Public Health Nutrition最新文献

Objective: Evaluate knowledge and beliefs about dietary nitrate among United Kingdom (UK)-based adults.

Design: An online questionnaire was administered to evaluate knowledge and beliefs about dietary nitrate. Overall knowledge of dietary nitrate was quantified using a twenty-one-point Nitrate Knowledge Index. Responses were compared between socio-demographic groups.

Setting: UK.

Participants: A nationally representative sample of 300 adults.

Results: Only 19 % of participants had heard of dietary nitrate prior to completing the questionnaire. Most participants (∼70 %) were unsure about the effects of dietary nitrate on health parameters (e.g. blood pressure, cognitive function and cancer risk) or exercise performance. Most participants were unsure of the average population intake (78 %) and acceptable daily intake (83 %) of nitrate. Knowledge of dietary sources of nitrate was generally low, with only ∼30 % of participants correctly identifying foods with higher or lower nitrate contents. Almost none of the participants had deliberately purchased, or avoided purchasing, a food based around its nitrate content. Nitrate Knowledge Index scores were generally low (median (interquartile range (IQR)): 5 (8)), but were significantly higher in individuals who were currently employed v. unemployed (median (IQR): 5 (7) v. 4 (7); P < 0·001), in those with previous nutrition education v. no nutrition education (median (IQR): 6 (7) v. 4 (8); P = 0·012) and in individuals who had heard of nitrate prior to completing the questionnaire v. those who had not (median (IQR): 9 (8) v. 4 (7); P < 0·001).

Conclusions: This study demonstrates low knowledge around dietary nitrate in UK-based adults. Greater education around dietary nitrate may be valuable to help individuals make more informed decisions about their consumption of this compound.

Objective: This study aimed to measure urinary sodium and potassium as a measure of sodium and potassium intake concerning the knowledge, attitude and practice towards sodium intake among a group of healthy residents in the UAE.

Design: A cross-sectional study on a sample of healthy adults in the UAE. In addition to the knowledge, attitude and practice questionnaire, sodium and potassium excretions and food records were taken.

Setting: The UAE.

Participants: A sample of 190 healthy individuals aged between 20 and 60 years.

Results: The mean (± sd) age of the sample was 38·6 (± 12·5) years, and 50·5 % were females. The mean urinary sodium and potassium intake were 2816·2 ± 675·7 mg/d and 2533·3 ± 615 mg/d, respectively. The means were significantly different compared with the WHO recommendation of sodium and potassium (P < 0·001). About 65 % of the participants exceeded the WHO recommendations for salt intake, and participants' knowledge classification for health-related issues was fair, while food-related knowledge was poor (P = 0·001). A two-stage stepwise multiple regression analysis revealed that knowledge, attitude and practice scores were negatively associated with urinary sodium excretion (r = -0·174; P = 0·017) and those older participants and females had lower urinary sodium excretion (P < 0·001).

Conclusions: These findings may suggest an increase in the risk of hypertension in the UAE population. Moreover, these findings emphasise the need to establish education and public awareness programmes focusing on identifying the sodium contents of foods and establishing national regulations regarding food reformulation, particularly for staple foods such as bread.

Objective: In this paper, we examined whether there are inequalities in access to food retail (by type and healthiness) across local government areas (LGA) in Greater Melbourne and by LGA grouped based on their distance from the central business district and Growth Area designation. We also examined whether these inequalities persisted over time.

Design: This is a secondary analysis of a repeated cross-sectional census of food outlets collected at four time points (2008, 2012, 2014 and 2016) across 31 LGA. Using Geographical Information Systems, we present a spatial analysis of food retail environments in Melbourne, Australia, at these four times over eight years.

Setting: Greater Melbourne, Australia.

Participants: 31 LGA in Greater Melbourne.

Results: Findings show significant inequalities in access to healthy food retail persisting over time at the LGA level. Residents in lower density urban growth areas had the least access to healthy food retail. Unhealthy food retail was comparatively more accessible, with a temporal trend indicating increased accessibility over time in urban growth areas only.

Conclusion: Accessibility to food outlets, particularly healthy food outlets and supermarkets, in Greater Melbourne is not equal. To identify and address health inequalities associated with rapid urban growth, further understanding of how people interact with the food environment needs to be explored.

Objective: The high availability of energy-dense nutrient-poor discretionary foods in large serving and package sizes may have shifted portion size norms (described as a typical perception of how much people choose to eat from a given food at a single eating occasion) towards larger sizes. Few public health recommendations exist around appropriate discretionary food portion sizes. This qualitative study aimed to explore the underlying rationale of portion size norms of discretionary foods among Australian adults 18-65 years.

Design: Four focus group sessions were conducted. Collected data were analysed using inductive thematic analysis.

Setting: Focus groups were held online via Zoom between September and October 2023.

Participants: Thirty-four participants were recruited in the study (mean age 38 years, 19 females).

Results: The key themes raised from inductive analysis were personal factors, eating context factors and food environment factors relevant to the portion size norms. A framework was established to illustrate the interaction across these themes during the conceptualisation of the norms. For serving size availability, consumers found that there were limited serving size choices when making portion size selections and lacked the knowledge and skills in portion control.

Conclusions: These findings highlight the need to make positive changes to the current food environment and develop relevant public health guidelines around appropriate portion sizes to promote healthier portion size norms and enable better portion control.

Objective: This study aimed to evaluate the association between vegetable intake and major depressive disorder (MDD) through cross-sectional analysis and bidirectional two-sample Mendelian randomisation (MR).

Design: Cross-sectional analysis was conducted on National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2018 and the corresponding Food Patterns Equivalents Database (FPED). Genome-wide association study (GWAS) data were obtained from UK Biobank and Psychiatric Genomics Consortium (PGC) dataset. Logistic regression analysis was performed after calculating the weights of the samples. Inverse variance weighted, MR-Egger and weighted median methods were used to evaluate the causal effects.

Setting: A Patient Health Questionnaire-9 score ≥ 10 was considered to indicate MDD. Low vegetable intake was defined as < 2 cups of vegetables per day.

Participants: 30 861 U.S. adults from NHANES. The GWAS data sample size related to vegetable intake were comprised 448 651 and 435 435 cases respectively, while the GWAS data sample size associated with MDD encompassed 500 199 cases.

Results: There were 23 249 (75·33 %) participants with low vegetable intake. The relationship between vegetable intake and MDD was nonlinear. In the multivariate model adjusted for sex, age, education, marital status, poverty income ratio, ethnicity and BMI, participants with low vegetable intake were associated with an increased risk of MDD (OR = 1·53, 95 % CI (1·32, 1·77), P < 0·001). Bidirectional MR showed no causal effects between vegetable intake and MDD.

Conclusions: Cross-sectional analysis identified a significant relationship between vegetable intake and MDD, whereas the results from bidirectional two-sample MR did not support a causal role.

Objective: To assess the availability and marketing of ultra-processed foods (UPF) in modern retail food outlets (supermarkets and minimarts) in Kenya and associated factors.

Design: This cross-sectional study was conducted in Kenya from August 2021 to October 2021. Variables included the geographic location and the socio-economic status (SES) levels, the food items displayed for sale and advertised in the stores, and locations in the stores such as the entrance.

Setting: Three counties in Kenya (Nairobi - urban, Mombasa - coastal tourist and Baringo - rural). Each county was stratified into high and low SES using national poverty indices.

Participants: Food outlets that offered a self-service, had at least one checkout and had a minimum of two stocked aisles were assessed.

Results: Of 115 outlets assessed, UPF occupied 33 % of the cumulative shelf space. UPF were the most advertised foods (60 %) and constituted 40 % of foods available for sale. The most commonly used promotional characters were cartoon characters (18 %). UPF were significantly more available for sale in Mombasa (urban) compared to Baringo (rural) (adjusted prevalence rate ratios (APRR): 1·13, 95 % CI 1·00, 1·26, P = 0·005). UPF advertisements were significantly higher in Mombasa ((APRR): 2·18: 1·26, 3·79, P = 0·005) compared to Baringo and Nairobi counties. There was a significantly higher rate of advertisement of UPF in larger outlets ((APRR): 1·68: 1·06, 2·67 P = 0·001) compared to smaller outlets.

Conclusions: The high marketing and availability of UPF in modern retail outlets in Kenya calls for policies regulating unhealthy food advertisements in different settings in the country.

Objective: Mandatory folic acid fortification of enriched grains has reduced neural tube defect prevalence in several countries. We examined salt as an additional vehicle for folic acid fortification. The primary objective was to examine the change in serum folate concentration after 1 month of consumption of fortified iodised salt with folic acid (FISFA) among women of reproductive age. The secondary objectives were to examine (1) the feasibility of implementing FISFA intervention and (2) the acceptability of FISFA.

Design: We conducted a pre–post intervention study (January–April 2023). Participants received a FISFA saltshaker with the study salt (1 g of sodium chloride salt fortified with 100 mcg of folic acid) to use instead of regular table salt for 1 month. Serum folate was measured using the Elecsys Folate-III immunoassay method at baseline and 1-month endpoint. Change in serum folate was assessed using a two-tailed Wilcoxon signed rank test for paired samples.

Setting: Metropolitan city, Southern USA.

Participants: Non-pregnant, 18–40-year-old women who lived alone/with a partner.

Results: Thirty-two eligible women consented to participate, including eleven non-Hispanic-White, eleven non-Hispanic-Black and ten Hispanic. Post-intervention, there was a significant increase in median serum folate concentration of 1·40 nmol/l (IQR 0·74–2·05; P < 0·001) from 24·08 nmol/l to 25·96 nmol/l in an analytical sample of n 29. An increase was seen in 28/29 (93 %) participants. Feasibility: 100 % study consent and compliance. FISFA acceptability: 25 d average use; 1·28 g average daily intake; 96·7 % and 90 % reported taste and colour of FISFA as highly acceptable, respectively.

Conclusions: FISFA is an effective approach to increasing serum folate concentrations among women of reproductive age. Findings should be replicated in a larger study.

Objective: This study aimed to assess the association between emotional attitudes towards diabetes, eating behaviour styles and glycaemic control in outpatients with type 2 diabetes.

Design: Observational study.

Setting: Endocrinology Division of Hospital de Clínicas de Porto Alegre, Brazil.

Participants: Ninety-one outpatients diagnosed with type 2 diabetes. Baseline assessments included data on clinical parameters, lifestyle factors, laboratory results, eating behaviour styles and emotional attitudes. All patients received nutritional counseling following diabetes recommendations. A follow-up visit was scheduled approximately 90 days later to evaluate changes in weight, medication dosages and glycated Hb (HbA1c) values. Patients were categorised based on their emotional attitude scores towards diabetes (positive or negative), and their characteristics were compared using appropriate statistical tests.

Results: At baseline, no differences were observed in the proportion of patients with good glycaemic control, eating behaviour styles and emotional attitudes. However, patients with a positive attitude towards the disease exhibited a significantly better response in glycaemic control compared with the reference group (OR = 3·47; 95 % CI = 1·12, 10·75), after adjusting for diabetes duration, sex and medication effect score. However, when BMI was included in the model, the association did not reach statistical significance. Therefore, these results should be interpreted with caution.

Conclusions: Patients with a positive attitude towards diabetes showed a greater reduction in HbA1c levels following nutritional counseling. However, baseline BMI could be a potential confounding factor.