates of body shape-related risk. Promoting physical activity and addressing nighttime eating may help improve anthropometric profiles linked to abdominal fat distribution.

Objective: To evaluate the nutritional status of adults with beta thalassemia major in Vietnam by analysing body composition parameters and assessing the adequacy of energy, macronutrient and micronutrient intake.

Design: A cross-sectional study was conducted among adult patients with beta thalassemia major. Nutritional status was assessed using three components: BMI, body composition and dietary intake.

Setting: Department of Thalassemia, The National Institute of Hematology and Blood Transfusion in Vietnam.

Participants: 317 adult patients with beta thalassemia major (54·2 % females, median age 32).

Results: Nearly half (49·5 %) of the patients had a normal BMI, while 18·3 % were severely underweight and 32·2 % were underweight. Severe underweight patients exhibited lower body fat, bone mineral content and visceral fat. Average daily energy intake (1449·9 kcal) was significantly below the estimated requirement (2079·5 kcal), with 81·4 % of patients consuming less than 85 % of their energy needs. Severely underweight patients consumed 12·06 g/d less fat (95 % CI: 6·85, 17·26) and 10·42 g/d less protein (95 % CI: 4·42, 16·42) than normal weight patients. Severe deficiencies in Ca, Mg, Fe and B-complex vitamins were prevalent, with the lowest mean probability of adequacy for minerals and vitamins observed in severely underweight patients.

Conclusion: This study provides the first comprehensive assessment of the nutritional status of beta thalassemia major patients in Vietnam, revealing critical gaps in energy and nutrient intake. Evidence-based strategies, including dietary education and interventions tailored to the unique needs of this population, are urgently needed to improve nutritional outcomes and overall health.

Objective: The current study examined perceptions of and experiences with Flint Families Cook, a virtual cooking and nutrition programme for youth and families.

Design: Families were invited to participate in virtual focus groups after completing the 5-week Flint Families Cook programme. The research study was guided by Social Cognitive Theory. Researchers used thematic analysis to examine the transcribed focus groups, identify patterns across transcripts and develop emerging themes.

Setting: Families living in Flint and surrounding Genesee County, Michigan, USA, engaged in virtual focus groups via Zoom.

Participants: Youth (n 32; 59 % female, 53 % African American) and adult caregivers (n 31; 90 % female, 39 % African American) participated in focus groups between October 2020 and February 2022.

Results: Five themes were generated from the focus group discussions: (i) general cooking challenges; (ii) class format; (iii) family support; (iv) provision of food; and (v) instruction and learning.

Conclusions: In addition to perceived positive impacts on cooking skills and nutrition education, many participants shared that Flint Families Cook encouraged family cohesion and support. Most caregivers felt the programme, which included instruction by a chef and dietitian as well as ingredient box delivery, had important impacts on the emotional health of youth and family resilience. Flint Families Cook, and similar virtual scalable programmes, could broadly reach children and families to support physical and psychosocial health, especially in low-resource communities where such interventions may be most beneficial.

Objective: This study aimed to evaluate adult women's cooking (CS) and food preparation skills (FPS) and their nutrition literacy (NL) levels and to examine the relationship between these two concepts.

Design: Data were collected via face-to-face interviews using a personal information form, the Cooking and Food Preparation Skills scale, and the Evaluation Instrument of Nutrition Literacy on Adults. Data were analysed with SPSS, with P < 0·05 considered significant.

Setting: Female adults aged 20-64 years who participated in family support courses in Tepebaşı, Eskişehir, Turkey.

Participants: The study sample consisted of 330 female individuals between the ages of 20 and 64 years who agreed to participate in the survey.

Results: NL was generally adequate (91·8 %), though gaps were identified in portion knowledge (54·2 %) and food label reading (44·2 %, borderline). Higher literacy levels were associated with being younger, more educated and employed (P < 0·05). CS and FPS were higher among married women and those with children. Cooking frequency and enjoyment significantly influenced these skills (P < 0·05). Those who cooked more often had higher scores in food label reading and basic math (P < 0·001) and higher total scores (P = 0·049). Participants who enjoyed cooking had better reading comprehension (P = 0·030). A weak but significant correlation was found between FPS and general nutrition knowledge, but no strong relationship was observed between overall cooking skills (CS) and total NL.

Conclusion: Although no strong link was found between NL and CS, these skills appear to support healthier eating behaviours. Promoting cooking and food preparation through nutrition education may help improve public health.

Objective: To evaluate eligibility and participation in nutrition assistance programmes (Supplemental Nutrition Assistance Program (SNAP) and Women, Infants and Children (WIC)) among transgender and gender diverse (TGD) adults in the USA and to capture their experiences when accessing food benefits.

Design: This was a cross-sectional analysis of the US Transgender Survey (USTS) dataset – the largest survey of TGD adults in the US SNAP and WIC participation and experiences when visiting the public assistance office were reported using descriptive statistics; stratified analyses were conducted based on race using multivariate logistic regression modelling.

Setting: The USTS was completed electronically in the USA.

Participants: 27 715 TGD adults.

Results: Approximately 40·9 % of the full sample were SNAP eligible, yet only 30·6 % of those eligible were receiving the benefit; 0·45 % of the sample reported receiving WIC. TGD adults avoided the public assistance office because they feared being mistreated (3·2 %), were identified as transgender (46·2 %), were denied equal treatment (6·5 %) or were verbally harassed (5·2 %). People of colour were more likely to be denied equal treatment and verbally harassed at the public benefits office than their white peers. The impact of age, education level, employment status, relationship status and census region varied within each racial group.

Conclusions: Far more TGD adults need food assistance compared with the general population, yet fewer are receiving the benefit. Culturally informed interventions are urgently needed to resolve the root causes of food insecurity, increase SNAP participation and address the negative experiences of TGD adults when accessing food benefits.

Objective: Aspects of the school food environment can influence food purchasing and consumption among adolescents, particularly those without access to a school meal programme. Our objective was to describe and compare food vendors of junior high schools (JHS) in Ghana.

Design: We conducted structured observations of food vendors within a 0·25-km radius of eight JHSs. We compared foods sold and hygiene practices by vendor and community characteristics, such as on- v. off-campus location, urban v. rural, and predominant income-generating activity of the community. We also assessed the relationship between adolescent diet quality (food group diversity, all-5, NCD-protect and NCD-risk scores) and procurement method for foods consumed during the school day.

Setting: Cape Coast and Elmina, Ghana.

Participants: 200 randomly selected students.

Results: Of 265 identified vendors, 25·3 % sold foods on-campus. On-campus vendors were less likely to sell branded snacks (19·4 % v. 33·8 %, P = 0·001) and beverages (17·9 % v. 35·4 %, P = 0·008) and more likely to sell prepared dishes (53·7 % v. 31·8 %, P = 0·001) than off-campus vendors. Vendors practised an average of 38·8 % of applicable food hygiene practices, which did not differ by on- or off-campus location. In the previous month, 59·4 % of students most often purchased food on campus. There were no significant relationships between method of food procurement and diet quality.

Conclusion: Many adolescents purchased food at school, and there were differences in foods sold by on- and off-campus vendors. School policies may be a promising avenue to alter food environments for adolescents.

Objective: Overweight and obesity have become a global public health concern, with prevalence rising sharply in low- and middle-income countries. This study analysed temporal trends in overweight and obesity among schoolchildren in the largest capital city of Brazil, from 2006 to 2024.

Design: Repeated cross-sectional.

Setting: Schoolchildren aged 6 to 19 years from Porto Velho, Rondônia, Brazil.

Participants: A total of 12 646 participants were evaluated. To assess the BMI z-score, standardised body mass and height measurements were used, stratified by sex (male and female) and age group (6-10 and 11-19 years). Temporal trends were assessed using joinpoint regression analysis.

Results: Overall, 17·8 % of participants were classified with overweight, and 8·6 % were classified with obesity. The study also found that obesity prevalence was consistently higher among younger age groups compared to adolescents. The results revealed a significant increase in obesity prevalence among girls (annual percentage change (APC) = 5·81 %; 95 % CI = 1·03-10·81; P-value = 0·021) and children aged 6 to 10 years (APC = 5·20 %; 95 % CI = 1·17-9·39; P-value = 0·017), while no significant trends were observed for overweight or for male adolescents or adolescents aged 11 to 19 years.

Conclusions: Our findings indicate rising obesity among girls and children aged 6-10 years and support the need for urgency. We recommend targeted action, including implementing mandatory quality physical education and school nutrition standards, enforcing restrictions on marketing to children and prioritising municipal policies that increase access to healthy foods.

Objective: This study assessed iron-rich food consumption and its factors among children aged 6-23 months in South and Southeast Asia.

Design: A cross-sectional study from the Standard Demographic and Health Survey (2015-2022).

Setting: South and Southeast Asian countries.

Subjects: Data collected from 95,515 children aged 6 to 23 months, including information from their parents or caregivers.

Results: The overall proportion of children, aged 6 to 23 months, consuming iron-rich foods in the region was 29.87% (95% CI: 29.58, 30.16). Higher odds of iron-rich food consumption were observed among children aged 12-23 months (AOR = 3.59; 95% CI: 3.45-3.76), had history of exclusive breastfeeding (AOR = 1.17; 95% CI: 1.12-1.23), born to teenage motherhood (AOR = 1.09; 95% CI: 1.02-1.17), born in health institution (AOR = 1.10; 95% CI: 1.02-1.19), and had pregnant mother at the time of the survey (AOR = 1.60; 95% CI: 1.50-1.72). Children of birth order 2-4 (AOR = 1.26; 95% CI: 1.20-1.32) and 5+ (AOR = 1.29; 95% CI: 1.18-1.43), from female-headed households (AOR = 1.06; 95% CI: 1.01-1.12), and those with household mass media exposure (AOR = 1.27; 95% CI: 1.19-1.36) also had significantly higher odds of iron-rich food consumption. Additionally, higher odds ratios (AOR > 1) of iron-rich food consumption were observed in Cambodia, Bangladesh, Indonesia, Myanmar, Maldives, Philippines, Pakistan, and Timor-Leste.

Conclusion: Across countries, only about 30% of children consumed iron-rich foods, with significant variation. Targeted public health efforts are essential to address maternal, child, and household factors that influence intake.