Public Health Nutrition最新文献

Objective: To assess associations between self-reported advertising exposure to foods high in fats, salt and sugar and household purchases of energy, nutrients and specific product categories.

Design: A cross-sectional design was used. Advertising exposure data were gathered using a questionnaire administered to the main shopper of each household, and purchase data from supermarkets and other stores for these households were accessed for a 4-week period during February 2019.

Setting: Households in London and the North of England.

Participants: Representative households (N 1289) from the Kantar Fast Moving Consumer Goods Panel. Main shoppers were predominantly female (71 %), with a mean age of 54 years (±13).

Results: Linear regression models identified that exposure to foods high in fats, salt and sugar advertising through traditional mediums (including broadcast and print), but not digital, transport, recreational or functional mediums, was associated with greater purchases of energy (9779 kcal; 95 % CI 3515, 16 043), protein (416 g; 95 % CI 161, 671), carbohydrate (1164 g; 95 % CI 368, 1886) and sugar (514 g; 95 % CI 187, 841). Generalised linear models showed that individuals who reported exposure to sugary drink advertising were more likely to purchase sugary drinks (1·16; 95 % CI 2·94, 4·99) but did not purchase more energy or nutrients from sugary drinks. There was no evidence of associations between exposure to advertising for sugary cereals or sweet snacks and purchases from these categories.

Conclusions: There was a strong influence of traditional advertising and sugar-sweetened beverage advertising on household food and drink purchases, thus supporting the need for advertising restrictions across traditional formats and for sugary drinks specifically.

Objective: To examine the association between red and processed meat consumption and total food expenditures in US households and explore whether households could reduce food costs by substituting these meats with other protein sources such as poultry, seafood, eggs and plant proteins.

Design: Cross-sectional study using data from the National Household Food Acquisition and Purchase Survey (FoodAPS). Using adult male equivalents (AME) for standardisation, we categorised red and processed meat purchases into quintiles. We used generalised linear models to explore the association between red or processed meat consumption and food expenditures and the cost effect of substituting meat with other proteins.

Setting: United States.

Participants: Data from 4739 households with valid acquisition information from FoodAPS, a stratified multistage probability sample of US households.

Results: Higher red and processed meat consumption were both significantly associated with higher total weekly food expenditures, particularly among households with low income. Substituting red or processed meat with poultry, eggs or plant proteins did not significantly affect overall food expenditures, whereas replacing meat with seafood, especially varieties high in n-3 fatty acids, led to increased costs.

Conclusions: Reducing red and processed meat consumption could offer savings for households, particularly those with low income. Although substitutions with seafood high in n-3 could increase expenses, alternative protein sources like poultry and plant proteins may serve as cost-neutral replacements. Public health strategies should emphasise dietary shifts' economic, health and environmental benefits and aim to make nutritious yet affordable protein sources more accessible.

Objective: To evaluate nudge strategies that increase the consumption of plant-based foods, defined as vegetarian or vegan food items, compared with meat-based options in post-secondary dining hall settings.

Design: A pilot study.

Setting: This study took place in the University of British Columbia Vancouver Campus's Gather Dining Hall (GDH) over a 6-week intervention period and two control periods. The intervention incorporated several nudges (proportion increases, item placement, taste-focused labelling, Chef's featured special verbal prompts, social media and promotional posters) into the menu and dining hall area with the goal of increasing the purchases of plant-based items. Sales data from meals that were purchased during the intervention period were compared with sales data from the two control periods.

Participants: Students and staff who purchased meals in the GDH.

Results: The proportion of plant-based items sold significantly increased during the intervention period (56·7 %; P < 0·01) compared with the last 6 weeks of term one (53·6 %) and the first 6 weeks of term two (53·4 %). The proportion of plant-based 'main' menu items was significantly higher in the intervention period (46·4; P < 0·01) when compared with the last 6 weeks of term one (40·9 %) and the first 6 weeks of term two (41·7 %).

Conclusions: The combination of nudges was effective at significantly increasing the selection of plant-based options over meat-based options in a post-secondary dining hall setting.

Objective: In the Netherlands, reformulation strategies have been established for several years, whereas Nutri-Score was implemented in 2024. Besides being a helpful tool for consumers to make healthier food choices, Nutri-Score also aims to stimulate food reformulation by food manufacturers. The present study investigates whether changes in food composition could have led to different calculated Nutri-Score classifications.

Design: Food compositions and Nutri-Score classifications were calculated using the updated Nutri-Score algorithm. Food groups with the largest change in the distribution of Nutri-Score classifications were analysed in-depth by plotting frequency distributions and calculating median contents for nutrient contents that relatively changed the most in 2020.

Setting: Food composition data were available from the Dutch Branded Food database in 2018 (n 38 295) and 2020 (n 48 091).

Participants: Not applicable.

Results: In general, median nutrient contents and calculated Nutri-Score classifications were similar for 2018 and 2020. The median sugar and SFA contents were lower for some food groups (e.g. breakfast cereals, meat preserves, sweets and sweet goods) in 2020 compared to 2018. The median SFA content for meat preserves and sweets and sweet goods was relatively low in Nutri-Score classification A ascending towards higher median content in Nutri-Score classification E.

Conclusions: Although food reformulation was not substantial in the Dutch food retail supply in 2018 and 2020, some differences in Nutri-Score classifications were observed. When implemented, Nutri-Score may encourage food manufacturers to increase their reformulation efforts. Repeated monitoring of food compositions and Nutri-Score classifications is recommended to establish reformulation efforts by food manufacturers.

Objective: To assess changes in caregiver practices for young children after integrating the Responsive Care and Early Learning (RCEL) Addendum package into nutrition services after 10 months of implementation.

Design: We measured changes in RCEL practices through a pre- and post-intervention assessment comprising a household survey and observations. To implement the intervention, we trained health service staff and community volunteers to deliver RCEL counselling to caregivers of children 0-23 months of age through existing community and facility-level platforms.

Setting: Jalal-Abad and Batken regions in the Kyrgyz Republic.

Participants: Caregivers of children aged 0-23 months at baseline.

Results: We found statistically significant increases in RCEL practices, availability of early learning opportunities in the home, decreases in parenting stress and improvements in complementary feeding practices after the intervention implementation period.

Conclusions: Findings show that delivery of RCEL counselling using the RCEL Addendum was associated with improved responsive care practices and early learning opportunities. We also found that integration of RCEL with infant and young child feeding counselling did not disrupt nutrition service delivery or negatively affect complementary feeding outcomes, but rather suggest synergistic benefits. Given the importance of providing holistic care to support optimal early childhood development, these findings provide new evidence on how to strengthen the delivery of nurturing care services in the Kyrgyz Republic.

Objective: To provide local policymakers with a guideline of potential actions to prevent the high consumption of Non-Nutritive Sweeteners (NNS) among children and adolescents observed in Chile, given the potential health problems related to NNS intake.

Design: The Delphi method was used for the evaluation of twenty-one recommendations to decrease the intake of NNS in paediatric population, with the participation of a panel of relevant actors.

Setting: The proposed recommendations were developed by the research team using the NOURISHING framework; potential actions were based on the increase in the use and intake of NNS by Chilean children, current local food regulations, recommendations of health organisations and foreign policy experiences.

Participants: Twenty-five relevant actors related to NNS, nutrition, food technology and paediatrics (out of thirty-nine invitations made to scholars, professional institutions and civil society’s organisations) participated in the Delphi study.

Results: A consensus was reached on nine recommendations regarding relevance and feasibility to be part of the guideline. Recommendations involved measures mostly related to improving the delivery of information (food content and potential health effects of NNS), supporting the generation of more evidence of NNS health effects and substitutes, and marketing restrictions when targeted to children.

Conclusions: The process produced a nine-action guideline to reduce the excessive NNS consumption among Chilean children and adolescents. Developed through a consensus-driven approach among key stakeholders, this guideline provides policymakers with a framework to adopt a precautionary stance, particularly concerning vulnerable populations, given the currently inconclusive evidence on the long-term health effects of NNS consumption.

Objective: Previous studies suggest a link between vitamin D status and COVID-19 susceptibility in hospitalised patients. This study aimed to investigate whether vitamin D concentrations in elderly individuals were associated with their susceptibility to Omicron COVID-19 incidence, the severity of the disease and the likelihood of reoccurrence during the era of the post-'zero-COVID-19' policies in China.

Design: In this retrospective study, participants were categorised into three groups based on their 25(OH)D concentrations: deficiency (< 20 ng/ml), insufficiency (20 to < 30 ng/ml) and sufficiency (≥ 30 ng/ml). The demographic and clinical characteristics, comorbidities and the incidence rate, reoccurrence rate and severity of Omicron COVID-19 were retrospectively recorded and analysed by using hospital information system data and an online questionnaire survey.

Setting: China.

Participants: 222 participants aged 60 years or older from a health management centre.

Results: Our findings revealed significant differences in the incidence (P = 0·03) and recurrent rate (P = 0·02) of Omicron COVID-19 among the three groups. Participants with lower 25(OH)D concentrations (< 20 ng/ml) exhibited higher rates of initial incidence and reoccurrence and a greater percentage of severe and critical cases. Conversely, individuals with 25(OH)D concentrations ≥ 30 ng/ml had a higher percentage of mild cases (P = 0·003). Binary and ordinal logistic regression models indicated that vitamin D supplementation was not a significant risk factor for COVID-19 outcomes.

Conclusions: In the elderly population, pre-infection vitamin D deficiency was associated with increased susceptibility to incidence, severity of illness and reoccurrence rates of Omicron COVID-19.

Objective: To understand the relationship between adolescents' unhealthy snacking behaviour during their school journey and their perceived and objective measures of food outlet availability in the school neighbourhood.

Design: A cross-sectional survey enquired about socio-demographic information, school transport modes, perceived presence of food outlets in the school neighbourhood and unhealthy food purchase and consumption on the school journey. A geographical information system analysis of the food outlets within 500 m and 1000 m school buffers was undertaken. Data were analysed using generalised linear mixed modelling.

Setting: All twelve secondary schools in Dunedin, Aotearoa New Zealand, March 2020-June 2022.

Participants: Adolescents aged 13-18 years (n 725) who reported being familiar with their school neighbourhood.

Results: Perceived availability of food outlets in the school neighbourhood was inversely correlated with distance to the closest food outlet from school and positively correlated with food outlet density within 500 m and 1000 m school buffers. Adolescents' purchase and consumption of unhealthy snacks and drinks during the school journey were associated with perceived availability of food outlets and with shorter distance to the closest food outlet from school. Mixed transport users, girls and those living in high-deprivation neighbourhoods had higher odds of purchasing and consuming unhealthy snacks and drinks during the school journey than active transport users, boys and those living in low-deprivation neighbourhoods, respectively.

Conclusions: Adolescents perceptions of the food environment and close access to food outlets in the school neighbourhood may influence adolescents' food purchase and consumption behaviours during the school journey.

Objective: To evaluate the association between ultra-processed food consumption and adherence to the EAT-Lancet diet in a representative sample of the Brazilian population.

Design: The study used data from the Brazilian National Dietary Survey 2017-2018 and employed linear regression models to evaluate the association between ultra-processed food consumption and adherence to the EAT-Lancet diet, as measured by the Nova food system and Planetary Health Diet Index (PHDI), respectively.

Setting: Nationally representative sample of the Brazilian population.

Participants: The study included 46 164 Brazilians ≥ 10 years old.

Results: The average PHDI total score was 45·9 points (95 % CI 45·6, 46·1). The ultra-processed food consumption was, with dose-response, inversely associated with the adherence to the EAT-Lancet diet. The PHDI total score was 5·38 points lower (95 % CI -6·01, -4·75) in individuals in the highest quintile of consumption of ultra-processed foods, as compared to those in the first quintile. The PHDI score was also inversely associated with the share of processed culinary ingredients and processed foods and positively associated with the share of unprocessed or minimally processed foods.

Conclusions: Our study showed an inverse relationship between the consumption of ultra-processed foods and the adherence to a healthy and sustainable diet.

Objective: To gain insight into the experiences and perspectives of registered dietitians (RD) in Canada regarding their interactions with commercial actors and actions undertaken to manage these interactions.

Design: Qualitative study using semi-structured interviews combined with a document analysis.

Setting: Quebec, Canada.

Participants: RD aged ≥ 18 years (n 18).

Results: All participants reported interacting with commercial actors during their careers, such as receiving continuing education provided or sponsored by food companies. RD in Quebec perceive these interactions as either trivial or acceptable, depending on the commercial actor or interaction type. Participants discussed how certain interactions could represent a threat to the credibility and public trust in dietitians, among other risks. They also discussed the benefits of these interactions, such as the possibility for professionals to improve the food supply and public health by sharing their knowledge and expertise. Participants reported ten mechanisms used to manage interactions with commercial actors, such as following a code of ethics (individual level) and policies such as partnerships policy (institutional level). Finally, RD also stressed the need for training and more explicit and specific tools for managing interactions with commercial actors.

Conclusions: RD in Quebec, Canada, may engage with commercial actors in their profession and hold nuanced perspectives on this matter. While some measures are in place to regulate these interactions, they are neither standardised nor evaluated for their effectiveness. To maintain the public's trust in RD, promoting awareness and developing training on this issue is essential.