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Intersections of Climate Change with Food Systems, Nutrition, and Health: An Overview and Evidence Map 气候变化与粮食系统、营养和健康的相互关系:概述和证据图。
IF 8 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-07-15 DOI: 10.1016/j.advnut.2024.100274

Scientific research linking climate change to food systems, nutrition, and nutrition-related health (FSNH) has proliferated, showing bidirectional and compounding dependencies that create cascading risks for human and planetary health. Within this proliferation, it is unclear which evidence to prioritize for action and which research gaps, if filled, would catalyze the most impact. We systematically searched for synthesis literature (i.e., reviews) related to FSNH published after 1 January, 2018. We screened and extracted characteristics of these reviews and mapped them in an interactive Evidence and Gap Map (EGM) supplemented by expert consultation. Eight hundred forty-four synthesis reports met inclusion criteria (from 2739 records) and were included in the EGM. The largest clusters of reports were those describing climate impacts on crop and animal-source food production and emissions from such (86%). Comparatively few reports assessed climate change impacts on nutrition-related health or food manufacture, processing, storage, and transportation. Reports focused on strategies of climate adaptation (40%), mitigation (29%), both (19%), or none (12%). Only 1 quarter of reports critically evaluated equity (25%), and fewer reports suggested that changes to equity and equitable practices would alter climate-FSNH dynamics (6%). The expert consultation mirrored the results of the EGM and contextualized findings further. This novel map describes a wide research landscape linking climate change to FSNH. We identified 4 key research gaps: 1) research on whole food systems or postharvest elements; 2) research evaluating relationships between climate change and nutrition-related health outcomes, especially among vulnerable populations; 3) promising methods (and additional data required) that can i) identify inflection points or levers for intervention, ii) incorporate complex dynamics and characterize trade-offs, iii) be understood and applied in context-specific, localized ways for decision making; and 4) research undertaken through interdisciplinary collaborations that enables producing and translating evidence to action, especially those that inherently consider coproduction and fairness.

将气候变化与粮食系统、营养和营养相关健康(FSNH)联系起来的科学研究大量涌现,显示出双向和复合的依赖关系,给人类和地球健康带来一连串的风险。在这种激增的情况下,尚不清楚哪些证据应优先用于行动,哪些研究缺口如果得到填补将产生最大影响。我们系统地检索了 2018 年 1 月 1 日之后发表的与 FSNH 相关的综合文献(即综述)。我们筛选并提取了这些综述的特征,并将其映射到交互式证据和差距图(EGM)中,同时辅以专家咨询。844篇综述报告符合纳入标准(来自2739条记录),并被纳入EGM。最大的报告集群是描述气候对作物和动物源性食品 (ASF) 生产的影响以及由此产生的排放的报告(86%)。评估气候变化对营养相关健康或食品制造、加工、储存和运输影响的报告相对较少。报告侧重于气候适应战略(40%)、减缓战略(29%)、两者兼顾战略(19%)或无战略(12%)。只有四分之一的报告对公平性进行了严格评估(25%),较少报告认为公平性和公平做法的改变会改变气候-FSNH 的动态变化(6%)。专家咨询会反映了 EGM 的结果,并将结论进一步背景化。这张新颖的地图描述了气候变化与家庭健康网之间的广泛研究前景。我们确定了四个关键的研究缺口,包括:1)关于整个食品系统或收获后要素的研究;2)评估气候变化与营养相关健康结果之间关系的研究,尤其是在弱势群体中;3) 有前景的方法(和所需的额外数据),能够 a) 确定干预的拐点或杠杆,b) 纳入复杂的动态变化并描述权衡的特点,c) 以特定的、本地化的方式理解和应用于决策;以及 4) 通过跨学科合作开展的研究,能够产生证据并将证据转化为行动,特别是那些本质上考虑共同生产和公平性的研究。
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引用次数: 0
Ceramides as Emerging Players in Cardiovascular Disease: Focus on Their Pathogenetic Effects and Regulation by Diet 神经酰胺是心血管疾病中的新兴角色:关注它们的致病作用和饮食调节。
IF 8 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-07-01 DOI: 10.1016/j.advnut.2024.100252
Riccardo Spaggiari , Sharon Angelini , Alessandra Di Vincenzo , Gerarda Scaglione , Sara Morrone , Veronica Finello , Sofia Fagioli , Fabiola Castaldo , Juana M Sanz , Domenico Sergi , Angelina Passaro

Impaired lipid metabolism is a pivotal driver of cardiovascular disease (CVD). In this regard, the accumulation of ceramides within the circulation as well as in metabolically active tissues and atherosclerotic plaques is a direct consequence of derailed lipid metabolism. Ceramides may be at the nexus between impaired lipid metabolism and CVD. Indeed, although on one hand ceramides have been implicated in the pathogenesis of CVD, on the other specific ceramide subspecies have also been proposed as predictors of major adverse cardiovascular events. This review will provide an updated overview of the role of ceramides in the pathogenesis of CVD, as well as their pathogenetic mechanisms of action. Furthermore, the manuscript will cover the importance of ceramides as biomarkers to predict cardiovascular events and the role of diet, both in terms of nutrients and dietary patterns, in modulating ceramide metabolism and homeostasis.

脂质代谢障碍是心血管疾病(CVD)的关键驱动因素。在这方面,神经酰胺在血液循环以及代谢活跃的组织和动脉粥样硬化斑块中的积累是脂质代谢失调的直接后果。神经酰胺可能是脂质代谢受损与心血管疾病之间的联系纽带。事实上,一方面神经酰胺与心血管疾病的发病机制有关,另一方面特定的神经酰胺亚种也被认为是主要不良心血管事件的预测因子。本综述将概述神经酰胺在心血管疾病发病机制中的作用及其致病机制。此外,手稿还将介绍神经酰胺作为生物标志物在预测心血管事件中的重要性,以及饮食(包括营养素和饮食模式)在调节神经酰胺代谢和平衡中的作用。
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引用次数: 0
Dietary Patterns and Cardiovascular Diseases in Asia: A Systematic Review and Meta-Analysis 亚洲的膳食模式与心血管疾病:系统回顾与元分析
IF 8 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-07-01 DOI: 10.1016/j.advnut.2024.100249
Gladys Huiyun Lim , Nithya Neelakantan , Yu Qi Lee , Su Hyun Park , Zhi Heng Kor , Rob M van Dam , Mary Foong-Fong Chong , Airu Chia

With emerging Asian-derived diet quality indices and data-driven dietary patterns available, we aimed to synthesize the various dietary patterns and quantify its association with cardiovascular diseases (CVDs) among Asian populations. We systematically searched PubMed, Embase, Scopus, and Web of Science for observational studies in South, Southeast, and East Asia. Dietary patterns were grouped “high-quality,” which included high intakes of three or more of the following food groups: 1) fruits and vegetables, 2) whole grains, 3) healthy protein sources (legumes and nuts, fish and seafood, low-fat dairy, and lean meat and poultry), and 4) liquid plant oils. High-quality patterns were further subcategorized based on their derivation methods: non-Asian indices, Asian indices, data-driven patterns, and plant-based indices. Dietary patterns were grouped “low-quality,” which included high intakes of two or more of the following: 5) ultraprocessed food, 6) beverages and foods with added sugars, 7) foods high in salt, and 8) alcoholic beverages. Data-driven dietary patterns characterized by animal food sources were labeled “animal-based,” and studies using dietary diversity scores were labeled “diet diversity indices.” Dietary patterns that could not be meaningfully categorized were summarized narratively. Study-specific effect estimates were pooled using a random-effects model. Forty-one studies were included in this review. Higher adherence to high-quality dietary patterns in the top compared with bottom tertile defined by non-Asian indices (RR: 0.78; 95% CI: 0.69, 0.88; GRADE: moderate), Asian indices (RR: 0.84; 95% CI: 0.79, 0.90; GRADE: low), and data-driven patterns (RR: 0.81; 95% CI: 0.74, 0.89; GRADE: moderate) were associated with lower CVD risk. Plant-based, low-quality, animal-based, and diet diversity indices dietary patterns were not associated with CVD. Associations of Asian diet quality indices and CVD risk were weaker than those with non-Asian indices, highlighting the need for current Asian diet quality criteria to be updated to better capture the impact of diet on CVD.

The systematic review and meta-analysis was registered at PROSPERO as CRD42021244318.

随着新兴的亚洲膳食质量指数和数据驱动的膳食模式的出现,我们旨在综合各种膳食模式并量化其与亚洲人群心血管疾病(CVDs)的关联。我们系统地检索了 PubMed、Embase、Scopus 和 Web of Science 中有关南亚、东南亚和东亚的观察性研究。膳食模式被归类为 "高质量",包括摄入以下三类或更多食物:1)水果和蔬菜;2)全谷物;3)健康蛋白质来源(豆类和坚果、鱼类和海鲜、低脂乳制品、瘦肉和家禽);4)液态植物油。高质量的膳食模式根据其推导方法进一步细分为:非亚洲指数、亚洲指数、数据驱动型膳食模式和植物性膳食模式。膳食模式被归类为 "低质量",其中包括以下两种或两种以上的高摄入量:5)超加工食品;6)添加糖的饮料和食品;7)高盐食品;8)酒精饮料。以动物性食物来源为特征的数据驱动膳食模式被称为 "动物性膳食",使用膳食多样性评分的研究被称为 "膳食多样性指数"。无法进行有意义分类的膳食模式则以叙述的方式进行总结。采用随机效应模型对特定研究的效应估计值进行汇总。本综述共纳入 41 项研究。与非亚洲人指数(RR:0.78;95% CI:0.69,0.88;GRADE:中度)、亚洲人指数(RR:0.84;95% CI:0.79,0.90;GRADE:低度)和数据驱动模式(RR:0.81;95% CI:0.74,0.89;GRADE:中度)所定义的最低三分位数相比,最高三分位数中更多人坚持高质量膳食模式与较低的心血管疾病风险相关。植物性膳食、低质量膳食、动物性膳食和膳食多样性指数膳食模式与心血管疾病无关。亚洲人的饮食质量指数与心血管疾病风险的相关性弱于非亚洲人的指数,这表明目前亚洲人的饮食质量标准需要更新,以更好地反映饮食对心血管疾病的影响。
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引用次数: 0
Dietary Patterns in Asia: Current Evidence and Future Directions 亚洲的膳食模式:当前证据与未来方向
IF 8 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-07-01 DOI: 10.1016/j.advnut.2024.100250
Lukas Schwingshackl , Georg Hoffmann
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引用次数: 0
A Systematic Review and Bayesian Network Meta-Analysis Comparing In-Person, Remote, and Blended Interventions in Physical Activity, Diet, Education, and Behavioral Modification on Gestational Weight Gain among Overweight or Obese Pregnant Individuals 系统性综述和贝叶斯网络元分析:比较面对面、远程和混合干预对超重或肥胖孕妇妊娠体重增加的影响。
IF 8 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-07-01 DOI: 10.1016/j.advnut.2024.100253
Hongli Yu , Mingmao Li , Guoping Qian , Shuqi Yue , Zbigniew Ossowski , Anna Szumilewicz

Background

Despite the well-documented adverse outcomes associated with obesity during pregnancy, this condition remains a promising modifiable risk factor.

Objectives

The aim of this study was to ascertain the most effective treatment modalities for gestational weight gain (GWG) in pregnant women classified as overweight or obese.

Methods

A systematic search was conducted across 4 electronic databases: Embase, EBSCOhost, PubMed, and Web of Science. To assess the quality of evidence, the Confidence In Network Meta-Analysis (CINeMA) approach, grounded in the Grading of Recommendations Assessment, Development, and Evaluation framework, was employed. A Bayesian network meta-analysis was conducted to synthesize the comparative effectiveness of treatment modalities based on GWG outcomes.

Results

The analysis incorporated 60 randomized controlled trials, encompassing 16,615 participants. Modes of intervention administration were classified as remote (R: eHealth [e] and mHealth [m]), in-person (I), and a combination of both (I+R). The interventions comprised 5 categories: education (E), physical activity (PA), dietary (D), behavior modification (B), and combinations thereof. The quality of the evidence, as evaluated by CINeMA, ranged from very low to high. Compared to the control group, the I-D intervention (mean difference [MD]: −1.27; 95% confidence interval [CI]: −2.23, −0.32), I-PADB (MD: −0.60, 95% CI: −1.19, −0.00), and I-B (MD: −0.34, 95% CI: −0.57, −0.10) interventions showed significant efficacy in reducing GWG.

Conclusions

Preliminary findings suggest that the I-D intervention is the most efficacious in managing GWG among pregnant women who are overweight or obese, followed by I-PADB and I-B+R-B(m) treatments. These conclusions are drawn from evidence of limited quality and directness, including insufficient data on PA components used in the interventions. Owing to the absence of robust, direct evidence delineating significant differences among various GWG management strategies, it is tentatively proposed that the I-D intervention is likely the most effective approach.

This study was registered with PROSPERO as CRD42023473627.

背景:尽管孕期肥胖带来的不良后果已得到充分证实,但这种情况仍然是一种很有希望改变的风险因素:本研究旨在确定治疗超重或肥胖孕妇妊娠体重增加(GWG)的最有效方法:方法:在四个电子数据库中进行了系统检索:方法:在四个电子数据库中进行了系统检索:Embase、EBSCOhost、PubMed 和 Web of Science。为了评估证据的质量,采用了基于建议评估、发展和评价分级(GRADE)框架的信心网络荟萃分析(CINeMA)方法。通过贝叶斯网络荟萃分析,综合了基于 GWG 结果的各种治疗方法的比较效果:分析纳入了 60 项 RCT,涉及 16,615 名参与者。干预管理模式分为远程(R:电子健康(e)和移动健康(m))、面对面(I)和两者结合(I+R)。干预措施包括五类:教育(E)、体育锻炼(PA)、饮食(D)、行为矫正(B)以及这些措施的组合。经 CINeMA 评估,证据的质量从很低到很高不等。与对照组相比,I-D 干预(平均差 (MD) =-1.27,95% CI [-2.23,-0.32])、I-PADB(MD =-0.60,95% CI [-1.19,-0.00])和 I-B 干预(MD =-0.34,95% CI [-0.57,-0.10])在降低 GWG 方面显示出显著疗效:初步研究结果表明,I-D 干预疗法对控制超重或肥胖孕妇的 GWG 最有效,其次是 I-PADB 和 I-B+R-B(m)疗法。这些结论是根据质量和直接性有限的证据得出的,包括干预措施中使用的 PA 成分数据不足。由于缺乏有力的直接证据来说明各种 GWG 管理策略之间的显著差异,因此初步认为 I-D 干预可能是最有效的方法。系统综述或荟萃分析的登记处和登记号:国际前瞻性系统综述注册表,CRD42023473627 意义声明:本研究提出了新的方法,利用系统综述和贝叶斯荟萃分析,结合直接和间接证据,评估管理超重和肥胖孕妇妊娠体重增加的有效干预措施。这种方法通过评估各种干预方法的有效性和管理过程,弥补了之前的不足;为这一特殊孕妇群体提供了更全面的分析。
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引用次数: 0
Galacto-Oligosaccharides and the Elderly Gut: Implications for Immune Restoration and Health 半乳糖寡糖(GOS)与老年人肠道:对免疫恢复和健康的影响。
IF 8 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-06-17 DOI: 10.1016/j.advnut.2024.100263
Yunan Hu , Mashael R Aljumaah , Maria Andrea Azcarate-Peril

The increasing prevalence of noncommunicable diseases in the aging population has been correlated with a decline in innate and adaptive immune responses; hence, it is imperative to identify approaches to improve immune function, prevent related disorders, and reduce or treat age-associated health complications. Prebiotic supplementation is a promising approach to modulate the gut microbiome and immune system, offering a potential strategy to maintain the integrity of immune function in older individuals. This review summarizes the current research on prebiotic galacto-oligosaccharide (GOS) immunomodulatory mechanisms mediated by bacterial-derived metabolites, including short-chain fatty acids and secondary bile acids, to maintain immune homeostasis. The potential applications of GOS as immunotherapy for age-related disease prevention in older individuals are also highlighted. This aligns with the global shift toward proactive healthcare and emphasizes the significance of early intervention in directing an individual’s health trajectory.

在老龄人口中,非传染性疾病的发病率越来越高,这与先天性免疫反应和适应性免疫反应的下降有关;因此,当务之急是找到改善免疫功能、预防相关疾病、减少或治疗与年龄有关的健康并发症的方法。补充益生元是调节肠道微生物组和免疫系统的一种很有前景的方法,为保持老年人免疫功能的完整性提供了一种潜在的策略。本综述总结了目前有关益生菌半乳寡糖(GOS)免疫调节机制的研究,这些机制由细菌衍生的代谢产物(包括短链脂肪酸(SCFA)和次级胆汁酸)介导,以维持免疫平衡。研究还强调了将 GOS 作为免疫疗法用于预防老年人与年龄有关的疾病的潜力。这与全球向前瞻性医疗保健的转变是一致的,并强调了早期干预对指导个人健康轨迹的重要意义。意义说明:综述提供了令人信服的证据,证明 GOS 作为一种膳食干预措施,可显著增强老年人的肠道健康和免疫调节能力。基于这些研究结果,综述敦促开展进一步研究,以提高我们对 GOS 及其优化老年人健康潜力的认识。
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引用次数: 0
The Effect of Time-Restricted Eating Combined with Exercise on Body Composition and Metabolic Health: A Systematic Review and Meta-Analysis 限时进食结合运动对身体成分和代谢健康的影响:系统综述和荟萃分析。
IF 8 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-06-17 DOI: 10.1016/j.advnut.2024.100262

Background

Time-restricted eating (TRE) is increasingly popular, but its benefits in combination with exercise still need to be determined.

Objectives

This systematic review and meta-analysis aimed to evaluate the efficacy of TRE combined with exercise compared with control diet with exercise in improving the body composition and metabolic health of adults.

Methods

Five electronic databases were searched for relevant studies. Randomized controlled trials (RCTs) examining the effect of TRE combined with exercise on body composition and metabolic health in adults were included. All results in the meta-analysis are reported as mean difference (MD) with 95% confidence interval (CI). Study quality was assessed using the revised Cochrane Risk of Bias Tool and Grading of Recommendations Assessment, Development, and Evaluation assessment.

Results

In total, 19 RCTs comprising 568 participants were included in this systematic review and meta-analysis. TRE combined with exercise likely reduced the participants’ body mass (MD: −1.86 kg; 95% CI: −2.75, −0.97 kg) and fat mass (MD: −1.52 kg; 95% CI: −2.07, −0.97 kg) when compared with the control diet with exercise. In terms of metabolic health, the TRE combined with exercise group likely reduced triglycerides (MD: −13.38 mg/dL, 95% CI: −21.22, −5.54 mg/dL) and may result in a reduction in low-density lipoprotein (MD: −8.52 mg/dL; 95% CI: −11.72, −5.33 mg/dL) and a large reduction in leptin (MD: −0.67 ng/mL; 95% CI: −1.02, −0.33 ng/mL). However, TRE plus exercise exhibited no additional benefit on the glucose profile, including fasting glucose and insulin, and other lipid profiles, including total cholesterol and high-density lipoprotein concentrations, compared with the control group.

Conclusions

Combining TRE with exercise may be more effective in reducing body weight and fat mass and improving lipid profile than control diet with exercise. Implementing this approach may benefit individuals aiming to achieve weight loss and enhance their metabolic well-being.

This study was registered in PROSPERO as CRD42022353834.

背景:限时进食(TRE)越来越受欢迎,但其与运动相结合的益处仍有待确定:本系统综述和荟萃分析旨在评估限时进食与运动相结合与控制饮食与运动相结合在改善成人身体成分和代谢健康方面的功效:方法: 在五个电子数据库中搜索相关研究。方法:检索了五个电子数据库中的相关研究,其中包括研究 TRE 与运动相结合对成人身体成分和代谢健康影响的随机对照试验(RCT)。荟萃分析中的所有结果均以平均差 (MD) 和 95% 置信区间 (Cl) 表示。研究质量采用修订后的 Cochrane 偏倚风险工具和建议评估、制定和评价分级法进行评估:本系统综述和荟萃分析共纳入了 19 项 RCT,共有 568 名参与者。与有运动的对照饮食相比,TRE 结合运动可能会减少参与者的体重(MD = -1.86 kg,95% CI [-2.75,-0.97])和脂肪量(MD = -1.52 kg,95% CI [-2.07,-0.97])。在新陈代谢健康方面,TRE 加运动组可能会降低甘油三酯(MD = -13.38 mg/dl,95% CI [-21.22,-5.54]),并可能导致低密度脂蛋白(MD = -8.52 mg/dl,95% CI [-11.72,-5.33])的降低和瘦素(MD -0.67 ng/ml;95% CI [-1.02,-0.33])的大幅降低。然而,与对照组相比,TRE加运动对血糖谱(包括空腹血糖和胰岛素)和其他血脂谱(包括总胆固醇和高密度脂蛋白水平)没有额外的益处:结论:在减少体重和脂肪量以及改善血脂状况方面,将 TRE 与运动相结合可能比控制饮食与运动相结合更有效。采用这种方法可能会对旨在实现减肥和提高新陈代谢健康水平的人有所裨益。系统综述或荟萃分析的注册表和注册表编号:CRD42022353834。
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引用次数: 0
National Policies to Limit Food Marketing and Competitive Food Sales in Schools: A Global Scoping Review 限制学校食品营销和竞争性食品销售的国家政策:全球范围审查。
IF 8 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-06-12 DOI: 10.1016/j.advnut.2024.100254
Michelle Perry , Kayla Mardin , Grace Chamberlin , Emily A Busey , Lindsey Smith Taillie , Francesca R Dillman Carpentier , Barry M Popkin

School food environments contribute to children’s nutritional intake and overall health. As such, the World Health Organization and other public health organizations encourage policies that restrict children’s access and exposure to foods and beverages that do not build health in and around schools. This global scoping review explores the presence and characteristics of policies that restrict competitive food sales and marketing for unhealthy foods across 193 countries using evidence from policy databases, gray literature, peer-reviewed literature, and primary policy documents. Policies were included if they were nationally mandated and regulated marketing and/or competitive foods in the school environments. Worldwide, only 28% of countries were found to have any national-level policy restricting food marketing or competitive food sales in schools: 16% of countries restrict marketing, 25% restrict competitive foods, and 12% restrict both. Over half of policies were found in high-income countries. No low-income countries had either policy type. Eight marketing policies (27%) and 14 competitive foods policies (29%) lacked explicit guidelines for either policy monitoring or enforcement. Future research is needed to assess the prevalence of policies aimed at improving other key aspects of the school food environment, such as dietary quality of school meals or food procurement, as well as assess the implementation and efficacy of existing policies.

学校食品环境有助于儿童的营养摄入和整体健康。因此,世界卫生组织和其他公共卫生组织鼓励制定政策,限制儿童在学校及周边地区获得和接触不利于健康的食品和饮料。本全球范围审查利用政策数据库、灰色文献、同行评审文献和主要政策文件中的证据,探讨了 193 个国家限制竞争性食品销售和不健康食品营销的政策的存在情况和特点。如果这些政策是国家强制执行的,并对学校环境中的营销和/或竞争性食品进行监管,则被纳入其中。在全球范围内,只有 28% 的国家制定了任何限制学校食品营销或竞争性食品销售的国家级政策:16%的国家限制营销,25%的国家限制竞争性食品,12%的国家同时限制营销和竞争性食品。超过一半的政策是在高收入国家制定的。低收入国家没有这两种政策。有 8 项营销政策(27%)和 14 项竞争性食品政策(29%)缺乏明确的政策监督或执行准则。未来的研究需要评估旨在改善学校食品环境其他关键方面(如学校膳食或食品采购的膳食质量)的政策的普遍性,并评估现有政策的实施情况和效果。
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引用次数: 0
The Extent, Range, and Nature of Quantitative Nutrition Research Engaging with Intersectional Inequalities: A Systematic Scoping Review 涉及交叉不平等的定量营养研究的程度、范围和性质:系统性范围审查。
IF 9.3 1区 医学 Q1 Nursing Pub Date : 2024-06-01 DOI: 10.1016/j.advnut.2024.100237
Emily Fivian , Helen Harris-Fry , Claudia Offner , Michele Zaman , Bhavani Shankar , Elizabeth Allen , Suneetha Kadiyala

Addressing malnutrition for all requires understanding inequalities in nutrition outcomes and how they intersect. Intersectionality is increasingly used as a theoretical tool for understanding how social characteristics intersect to shape inequalities in health outcomes. However, little is known about the extent, range, and nature of quantitative nutrition research engaging with intersectional inequalities. This systematic scoping review aimed to address this gap. Between 15 May 2021 and 15 May 2022, we searched 8 databases. Studies eligible for inclusion used any quantitative research methodology and aimed to investigate how social characteristics intersect to influence nutrition outcomes. In total, 55 studies were included, with 85% published since 2015. Studies spanned populations in 14 countries but were concentrated in the United States (n = 35) and India (n = 7), with just 1 in a low-income country (Mozambique). Race or ethnicity and gender were most commonly intersected (n = 20), and body mass index and overweight and/or obesity were the most common outcomes. No studies investigated indicators of infant and young child feeding or micronutrient status. Study designs were mostly cross-sectional (80%); no mixed-method or interventional research was identified. Regression with interaction terms was the most prevalent method (n = 26); 2 of 15 studies using nonlinear models took extra steps to assess interaction on the additive scale, as recommended for understanding intersectionality and assessing public health impacts. Nine studies investigated mechanisms that may explain why intersectional inequalities in nutrition outcomes exist, but intervention-relevant interpretations were mostly limited. We conclude that quantitative nutrition research engaging with intersectionality is gaining traction but is mostly limited to the United States and India. Future research must consider the intersectionality of a wider spectrum of public health nutrition challenges across diverse settings and use more robust and mixed-method research to identify specific interventions for addressing intersectional inequalities in nutrition outcomes. Data systems in nutrition must improve to facilitate this.

This review was registered in PROSPERO as CRD42021253339.

要解决所有人的营养不良问题,就必须了解营养结果的不平等以及它们是如何相互交织的。交叉性越来越多地被用作一种理论工具,用于理解社会特征如何相互交织,从而形成健康结果的不平等。然而,人们对涉及交叉性不平等的定量营养研究的程度、范围和性质知之甚少。本系统性范围界定综述旨在填补这一空白。在 2021 年 5 月 15 日至 2022 年 5 月 15 日期间,我们检索了 8 个数据库。符合纳入条件的研究使用了任何定量研究方法,旨在调查社会特征如何交叉影响营养结果。共纳入 55 项研究,其中 85% 的研究发表于 2015 年之后。研究涉及 14 个国家的人口,但主要集中在美国(35 项)和印度(7 项),只有一项研究涉及低收入国家(莫桑比克)。种族或民族与性别的交叉最为常见(20 项),体重指数和超重和/或肥胖是最常见的结果。没有研究调查了婴幼儿喂养或微量营养素状况的指标。研究设计大多为横断面研究(80%);没有发现混合方法或干预性研究。带有交互项的回归是最普遍的方法(n=26);在 15 项使用非线性模型的研究中,有两项研究采取了额外的步骤来评估加法尺度上的交互作用,这是理解交叉性和评估公共健康影响所建议的。九项研究调查了可能解释营养结果中存在交叉不平等的机制,但与干预相关的解释大多有限。我们得出的结论是,涉及交叉性的定量营养研究正获得越来越多的关注,但大多局限于美国和印度。未来的研究必须考虑不同环境中更广泛的公共卫生营养挑战的交叉性,并使用更强大的混合方法研究来确定具体的干预措施,以解决营养结果的交叉不平等问题。必须改进营养数据系统,以促进这项工作。
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引用次数: 0
Prioritizing Nutrition in Medical Education—the Time Has Come 优先考虑医学教育中的营养问题--时机已到。
IF 8 1区 医学 Q1 Nursing Pub Date : 2024-06-01 DOI: 10.1016/j.advnut.2024.100231
Andrew A Bremer
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引用次数: 0
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Advances in Nutrition
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