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Response to Dewey et al.’s Letter 对杜威等人来信的回应
4区 医学 Pub Date : 2023-06-30 DOI: 10.26596/wn.202314295-99
A. Gupta, P. Rundall, N. Ntombela, H. Sachdev
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没有一个
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引用次数: 0
Greenfeeding - an urgent environmental and public health issue! 绿色喂养——一个紧迫的环境和公共健康问题!
4区 医学 Pub Date : 2023-06-30 DOI: 10.26596/wn.202314291-94
Britta Boutry-stadelmann, A. Linnecar
Key messages • Food has a measurable impact on climate change at every stage of production, packaging, transport, waste treatment. Greenfeeding (sometimes referred to as eco-feeding or ecofriendly feeding) means producing and eating local, healthy and sustainable foods. • Ultra-processed foods (UPFs) top the list of planetary burdens in terms of manufacturing as well as in terms of health impacts (NDCs and infections). Formula and industrial baby foods are UPFs and therefore make an important contribution to negative impacts on climate and natural resources. • Exclusive breastfeeding for the first 6 months and continued breastfeeding while giving family foods produced locally by sustainable agriculture are vital measures for the health of the child, the mother and the environment. They are of critical importance to reduce carbon and water footprints and mitigate the impact of climate change and pollution. • Therefore, type of policy and legal measure to protect, promote and support breastfeeding is a direct and fundamental contribution to mother and child health, to public health and to the health of our planet. • It is crucial to combine legislation (implementation of the International Code of Marketing of Breast-milk Substitutes and related WHA Resolutions) and traditional cultural contexts to assure success of greenfeeding campaigns.
•食品在生产、包装、运输、废物处理的每个阶段都对气候变化产生可衡量的影响。绿色喂养(有时被称为生态喂养或生态友好喂养)意味着生产和食用当地的、健康的和可持续的食物。•超加工食品(upf)在制造和健康影响(国家自主贡献和感染)方面位居全球负担之首。配方奶粉和工业婴儿食品属于UPFs,因此对气候和自然资源产生了重大的负面影响。•头6个月的纯母乳喂养和继续母乳喂养,同时提供当地可持续农业生产的家庭食品,是儿童、母亲和环境健康的重要措施。它们对于减少碳足迹和水足迹以及减轻气候变化和污染的影响至关重要。•因此,保护、促进和支持母乳喂养的政策和法律措施是对母婴健康、公共健康和地球健康的直接和根本贡献。•将立法(实施《国际母乳代用品销售守则》和相关的世界卫生大会决议)与传统文化背景结合起来,以确保绿色喂养运动的成功,这一点至关重要。
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引用次数: 1
Formula for deception: Corporate violations and State negligence; Labelling and advertising in breast-milk substitutes in Argentina 欺骗公式:公司违规和国家疏忽;阿根廷母乳代用品的标签和广告
4区 医学 Pub Date : 2023-06-30 DOI: 10.26596/wn.202314213-32
L. Piaggio, B. Núñez, Ignacio Porras, Florencia Guma
The protection of breastfeeding is a human rights issue. It is closely related to the right that babies and mothers have to the highest attainable standard of health, to adequate nutrition and to reliable information. Argentina has incorporated the “International Code of Marketing of Breastmilk Substitutes” into different regulations in a partial and fragmentary manner, being considered a country “with some provisions of the Code included”.This article is intended to present an assessment of the level of compliance with the rules currently in force in Argentina by corporations as well as by state agencies responsible for enforcement and supervision, focusing on labelling and advertising aspects. The study comprised two different methods for data collection. First, labels found on containers of infant formulas and modified milks for children were collected and analysed according to NetCode Protocol for periodic assessments. Second, ads in digital ecosystem were collected and a content analysis of texts and images was performed.The packages of 54 types of breastmilk substitutes were photographed and examined. 100% of the examined labels of substitutes were in violation of the national rules and regulations and the provisions set forth in the Code. The most frequent reasons were nutrition and/or health claims or declarations, imagery and language idealizing the use of the product, and invitations to make contact with the company. Regarding mandatory texts or designs, violations included the omission, modification, and font size or position that minimizes their presence.In relation to advertising, a database of 440 Instagram and Facebook ads was created. The most profusely advertised products were modified milks for children from 1 year of age, marketed with a figure ‘3’, which constitutes a way of cross-promoting all the line-products. In addition, it was documented that the state agencies involved in approval and control of product labelling and the supervision of advertising either accepted or did nothing about companies’ violations. Moreover, the channels to file complaints were fragmented and usually non-responsive.All of this constitutes a “formula for deception”, an abusive marketing environment. Therefore, currently the major imperative is for Argentina to immediately apply the existing regulations, and to monitor and penalize violations. In the longer term, it is necessary to design a comprehensive law that covers all the provisions of the Code.
保护母乳喂养是一个人权问题。这与婴儿和母亲享有可达到的最高健康标准、获得充足营养和获得可靠信息的权利密切相关。阿根廷已将《国际母乳代用品销售守则》以部分和零碎的方式纳入不同的条例,被认为是一个“包含了《守则》某些条款”的国家。本文的目的是评估公司以及负责执行和监督的国家机构对阿根廷现行规则的遵守程度,重点是标签和广告方面。该研究包括两种不同的数据收集方法。首先,根据NetCode协议收集并分析了婴儿配方奶粉和儿童改性奶粉容器上的标签,以便进行定期评估。其次,收集数字生态系统中的广告,并对文本和图像进行内容分析。对54种母乳代用品的包装进行了拍照和检查。经检查的代用品标签100%不符合国家法规和《准则》的规定。最常见的原因是营养和/或健康声称或声明、将产品使用理想化的图像和语言,以及邀请与公司联系。关于强制性文本或设计,违规行为包括遗漏、修改、字体大小或位置最小化它们的存在。在广告方面,我们创建了一个包含440个Instagram和Facebook广告的数据库。广告最多的产品是针对1岁以下儿童的改性牛奶,以数字“3”进行销售,这构成了所有系列产品的交叉促销方式。此外,有文件表明,参与批准和控制产品标签以及监督广告的国家机构对公司的违规行为要么接受,要么不采取任何行动。此外,提出投诉的渠道支离破碎,通常没有回应。所有这些都构成了一个“欺骗公式”,一个滥用的营销环境。因此,目前阿根廷的当务之急是立即实施现有的条例,并监测和惩处违反规定的行为。从长期来看,有必要制定一项涵盖《治罪法》所有条款的综合性法律。
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引用次数: 0
Nutritional Status, Diet Quality and Levels of Anxiety During Training and Match Day in Turkish Super League Male Water Polo Players 土耳其超级联赛男子水球运动员训练和比赛日期间的营养状况、饮食质量和焦虑水平
4区 医学 Pub Date : 2023-03-31 DOI: 10.26596/wn.20231412-9
Duygu Sağlam, Gulsah Evren
This study was carried out to determine the relationship between the anxiety levels of the players playing in the Men‘s Water Polo Turkish First Division (known as Super League) teams at different periods and their nutritional status, and diet quality. The study was conducted among 60 players who professionally play water polo at different sports clubs. In order to determine the anxiety levels of the players at different time periods, the Sports Competition Anxiety Test (SCAT-A) was applied to the players on two different days. To evaluate the players’ nutritional status, 2 days of food consumption were recorded, 1 day for training and the other for match day. The quality of the players’ diet was evaluated using the Healthy Eating Index -2010. The players’ anxiety (SCAT-A scores) on the match day was found to be higher than on the training day (p<0.05). There was no statistically significant relationship between the players’ anxiety levels on training and match days and the diet quality components nor total Healty Eating Index (HEI-2010) scores on either day (p>0.05). Further studies are needed to clarify the relationship between anxiety levels experienced by players at different times and nutritional status and diet quality.
本研究旨在确定土耳其男子水球甲级联赛(即超级联赛)不同时期球员的焦虑水平与其营养状况和饮食质量之间的关系。这项研究是在不同运动俱乐部的60名职业水球运动员中进行的。为了确定运动员在不同时间段的焦虑水平,在两个不同的日子对运动员进行了体育竞赛焦虑测试(SCAT-A)。为了评估球员的营养状况,记录了2天的食物消耗,1天用于训练,1天用于比赛日。使用健康饮食指数-2010对球员的饮食质量进行评估。运动员在比赛日的焦虑(SCAT-A)得分高于训练日(p0.05)。需要进一步的研究来澄清球员在不同时间所经历的焦虑水平与营养状况和饮食质量之间的关系。
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引用次数: 0
Key considerations for developing patient management tools for small and nutritionally at-risk infants: A scoping review 为小婴儿和营养风险婴儿开发患者管理工具的关键考虑因素:范围审查
4区 医学 Pub Date : 2023-03-31 DOI: 10.26596/wn.202314158-75
Kelsey Grey, R. Rana, M. McGrath, Marko Kerac
Background: To improve global child health, efficacious interventions are important but real-world effectiveness is crucial; this requires translating technical guidance into frontline clinical and patient care practices. Patient management ‘tools’ are frequently used for this purpose, guiding healthcare workers to deliver quality care. Ahead of an update to a patient management tool for small and nutritionally at-risk infants under six months of age (C-MAMI Tool, V2), we reviewed how others have done this in the past. Our aim was to ensure an evidence-based development process to optimise future success and impact. Methods: We investigated five patient management tools: Integrated Care Pathways (ICPs), Integrated Management of Childhood Illness (IMCI), Paediatric Early Warning Systems (PEWS), Growth Monitoring (GM), and Emergency Triage Assessment and Treatment (ETAT). Searches were run in PubMed and examined evidence on the development, uptake, and effectiveness of these tools. Results: The tools were developed between approximately 1960-2005, with ongoing development of electronic patient management tools (e-tools). IMCI and ETAT were the most widely used in low- and middle-income countries (LMICs), but low coverage remains a major barrier to effectiveness. Growth monitoring is also widely used in LMICs but lacks strong evidence of effectiveness. Evidence on the use of e-tools for patient management in LMICs is growing. Whilst overall evidence for all these approaches was limited, the strongest evidence of effectiveness was for ICPs. Though evidence was sparse, formative work developing the tools prior to implementation seems important to their future success. Conclusions: Informed by this review, the C-MAMI Tool was updated to the MAMI Care Pathway Package, using an ICP approach and modelled on IMCI. This living resource continues to evolve: aligning with and accounting for existing pathways and systems; baseline formative user-experience research; formal effectiveness research to actively plan for future scale up; collecting information on variance from and adaptations to the care pathway; possible future e-tools. An ICP approach is relevant to other child health and nutrition topics.
背景:为了改善全球儿童健康,有效的干预措施很重要,但现实世界的有效性至关重要;这需要将技术指导转化为一线临床和患者护理实践。患者管理“工具”经常用于此目的,指导医护人员提供高质量的护理。在更新针对6个月以下小婴儿和营养风险婴儿的患者管理工具(C-MAMI工具,V2)之前,我们回顾了过去其他人是如何做到这一点的。我们的目标是确保以证据为基础的发展过程,以优化未来的成功和影响。方法:我们研究了五种患者管理工具:综合护理途径(ICPs)、儿童疾病综合管理(IMCI)、儿科早期预警系统(PEWS)、生长监测(GM)和紧急分诊评估和治疗(ETAT)。在PubMed中进行了搜索,并检查了这些工具的开发、使用和有效性的证据。结果:这些工具大约是在1960-2005年间开发的,与此同时,电子患者管理工具(e-tools)也在不断发展。低收入和中等收入国家(LMICs)使用最为广泛的是儿童疾病综合管理和ETAT,但低覆盖率仍然是影响有效性的主要障碍。生长监测也广泛用于中低收入国家,但缺乏有效的有力证据。关于中低收入国家使用电子工具进行患者管理的证据越来越多。虽然所有这些方法的总体证据有限,但最有力的证据是icp的有效性。尽管证据很少,但在实施之前开发工具的形成性工作似乎对它们未来的成功很重要。结论:根据这篇综述,C-MAMI工具更新为MAMI护理路径包,使用ICP方法并以IMCI为模型。这种生物资源继续进化:与现有的途径和系统保持一致并考虑到这些途径和系统;基线形成型用户体验研究;正式的有效性研究,积极规划未来的规模扩大;收集关于护理途径的差异和适应的信息;未来可能的电子工具。国际合作方案的做法与其他儿童健康和营养问题有关。
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引用次数: 1
Consumer understanding and use of food labels in Ghana: A review of the evidence 加纳消费者对食品标签的理解和使用:证据综述
4区 医学 Pub Date : 2023-03-31 DOI: 10.26596/wn.202314116-21
M. Y. Konlan, Paul Konka, Benedict O. Appiah, Felicia Danso, B. Abubakari, H. A. K. Abiwu
Background Creating a supportive environment can help manage the growing burden of obesity and diet-related non-communicable diseases (DR-NCDs) through informed diet choices. Food labelling is a typical approach that helps consumers make informed choices when shopping. However, studies on the understanding and use of food labels by consumers in Ghana are limited. To the best of our knowledge, it is the first review to assess the consumer understanding and use of food labels in Ghana. Methods This scoping review was conducted up to the end of December 2021 and included both published and unpublished literature on consumer understanding and use of food labels in Ghana. Results Eight (8) studies were identified. All, except two, assessed self-reported understanding and use of food labels. Although self-reported understanding of food labels was high, actual understanding through objective measurements was low. The study sheds light on the drivers and challenges of the consumer's use of labels, both of which tend to relate to practical issues (examples include health or religious issues in the former case and time constraints in the latter). Conclusions The Government of Ghana and the food industry need to explore new ways to improve consumer understanding of food labels and how they are used.
创造一个支持性环境可以通过明智的饮食选择,帮助管理肥胖和与饮食有关的非传染性疾病日益加重的负担。食品标签是一种典型的方法,帮助消费者在购物时做出明智的选择。然而,加纳消费者对食品标签的理解和使用的研究是有限的。据我们所知,这是第一次审查评估消费者的理解和使用食品标签在加纳。方法:该范围综述进行至2021年12月底,包括已发表和未发表的关于加纳消费者对食品标签的理解和使用的文献。结果共纳入8项研究。除两项外,所有研究都评估了自我报告的对食品标签的理解和使用情况。虽然自我报告对食品标签的理解程度很高,但通过客观测量的实际理解程度很低。这项研究揭示了消费者使用标签的驱动因素和挑战,这两者往往与实际问题有关(例如,前者涉及健康或宗教问题,后者涉及时间限制)。加纳政府和食品行业需要探索新的方法来提高消费者对食品标签的理解以及如何使用食品标签。
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引用次数: 0
Book review: Reshaping Food Systems to Improve Nutrition and Health in the Eastern Mediterranean Region 书评:重塑粮食系统以改善东地中海地区的营养和健康
4区 医学 Pub Date : 2023-03-31 DOI: 10.26596/wn.2023141113-115
Shamim Ghazi
The book titled “Reshaping Food systems to improve nutrition and health in the eastern Mediterranean Region,” written by Ayoub Al-Jawaldeh and Alexa L. Meyer points out that to make healthy and sustainable diets accessible to all, we need to significantly change current methods of food production and consumption, also in the face of climate change. Therefore, the United Nations have convened a Food Systems Summit in September 2021 to offer a platform for exchange and cooperation between countries and actors in the food system and they are organized into five courses of action that include: 1. Ensure access to safe and nutrition food for all, 2. Shift to sustainable consumption patterns, 3. Boost nature-positive production, 4. Advance equitable livelihoods, 5. Build resilience to vulnerabilities, shocks and stress. The aims of this book are to eliminate malnutrition and food insecurity and increase access to safe food in order to achieve high priorities in the fight against poverty.
由Ayoub Al-Jawaldeh和Alexa L. Meyer撰写的《重塑粮食系统,改善东地中海地区的营养和健康》一书指出,为了让所有人都能获得健康和可持续的饮食,我们需要在气候变化的背景下,对目前的粮食生产和消费方式进行重大改变。因此,联合国将于2021年9月召开粮食系统首脑会议,为各国和粮食系统行为体之间的交流与合作提供平台,并将其组织为五项行动方案,包括:1 .确保所有人都能获得安全和营养的食品;2 .转向可持续消费模式。促进对自然有利的生产;4 .促进公平生计;建立抵御脆弱性、冲击和压力的能力。这本书的目的是消除营养不良和粮食不安全,增加获得安全食品的机会,以实现与贫困作斗争的高度优先事项。
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引用次数: 0
How does the U.S. Government violate the infant formula marketing code? 美国政府如何违反婴儿配方奶粉营销法规?
4区 医学 Pub Date : 2023-03-31 DOI: 10.26596/wn.202314176-85
George Kent
The United States’ Special Supplemental Nutrition Program for Women, Infants, and Children, commonly known as WIC, is based in the United States Department of Agriculture (USDA). It provides services to about half the infants born in the country, with many of them getting subsidized infant formula. WIC manages this in close collaboration with major manufacturers of formula. This commentary examines WIC’s practices in relation to the International Code of Marketing of Breastmilk Substitutes and concludes that the United States is a major violator of the aims and principles of the Code.
美国妇女、婴儿和儿童特殊补充营养计划,通常被称为WIC,总部设在美国农业部(USDA)。它为该国大约一半的婴儿提供服务,其中许多婴儿获得了婴儿配方奶粉的补贴。WIC与主要配方奶粉制造商密切合作,管理这一工作。本评论审查了世卫组织在《国际母乳代用品销售守则》方面的做法,并得出结论认为,美国是违反《守则》宗旨和原则的主要国家。
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引用次数: 0
A discussion of stronger public policies to protect and promote healthy diets: what can the U.S. learn from other countries? 关于加强公共政策以保护和促进健康饮食的讨论:美国可以向其他国家学习什么?
4区 医学 Pub Date : 2023-03-31 DOI: 10.26596/wn.202314186-99
M. Mialon, Ashka Naik
The aim of this paper is to contribute to global discussion on public health policies for protecting and promoting healthy diets, as it is advancing in the U.S. This discussion assesses specific cases of successful policy making from several countries across the world, often against industry resistance. We discuss five key public policies and interventions: i) food labeling; ii) marketing restrictions and healthy school food policies; iii) fiscal policies; iv)  models for classifying the (un)healthiness of a product; v) interventions to address food industry influence and conflicts of interest in public health policy. The paper also argues how the U.S can adapt or adopt some of these public policies, while also preparing for the challenges from the ultra-processed food industry that may perceive these advances as threats to its business. We conclude the discussion by postulating that the U.S. is primed to advance several of these initiatives that have already been espoused in law and evaluated to be effective in other countries. The U.S. will have unique challenges, as many of the food industry actors have deep political influence on American politics and markets, although these global lessons can enable the legislative, policy, and civil society ecosystems with additional tools and strategies to progress policy movement toward defending people’s health and wellbeing over industry’s influence and profit.
本文的目的是促进全球对保护和促进健康饮食的公共卫生政策的讨论,因为它在美国正在推进。本讨论评估了来自世界各地几个国家的成功政策制定的具体案例,通常是反对行业抵制。我们讨论了五项关键的公共政策和干预措施:1)食品标签;Ii)营销限制和健康学校食品政策;Iii)财政政策;Iv)产品健康(不健康)分类模型;㈤为解决食品工业影响和公共卫生政策中的利益冲突而采取的干预措施。本文还讨论了美国如何适应或采用这些公共政策,同时也为来自超加工食品行业的挑战做好准备,这些行业可能将这些进步视为对其业务的威胁。我们通过假设美国准备推进其中一些已经在法律上得到支持并在其他国家被评估为有效的举措来结束讨论。美国将面临独特的挑战,因为许多食品行业的参与者对美国的政治和市场有着深刻的政治影响,尽管这些全球性的经验教训可以使立法、政策和民间社会生态系统有更多的工具和战略来推进政策运动,以捍卫人民的健康和福祉,而不是行业的影响力和利润。
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引用次数: 0
Effect of Diet on Depression: A Review of Nutritional Solutions 饮食对抑郁症的影响:营养解决方案综述
4区 医学 Pub Date : 2023-03-31 DOI: 10.26596/wn.202314128-57
Hananeh Ahmadnia, H. Bahrami, Soraya Mohamadzadeh
Depression is a mental illness with several categories that have common symptoms such as chronic sorrow, lack of interest, lack of pleasure, mood swings between guilt and poor self-esteem, sleep disturbances, and a loss of appetite. Over 300 million individuals globally suffer from depression, and the socioeconomic cost of this debilitating disorder is expected to rise dramatically in the future decades. Behavioral health illnesses can be prevented and treated to some extent with dietary and nutritional means. Nutritional psychiatry has produced observational and effectiveness evidence regarding the role of healthy dietary patterns in the onset and treatment of depressive symptoms. Diet is associated with depressive symptoms or depression, meaning that an increase in depressive disorders coincide with a deterioration in healthy living choices, including poor quality diets. Healthy eating habits and adequate intake of essential nutrients via the diet can help prevent and treat depression by reducing symptoms of mental illness. In addition, because nutrition is a modifiable risk factor for depression, it is practical for the public to consider dietary changes to reduce the prevalence of depressive disorders. This paper reviews the potential value of diet-based actions to manage depression, and ways in which dietary changes could be made to improve mental and cognitive health. Furthermore, some practical solutions for preventing and controlling depression are proposed based on health-related effects of improving dietary habits and life style.  
抑郁症是一种精神疾病,有几种常见症状,如慢性悲伤、缺乏兴趣、缺乏快乐、情绪在内疚和缺乏自尊之间波动、睡眠障碍和食欲不振。全球有超过3亿人患有抑郁症,这种使人衰弱的疾病的社会经济成本预计在未来几十年将急剧上升。行为健康疾病可以通过饮食和营养手段在一定程度上加以预防和治疗。营养精神病学已经提供了关于健康饮食模式在抑郁症状的发病和治疗中的作用的观察性和有效性证据。饮食与抑郁症状或抑郁有关,这意味着抑郁症的增加伴随着健康生活选择的恶化,包括低质量的饮食。健康的饮食习惯和通过饮食摄入足够的必需营养素可以通过减少精神疾病的症状来帮助预防和治疗抑郁症。此外,由于营养是抑郁症的一个可改变的风险因素,因此公众考虑改变饮食以减少抑郁症的患病率是可行的。本文回顾了以饮食为基础的行动来管理抑郁症的潜在价值,以及饮食改变可以改善心理和认知健康的方法。此外,根据改善饮食习惯和生活方式对健康的影响,提出了一些预防和控制抑郁症的实际解决方案。
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引用次数: 1
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World review of nutrition and dietetics
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