Public Health Nutrition最新文献

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: 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.

Objective: To describe and evaluate nutrition-related policy, system and environmental (PSE) change strategies implemented in a rural, volunteer-run Georgia food pantry, exploring facilitators and barriers and changes in clients' perceptions of food distributed following implementation of nutrition-related PSE changes.

Design: The mixed-methods evaluation used pre-post key informant interviews, client surveys and programme documents to assess implementation and outcomes of a nutrition policy and other PSE changes.

Setting: Hancock County, Georgia.

Participants: Survey respondents were food pantry clients who completed surveys both in January 2021 and March 2022 (n 155). Key informants were programme staff, a local coalition member and food pantry leadership (n 9).

Results: Nutrition-related PSE changes included a nutrition policy, produce procurement partnerships and enhanced refrigeration; an awareness campaign and nutrition education were also conducted. Facilitators included the implementation approach (e.g., encouraging small steps and joint policy development), relationship formation and partnerships. Barriers were modest capacity (e.g., funding and other resources), staffing/volunteers and limited experience with food policy and procurement processes. Client surveys in 2021-2022 showed canned/dried foods as most commonly received, with significant (p < 0.05) increases at follow-up in always receiving meat/poultry/seafood and significant decreases in always receiving canned fruits and dry beans/lentils. In both 2021 and 2022, substantial proportions of respondents reported food insecurity (>60 %), having obesity (>40 %), poor/fair health (>30 %) and a household member with hypertension/high blood pressure (>70 %).

Conclusions: Nutrition-related PSE changes in rural food pantries to improve the healthfulness of foods distributed require substantial resources, yet if sustained, may increase client access to healthy foods and improve diets.

Objective: The present study examined the association of body mass index (BMI), screen and sleep time, physical fitness and eating behaviour with Mediterranean diet (MD) adherence in a sample of pre-schoolers from Granada, Spain.

Design: A cross-sectional, non-randomised design was employed. A multilinear regression model with backward elimination was used for analysis.

Setting: Variables included age, BMI, screen time, hours of nightly sleep, physical fitness, food approach and food avoidance. The developed model met assumptions of multiple regression in terms of linearity, homoscedasticity, normality, independence and non-multicollinearity.

Participants: Data were collected from 653 of the 2250 three-to-six-year-old children attending the 18 schools invited to take part in the present study.

Results: Better sleep time and lower screen time and food avoidance were found to be predictive of MD adherence. These variables explained 15% of the variance in pre-schoolers MD adherence.

Conclusions: The present study suggests that sleep and screen time and food avoidance are important components to consider when targeting improvements in MD adherence in pre-schoolers. Future research should explore the way in which parental health behaviours influence their children's health habits in order to better understand outcomes.

Objective: Governments are seeking to regulate food environments to promote health by restricting sales and marketing of processed foods high in fat, sugar and sodium. We aimed to evaluate whether the legal instruments in member states of the Western Pacific Region (WPR) mandate the declaration of nutrient composition for nutrients of concern in relation to Codex Alimentarius and non-communicable disease (NCD) prevention.

Design: We undertook content analysis of legal instruments governing food quality and safety, documenting mandates for nutrient declarations in the WPR. Legal instruments were purposefully sourced through a systematic search of regional legal databases and Google. We performed qualitative and quantitative analysis, using an adapted version of Reeve and Magnusson's Framework for Analysing and Improving the Performance of Regulatory Instruments.

Setting: Legal instruments governing food quality and safety in twenty-eight member states of the WPR.

Results: There was substantial variation in the nutrient declaration mandates within legal instruments, with only three out of twenty-eight countries mandating nutrient declarations in full alignment with Codex recommendations (energy, protein, available carbohydrate, fat, saturated fat, sodium and total sugars). Just four countries mandated the display of sodium, sugar, saturated fat and trans-fats, in line with NCD prevention recommendations. Sodium labelling was mandated in ten countries, sugar in seven and saturated fat in six.

Conclusions: There is scope for countries to strengthen legal instruments for nutrient declarations to better support diet-related NCD prevention efforts. Regional support agencies can play a key role in promoting greater policy coherence and alignment with international best practice.

Objective: This study assessed the suitability of nutritional composition data from a commercial dataset for policy evaluation in Brazil.

Design: We compared the proportions of packaged foods and beverages, classified according to the Nova food classification and the nutritional composition of matched products using data from a commercial database of food labels (Mintel-Global New Products Database (GNPD)) and the Brazilian Food Labels Database (BFLD), collected in 2017 as a 'gold standard.' We evaluated the agreement between the two datasets using paired t tests, Wilcoxon-Mann-Whitney test and the Intraclass Correlation Coefficient (ICC) for energy, carbohydrates, total sugars, proteins, total fats, saturated fats, trans-fats, sodium and fiber.

Setting: Brazil.

Participants: Totally, 11 434 packaged foods and beverages collected in 2017 provided by BFLD and 67 042 packaged foods and beverages launched from 2001 to 2017 provided by Mintel-GNPD.

Results: The proportions of ultra-processed foods (UPF) were similar in both datasets. Paired products exhibited an excellent correlation (ICC > 0·80), with no statistically significant difference in the mean values (P ≥ 0·05) of most nutrients analysed. Discrepancies in fibre and fat content were noted in some UPF subcategories, including sweet biscuits, ice cream, candies, dairy beverages, sauces and condiments.

Conclusion: The Mintel-GNPD dataset closely aligns with the BFLD in UPF distribution and shows a similar nutritional composition to a sample of matched foods available for purchase in stores, indicating its potential contribution to monitoring and evaluating food labelling policies in Brazil and in studies of food and beverages composition in food retail through the verification of policy compliance.

Objective: To assess the frequency and correlates of meal-kit use across five countries using population-level data.

Design: Online surveys conducted in 2022 assessed meal-kit use in the past week. Binary logistic regression models examined sociodemographic and nutrition-related correlates of meal-kit use, including self-reported home meal preparation and cooking skills, commercially prepared meal consumption and healthy eating, weight change and sustainability efforts.

Setting: Canada, Australia, the UK, the USA and Mexico.

Participants: 20,401 adults aged 18-100 years.

Results: Overall, 14 % of participants reported using meal-kits in the past week. Use was highest in the USA (18 %) and lowest in Canada (9 %). Meal-kit use was greater among individuals who were younger, male, of minority ethnicity, had high educational attainment, had higher income adequacy or had children living in the household (P < 0·01 for all). Use was greater for those who participated in any food shopping (v. none), those who prepared food sometimes (3-4 d/week or less v. never) and those who reported 'fair' or better cooking skills (v. poor; P < 0·05 for all). Consuming any 'ready-to-eat' food (v. none) and visiting restaurants more recently (v. > 6 months ago; P < 0·001 for all) were associated with greater meal-kit use. Eating fruits/vegetables more than 2 times/d and engaging in diet modification efforts were also associated with increased meal-kit use, as was engaging in weight change or sustainability efforts (P < 0·001 for all).

Conclusions: Meal-kits tend to be used by individuals who make efforts to support their health and sustainability, potentially valuing 'convenient' alternatives to traditional home meal preparation; however, use is concentrated amongst those with higher income adequacy.

Objective: This study is the first study in Middle Eastern population that aimed to investigate the association between global diet quality Score(GDQS) and risk of hypertension(HTN) in Iranian adults.

Design: This population-based cohort study was conducted on 5,718 individuals aged≥18 years from the third and fourth TLGS surveys, who were followed until the sixth survey(mean follow-up:7.8 years). Dietary data were collected using a validated food frequency questionnaire to calculate GDQS as a novel food-based metric designed to assess diet quality across diverse populations. It evaluates the adequacy of healthy food groups(e.g., fruits, vegetables, whole grains) while monitoring the moderation of unhealthy or excessive intake(e.g., refined grains, processed meats, sugary foods).

Setting: Tehran Lipid and Glucose Study.

Participants: Iranian men and women.

Results: Participants had a mean±SD age of 37.7±12.8 years, BMI of 26.6±4.7 kg/m², and GDQS of 25.3±4.4. During the 7.8-year follow-up, 1302(18%) new cases of HTN were identified. Higher GDQS and its healthy components were associated with reduced HTN risk(HR:0.83;95%CI:0.70-0.98;P_trend=0.034 and HR:0.78;95%CI:0.65-0.92;P_trend=0.005, respectively), while unhealthy components of GDQS showed no association with HTN risk (HR:1.14;95%CI:0.98-1.33;P_trend=0.059). These protective associations were observed across all weight categories and both genders, with stronger effects among obese individuals(for GDQS:HR:0.75;95%CI:0.58-0.98;P=0.041; for healthy components:HR:0.75;95%CI:0.57-0.99;P=0.044) and females(for GDQS:HR:0.77;95%CI:0.62-0.97;P=0.028; for healthy components:HR:0.76;95%CI:0.60-0.96;P=0.023).

Conclusions: A higher GDQS was associated with a reduced risk of incident HTN among Iranian adults. Adherence to a high-quality diet, particularly focusing on the healthy dietary components of GDQS, may serve as an effective strategy for preventing HTN, especially among obese individuals and women.

Objectives: To assess the prevalence and identify sociodemographic predictors of regular fast-food consumption (R-FFC) among United Arab Emirates (UAE) adults to inform public health nutrition responses to growing diet-related ill health in the region.

Design: This is a descriptive cross-sectional study using purposive, convenience sampling. Data were collected using an online survey adapted from two validated surveys and distributed via social media platforms. R-FFC was defined as visiting a fast-food restaurant to eat ≥ 2 times/week. Pearson's χ² tests and multiple binary logistic regression models were used to investigate prevalence and predictors of R-FFC. All statistical significance was considered at P-value < 0·05.

Setting: Community, adults living in the UAE.

Participants: UAE residents, ≥ 18 years, who consumed fast food ≥ once during the previous month.

Results: Totally, 320 respondents met the inclusion criteria (age = mean 23·7 (sd 7·7) years). The prevalence of R-FFC was 46·6 %. Based on results from the regression model, predictors of R-FFC were being female (AOR 2·47; 95 % CI 1·06, 5·79), married (AOR 3·11; 95 % CI 1·25, 7·77), BMI ≥ 25·0 (AOR 2·09; 95 % CI 1·10, 4·00) and residing outside Abu Dhabi (AOR 32·79; 95 % CI 12·06, 89·16). None of the remaining variables reached statistical significance. Taste was the most common reason for FFC (56·9 %), followed by convenience (21·6 %). Regular fast-food consumers were more likely to 'super-size' meals (P = 0·011), eat alone (P = 0·009) and not have regular meal patterns (P = 0·004).

Conclusions: The study revealed a high prevalence of R-FFC among UAE adults, and novel cultural predictors and characteristics of FFC in this context, highlighting the importance of socially and culturally informed research and public health strategies in this region.