Public Health Nutrition最新文献

Objective: Orthorexia has been widely studied, but recently, a new conceptualisation was proposed to distinguish its healthy characteristics from its pathological ones. The objective of this study was to differentiate healthy orthorexia (HeOr) from orthorexia nervosa (OrNe) by exploring their sociodemographic, psychological, health, and dietary characteristics using comparative and correlational statistical methods.

Design: Cross-sectional analysis. Participants completed an online, self-administered questionnaire assessing their sociodemographic characteristics, orthorexia, exercise dependence, personality, health anxiety, food choice motives, emotional competences, and eating disorders.

Setting: Data were collected between May 2021 and September 2022.

Participants: 1,515 French females (mean_age = 37.67). Responses from men were excluded.

Results: While OrNe was mainly associated with weight control motives in food choices (r = .42), HeOr was more strongly correlated with natural content (r=.60) and health motives (r = .49). In relation to exercising, OrNe showed its highest association with weight control (r = 41). Health anxiety was more strongly associated with OrNe than with HeOr. Both OrNe and HeOr were related to diet adherence and regular exercise, but the association was stronger for the latter. Orthorexia scores, mainly OrNe, were higher in participants at the risk of eating disorders. Participants who were afraid to gain weight showed higher OrNe scores.

Conclusions: HeOr seems to be part of a healthy lifestyle in general. In contrast, OrNe falls into the category of an eating disorder and is associated with more problematic psychological functioning. Particular attention should be given to individuals who are beginning to control and reduce their food intake to prevent them from developing OrNe.

Objective: School-based interventions encouraging children to replace sugar-sweetened beverages (SSBs) with water show promise for reducing child overweight. However, students with child food insecurity (CFI) may not respond to nutrition interventions like children who are food-secure.

Design: The Water First cluster randomized trial found that school water access and promotion prevented child overweight and increased water intake. This secondary analysis used mixed-effects regression to evaluate the interaction between the Water First intervention and food insecurity, measured using the Child Food Security Assessment, on child weight status (anthropometric measurements) and dietary intake (student 24-hour recalls).

Setting: Eighteen elementary schools (serving ≤ 50% children from low-income households), in which drinking water had not been previously promoted, in the San Francisco Bay Area.

Participants: Students in fourth-grade classes (n=1056).

Results: Food insecurity interacted with the intervention. Among students with no CFI, the intervention group had a lower prevalence of obesity from baseline to 7 months (-0.04, confidence interval [CI] -0.08 to 0.01) compared to no CFI controls (0.01, CI -0.01 to 0.04) (p=0.04). Among students with high CFI, the intervention group had a pronounced increase in the volume of water consumed between baseline and 7 months (86.2%, CI 21.7 to 185.0%) compared to high CFI controls (-13.6%, CI -45.3 to 36.6%) (p=0.02).

Conclusions: Addressing food insecurity in the design of water promotion interventions may enhance the benefit to children, reducing the prevalence of obesity.

Objective: This study examined changes food and drink purchasing during the first three months of the COVID-19 pandemic in England, and if changes varied by population subgroups.

Design: We investigated changes in take-home food and drink purchasing and frequency of out-of-home purchasing using an interrupted time series analysis design. The start of pandemic restrictions (the intervention) was defined as 16^th March 2020, when first announced in the UK.

Setting: London and the North of England.

Participants: 1,245 households reporting take-home and 226 individuals reporting out-of-home purchases between January 2019 and mid-June 2020 from the GB Kantar Fast Moving Consumer Goods Panel.

Results: The marginal mean estimate of total take-home energy purchased was 17.4% (95% CI 14.9, 19.9) higher during the pandemic restriction period compared to the counterfactual. Increases of 35.2% (95% CI 23.4, 47.0) in take-home volume of alcoholic beverages and 1.2% (95% CI 0.1, 2.4) in foods and drinks high in fat, salt and sugar were observed. Reductions in purchased energy from fruit and vegetables (-7.3%, 95% CI -10.9, -3.6), ultra-processed foods (-4.0%, 95% CI -5.2, -2.8), and in out-of-home purchasing frequency (-44.0%, 95% CI -58.3, -29.6) were observed. Changes in chocolate and confectionery, soft drink and savoury snack purchases levelled off over time. Changes in all studied outcomes varied by sociodemographic characteristics and usual purchasing.

Conclusions: Pandemic restrictions were associated with positive and negative changes in food and drink purchasing, which differed by individual characteristics. Future research should ascertain if changes persist and translate into changes in health.

Objective: We aimed to analyze the evolving trends in macronutrient intake and dietary composition among Korean children and adolescents over a 10-year period.

Design: We utilized cross-sectional data from the Korean National Health and Nutrition Examination Survey (KNHANES) spanning the years 2010-2020. Overall, the study included 11,861 participants aged 6-18 years who completed the 24-h dietary recall survey. Subsequently, we assessed trends in energy consumption and macronutrient intake across population subgroups, including age, sex, and obesity status. Survey-weighted linear regression was employed to determine the beta coefficient and p-value for trends in dietary nutrient consumption, treating the survey year as a continuous variable.

Setting: KNHANES from 2010 to 2020.

Participants: 11,861 children and adolescents aged 6-18 years.

Results: Total energy intake significantly decreased across the 10-year survey period, with a corresponding decline in the percentage of energy intake from carbohydrates. Conversely, the proportion of energy intake from fat increased during the same period. Subgroup analysis revealed changes in the composition of energy intake across age, sex, and obesity status, with a consistent increase in total fat intake observed across all subgroups. Upon analyzing data on dietary fibers, total sugars, and fat subtypes intake, we found insufficient dietary fiber intake and increased intake of all fat subtypes.

Conclusions: This study underscores the gradually changing dietary intake patterns among Korean children and adolescents. Our findings revealed that these transitions in dietary nutrient consumption may pose potential risks of diet-related diseases in the future.

Objective: To evaluate the effectiveness of a radio campaign involving serial 10-minute drama episodes, 10-minute on air discussion of each episode by trained community health workers and 30-minute phone-ins from listeners in improving mothers' nutrition- and health-related attitudes (HNRAs) and children's minimum acceptable diet (MAD).

Design: A two-arm quasi-experimental trial with a pre-post design was used to quantify the effect of a radio campaign on nutrition before and immediately after the 6-month intervention. Difference-in-difference (DID) analysis was performed to assess the intervention's effect.

Setting: Saboba district (intervention) and Central Gonja (comparison district) of northern region of Ghana.

Participants: At baseline, a total of 598 mothers with children aged 6-22 months were randomly selected from the intervention (n 298) and control (n 300) districts. At endline (6 months post-intervention), 252 mother-child dyads in the intervention district and 275 mother-child dyads in the control district were followed up.

Results: The radio campaign was significantly and positively associated with a change in health- and nutrition-related attitudes (HNRA) over time, with DID in mean attitudes significantly improving more over time in the intervention district than the control (DID = 1·398, P < 0·001). Also, the prevalence of MAD over time in the intervention district was significantly higher than the control district (DID = 16·1 percentage points, P = 0·02) in the presence of food insecurity.

Conclusions: The study indicates that a radio campaign on nutrition is associated with improved mothers' HNRA and children's MAD. Communication interventions on child nutrition targeting low-resource settings should consider this innovative approach.

Objectives: Over recent decades, the commercial ultra-processed food industry has grown, making snacks high in energy, added sugar, saturated fat and sodium affordable and accessible to consumers. Dietary patterns high in ultra-processed snacks are concerning as this can result in negative health outcomes. This study aims to provide insight on available snack products in South African supermarkets, and the marketing thereof, which can be used to support policy development aimed at improving the healthfulness of the food supply and consumption patterns.

Design: This was an observational cross-sectional, mixed-method study.

Setting: Secondary data from six major supermarket chains (eight stores) in three different suburbs in Cape Town, South Africa was analysed to evaluate the nutritional composition of snack products (n=3837). The same eight supermarkets were revisited to obtain information on marketing via an observational checklist. Qualitative interviews were also conducted with store managers.

Results: Majority (89%) of the products assessed either contained non-sugar sweeteners or were high in sugar, saturated fat, or sodium. These snack items that are high in nutrients of concern to limit were available at checkout areas in all stores, were found in high traffic areas and several in-store promotional strategies such as branded displays, special offers and combo-deals were commonly found.

Conclusion: The current South African supermarket environment encourages consumers to purchase unhealthy snacks. Most snacks assessed in this study cannot be recommended for regular consumption due to the nutritional composition being high in nutrients linked to poor health outcomes. There is a need for regulation of the in-store marketing of unhealthy snacks in South Africa. Retail settings are potential intervention points for limiting exposure to these unhealthy products.

Objective: The aim of this study was to investigate factors associated with reported need of weight loss support among adults with overweight or obesity in the general population.

Design: A cross-sectional population study based on a survey questionnaire sent to a random population sample. Multivariate odds ratios for reported need of weight loss support were calculated for socio-economic, lifestyle and health indicators, in total and by gender and age group.

Setting: Five counties in Sweden in 2022.

Participants: The study includes 10 069 persons with overweight or obesity (BMI ≥ 25 kg/m²) aged 30-69 years. BMI was based on self-reported weight and height.

Results: In total, about 20 % reported needing weight loss support. The factors most strongly associated with reported need of weight loss support were obesity and female gender. Lack of social support, economic difficulties, physical inactivity, poor self-rated health, musculoskeletal pain and depression were also associated with reported need of weight loss support, whereas diabetes and hypertension were not. Some differences in these associations were observed between age groups.

Conclusion: Reported need of weight loss support is more common among women than among men and associated with obesity, lack of social support, economic difficulties, physical inactivity, poor self-rated health, musculoskeletal pain and depression in both genders. These factors are important for planning preventive and weight-control measures among adults with overweight or obesity.

Objective: Technological innovations in the online food delivery sector include the use of autonomous delivery vehicles. The aim of the present study was to investigate consumers' intentions to use these services once they are widely available and their motivations for using them to access unhealthy food.

Design: Online survey including a vignette describing a future world where autonomous food deliveries are in common use in both metropolitan and non-metropolitan areas.

Setting: Australia.

Participants: 1078 Australians aged 18 years and older, nationally representative by sex, age, and location (metropolitan versus non-metropolitan residence).

Results: Around half of the sample reported intending to use an autonomous food delivery service at least once per week for fast food (53%) and/or healthy pre-prepared food (50%). Almost two-thirds (60%) intended using autonomous vehicle deliveries to receive groceries. Around one in five (17%) anticipated an increase in their fast food intake as a result of access to autonomous delivery services compared to one in two (46%) expecting others' total fast food intake to increase. The most common reason provided for using autonomous food deliveries was increased convenience. More frequent current fast food ordering, higher socioeconomic status, younger age, and regional location were significantly associated with an anticipated increase in fast food consumption.

Conclusions: The emergence of autonomous food delivery systems may bring both benefits and adverse consequences that in combination are likely to constitute a substantial regulatory challenge. Proactive efforts will be required to avoid negative public health nutrition outcomes of this transport evolution.

Objective: To assess the potential contribution of large-scale food fortification (LSFF) towards meeting dietary micronutrient requirements in Tanzania.

Design: We used household food consumption data from the National Panel Survey 2014-15 to estimate fortifiable food vehicle coverage and consumption (standardised using the adult female equivalent approach) and the prevalence at risk of inadequate apparent intake of five micronutrients included in Tanzania's fortification legislation. We modelled four LSFF scenarios: no fortification, status quo (i.e. compliance with current fortification contents) and full fortification with and without maize flour fortification.

Setting: Tanzania.

Participants: A nationally representative sample of 3290 Tanzanian households.

Results: The coverage of edible oils and maize and wheat flours (including products of wheat flour and oil such as bread and cakes) was high, with 91 percent, 88 percent and 53 percent of households consuming these commodities, respectively. We estimated that vitamin A-fortified oil could reduce the prevalence of inadequate apparent intake of vitamin A (retinol activity equivalent) from 92 percent without LSFF to 80 percent with LSFF at current fortification levels. Low industry LSFF compliance of flour fortification limits the contribution of other micronutrients, but a hypothetical full fortification scenario shows that LSFF of cereal flours could substantially reduce the prevalence at risk of inadequate intakes of iron, zinc, folate and vitamin B₁₂.

Conclusions: The current Tanzania LSFF programme likely contributes to reducing vitamin A inadequacy. Policies that support increased compliance could improve the supply of multiple nutrients, but the prominence of small-scale maize mills restricts this theoretical benefit.

Objective: The objective of our study was to determine the prevalence of anemia among 14-19 years school going girls, risk factors for it and profile of micronutrient status among rural girls from western state of India.

Design: Using a cross-sectional design, we obtained information on socio-demography, menstruation, dietary habits, knowledge and daily consumption of the government recommended iron and folic acid (IFA) tablets, and anthropometry. Blood was collected to assess haemoglobin, red blood cell indices, serum iron, folate and vitamin B₁₂ levels.

Settings: Nagpur district, Maharashtra, India.

Participants: A total of 221 girls aged 14-19 years studying in 24 government institutes included.

Results: 57% girls were anaemic, 84% had deficiency of one or more micronutrients and 60% were malnourished based on Body Mass Index (BMI). The prevalence of iron, vitamin B₁₂ and folate deficiency was 37.7%, 69.8% and 1.4% respectively. Among anaemic girls, iron and vitamin B₁₂ deficiency was observed in 45.5% and 67.5% respectively, vs. among non-anaemic girls it was 27% and 73% respectively. Iron deficiency was a predictor of anaemia and its severity. Girls residing in non-nuclear family were more likely to have anaemia. The consumption of daily non-vegetarian food and green leafy vegetables was 3% and 3.6% respectively. Only 9% consumed IFA tablets in the past two weeks.

Conclusions: Anemia is common in adolescent girls, particularly associated with iron and vitamin B12 deficiency. There is need to reconsider the approach to prevention of anaemia in adolescent girls, particularly before they become pregnant.