Public Health Nutrition最新文献

Objective: To explore the meanings that newly arrived refugee adolescents residing in the Southeastern USA attribute to foods.

Design: We used methods from cognitive anthropology to assess whether adolescents from different countries share a cultural model of eating behaviours.

Setting: A school-based study in a community in the Southeastern USA.

Participants: Adolescents (10-17 years) who arrived in the USA on a refugee visa in the previous year.

Results: Adolescents showed consensus in grouping items and in identifying some foods as associated with adults and others with children. There was evidence of a shared model of eating practices across age, gender and number of siblings. Adolescents who had lived in a refugee camp were significantly different in how they grouped items.

Conclusions: Adolescents from nine countries shared a model of eating behaviours; these patterns are consistent with rapid dietary acculturation within 1 year of arrival or with shared models held from pre-arrival. Our finding that adolescents who recently arrived in the USA generally agree about how foods relate to one another holds promise for generalised nutrition and dietary interventions across diverse adolescent groups.

Objective: This study examines public support - and its drivers - for comprehensive policy packages (i.e. bundles of coherent policy measures introduced together) aimed at improving food environments.

Design: Participants completed an online survey with a choice-based conjoint experiment, where they evaluated pairs of policy packages comprising up to seven distinct food environment measures. After choosing a preferred package or opting for a single policy, participants designed their ideal policy package. Based on their choices, respondents were categorised as resistant, inclined or supportive towards policy packaging according to their frequency of opting out for single measures and the number of policies they included in their ideal package.

Setting: The study was conducted in Germany via an online survey.

Participants: The sample included 1200 eligible German voters, recruited based on age, gender and income quotas.

Results: Based on both opt-out frequency (44·7 %) and ideal policy packaging (72·8 %) outcomes, most respondents were inclined towards policy packages. The inclusion of fiscal incentives and school-based measures in packages enhanced support, while fiscal disincentives reduced it. Key drivers of support included beliefs about the importance of diet-related issues and the role of government in regulation, while socio-demographic factors, political leaning and personal experience with diet-related disease had minimal impact.

Conclusions: The results reveal public appetite for policy packages to address unhealthy food environments, contingent on package design and beliefs about the issue's severity and legitimacy of intervention. Public health advocates should design and promote policy packages aligned with public preferences, especially given anticipated opposition from commercial interests.

Objective: To describe the economic, lifestyle and nutritional impact of the COVID-19 pandemic on parents, guardians and children in Malaysia, Indonesia, Thailand and Vietnam.

Design: Data from the SEANUTS II cohort were used. Questionnaires, including a COVID-19 questionnaire, were used to study the impact of the pandemic on parents/guardians and their children with respect to work status, household expenditures and children's dietary intake and lifestyle behaviours.

Setting: Data were collected in Malaysia, Indonesia, Thailand and Vietnam between May 2019 and April 2021.

Participants: In total, 9203 children, aged 0·5-12·9 years, including their parents/guardians.

Results: Children and their families were significantly affected by the pandemic. Although the impact of lockdown measures on children's food intake has been relatively mild in all countries, food security was negatively impacted, especially in Indonesia. Surprisingly, in Malaysia, lockdown resulted in overall healthier dietary patterns with more basic food groups and less discretionary foods. Consumption of milk/dairy products, however, decreased. In the other countries, intake of most food groups did not change much during lockdown for households based on self-reporting. Only in rural Thailand, some marginal decreases in food intakes during lockdown persisted after lockdown. Physical activity of children, monthly household income and job security of the parents/guardians were negatively affected in all countries due to the pandemic.

Conclusion: The COVID-19 pandemic has significantly impacted societies in South-East Asia. To counteract negative effects, economic measures should be combined with strategies to promote physical activity and eating nutrient-adequate diets to increase resilience of the population.

Objective: To investigate the co-existence of single and multiple anthropometric failures among children using an extended composite index of anthropometric failure (ECIAF). This study aims to elucidate the complex interplay between child-specific and maternal factors, highlighting the multifaceted nature of childhood malnutrition.

Design: A multicentre cross-sectional study as part of the BESLEN project.

Setting: Mother-Child Education Centre in the Pendik district of Istanbul, Türkiye.

Participants: 1283 children (preschool children, n 822, school-aged children, n 462) and 1044 mothers.

Results: Almost 1/3 of the children included in the study had an anthropometric failure as determined by ECIAF. Weight excess was the leading cause of the total anthropometric failures, most of which were observed to be slightly higher in boys, except for stunting only and co-occurrence of stunting and underweight. Among the mother-related factors, including higher BMI and waist circumference, low maternal age at delivery, low number of children in the household and being a single parent may be considered predisposing factors to any phenomenon of childhood malnutrition. Among child-related factors, birth weight being ≥ 3500 g had a higher risk for ECIAF failure, and children aged ≥ 60 months were more likely to experience stunting and underweight, while those < 60 months had a higher prevalence of weight excess.

Conclusions: The co-existence of stunting and overweight, the occurrence of weight excess in one in three stunted children and the high risk of central obesity are public health concerns. Also, ECIAF can better assess all aspects of childhood malnutrition than conventional measures.

Objectives: Despite bold commitments to reduce anaemia, little change in prevalence was observed over the past decade. We aimed to generate subnational maps of anaemia among women of reproductive age (WRA), malaria transmission and hemoglobinopathies to identify priority areas but also explore their geographical overlap.

Design: Using the most recent Demographic and Health Surveys (DHS), we first mapped anaemia clusters across sub-Saharan Africa and identified the West and Central Africa (WCA) as a major cluster. Geographic clusters with high anaemia and related aetiologic factors were identified using spatial statistics. Multilevel regression models were run to identify factors associated with any, moderate and severe anaemia.

Settings: West and Central African countries (n 17).

Participants: WRA (n 112 024) residing in seventeen WCA countries.

Results: There was a significant overlap in geographical clusters of anaemia, malaria and hemoglobinopathies, particularly in the coastal areas of the WCA region. Low birth interval (0·86 (0·77, 0·97)), number of childbirth (1·12 (1·02, 1·23)) and being in the 15-19 age range (1·47 (1·09, 1·98)) were associated with increased odds of any anaemia. Unimproved toilet facility and open defecation were associated with any anaemia, whereas the use of unclean cooking fuel was associated with moderate/severe anaemia (P < 0·05). Access to healthcare facility, living in malaria-prone areas and hemoglobinopathies (HbC and HbS) were all associated with any, moderate or severe anaemia.

Conclusion: Interlinkages between infection, hemoglobinopathies and nutritional deficiencies complicate the aetiology of anaemia in the WCA region. Without renewed efforts to integrate activities and align various sectors in the prevention of anaemia, progress is likely to remain elusive.

Objective: To characterise the nature of digital food and beverage advertising in Singapore.

Setting: Food and beverage advertisements within twenty clicks on the top twelve non-food websites and all posts on the Facebook and Instagram pages of fifteen major food companies in Singapore were sampled from 1 January to 30 June 2018.

Design: Advertised foods were classified as being core (healthier), non-core or mixed dishes (e.g. burger) using the WHO nutrient profile model and national guidelines. Marketing techniques were assessed using published coding frameworks.

Participants: NA.

Results: Advertisements (n 117) on the twelve non-food websites were largely presented as editorial content. Food companies posted twice weekly on average on social media sites (n 1261), with eatery chains posting most frequently and generating the largest amount of likes and shares. Key marketing techniques emphasised non-health attributes, for example, hedonic or convenience attributes (85 % of advertisements). Only a minority of foods and beverages advertised were core foods (non-food website: 16·2 %; social media: 13·5 %).

Conclusions: Top food and beverage companies in Singapore actively use social media as a platform for promotion with a complex array of marketing techniques. A vast majority of these posts were unhealthy highlighting an urgent need to consider regulating digital food and beverage advertising in Singapore.

Objective: Recent studies have shown that inclusion of eggs in young children's diet can help meet nutritional requirements associated with cognitive development. This study aims to investigate the effect of egg consumption on Early Childhood Development (ECD) using Ages and Stages Questionnaire-3(ASQ-3) in Burkina Faso.

Design: The study presented here uses data collected during a follow-up of the Un Oeuf-a 3 arm clustered randomized controlled trial (RCT), conducted roughly four months after the end of the RCT.

Setting: This research was conducted in 18 rural villages within the Kaya Department of the Sanmatenga Province in Burkina Faso.

Participants: Participants of this study include a total of 244 children aged between 18-33 months, with 78 children in the full intervention group, 83 in the partial group, and 83 in the control group.

Results: Results show that children with consistent egg consumption (in all months) had a lower odd of falling below the cut-off scores in gross motor (OR = 0.13, p = 0.02) and personal social skills (OR = 0.34, p = 0.05). And a dose response was established; for each additional egg/week, a 1.9% increase in scores for problem-solving skills was observed.

Conclusions: Findings from this study contribute to a growing body of evidence that increasing egg consumption among children in LMICs can improve growth and development. The study highlights the need for additional research in LMICs to better understand the multifactorial relationship between diet and childhood development.

Objective: To assess associations between dietary fat quality indices and risk of pre-diabetes and type 2 diabetes mellitus (T2DM) among Iranian adults.

Design: Daily intakes of fatty acids were estimated using a validated FFQ with 168 food items. Adjusted hazard ratios (HR) and 95 % CI for pre-diabetes and T2DM were calculated across tertile categories of dietary fat quality indices including the atherogenic index, thrombogenic index, health-promoting index, ratio of PUFA to SFA (PUFA:SFA) and ratio of hypo- and hypercholesterolaemia (h:H).

Setting: Tehran Lipid and Glucose Study.

Participants: Iranian men and women.

Results: The mean (sd) age of the 2042 pre-diabetes-free participants in pre-diabetes analysis was 38·84 (12·97), and 55·2 % were women. In T2DM analysis, the mean (sd) age of the 2295 T2DM-free participants was 40·06 (13·42), and 54·6 % of them were women. In the crude model, the PUFA:SFA ratio was positively associated with T2DM incidence (HR = 1·43; 95 % CI 1·04, 1·98). However, after adjustment for confounding variables, there were no significant associations between dietary fat quality indices and risk of pre-diabetes and T2DM.

Conclusions: We found no significant association between fat quality indices and risk of pre-diabetes and T2DM. Further prospective and clinical trial studies are needed to clarify the issue.

Objective: To co-design support strategies to enable sustainable, healthy, affordable food provision, including waste mitigation practices, in Australian Early Childhood Education and Care (ECEC) settings.

Design: Based on the co-design IDEAS framework (Ideate, DEsign, Assess & Share), this co-design process involved iterative interviews and focus groups with ECEC centre staff and workshops with Nutrition Australia. Interview and workshop themes were coded to the Theoretical Domains Framework (TDF) to develop initial prototypes for support strategies that were further developed and refined in focus groups.

Setting: ECEC with onsite food provision, in Victoria, Australia.

Participants: ECEC staff and a Victorian Government-funded programme delivered through Nutrition Australia that provides nutrition support to ECEC services.

Results: ECEC staff interviews (n 17) suggested a lack of knowledge on the topic of sustainable healthy food provision and a need for resources and support for all staff and children. Workshops with Nutrition Australia built on interviews and suggested a focus on lower intensity strategies and a suggestion to embed knowledge-related activities into the children's curriculum. Focus groups (n 8) further informed co-design of strategies, producing a visual representation of sustainable healthy food provision with supporting tips and a whole-of-centre approach that includes children through a classroom activity.

Conclusions: The co-designed resources could provide feasible strategies for the adoption of sustainable, healthy and affordable provision practices in the ECEC setting. Involvement of a local government-funded health promotion service provides valuable research-to-practice contribution as well opportunity for scalable dissemination of resources through existing infrastructure.

Objective: For the past three decades, India has implemented several nutrition programmes to address malnutrition in the under-fives. To understand the programme's impact, this study assesses the prevalence of acute malnutrition, moderate acute malnutrition (MAM) and severe acute malnutrition (SAM), using mid-upper arm circumference (MUAC) among tribal children.

Design: The survey was conducted in two tribal blocks (Desaiganj and Bhamragad) of the Gadchiroli district in Maharashtra to identify children registered in the 'Anganwadi' program.

Setting: A community-based cross-sectional survey was carried out.

Participants: The total sample size was 1055 children (aged 0-59 months).

Results: The overall prevalence of SAM and MAM was 1·4 % (n 15) and 9·8 % (n 103). A higher prevalence of MAM was found in males (38·5 %, n 40) and females (27·1 %, n 28) in below 6 months. Additionally, a higher prevalence of MAM was observed in females (10·7 %, n 113) compared with males (9·0 %, n 95). The prevalence of SAM was significantly (P < 0·001) higher in females (1·7 %, n 18) than in males (1·0 %, n 11). Children aged between 12 and 17 months were sixteen times more likely (OR = 16·9, P < 0·001, CI = 4·8, 59·6) to have MAM (MUAC < 12·5 cm) than children aged between 6 and 11 months. Children from the Desaiganj block were significantly less likely (OR = 0·4, P < 0·001, CI = 0·2, 0·7) to have MAM compared with children from Bhamragad. Approximately 4 % (n 42) of children were classified as critically malnourished.

Conclusion: There is an urgent need for block-level monitoring of MAM and SAM, as well as evaluation of existing nutrition programmes, to address the disparity in the sex-specific prevalence of MAM and SAM in tribal areas.