Introduction: Overweight has become a very important issue in the epidemiological scenario of nutrition due to its increasing rates and association with several chronic noncommunicable diseases. The etiology of overweight is complex, but diet is one of the modifiable factors that may interfere in the nutritional status of individuals and consequently on overweight and obesity. One aspect of the diet that has been related to overweight is the increase of energy intake, and related to that, the increase on food portion size.

Objective: To evaluate differences in food portions size and its energy contribution in adolescents from São Paulo, Brazil between 2003, 2008 and 2015.

Materials and Methods: Cross-sectional population-based study with a representative sample of 1711 adolescents aged 12 to 19 years who participated in the Health Survey of São Paulo (HS-SP). The HS-SP was conducted in 2003, 2008 and 2015. Overweight was defined according to the cutoff points of the World Health Organization (WHO) for adolescents (BMI ≥ p85). Dietary data were obtained from two 24-hour recalls.Reported foods were classified into groups and the prevalence of consumers, the percentage of energy contribution, and the mean and median of portion sizes in each food group were calculated.

Results: Over the years, the prevalence of overweight in adolescents increased from 13.8% to 29.4%. The prevalence of consumers of salty snacks, fruits, industrialized juices, red meats, rice, sweets/desserts and toast/cookies has increased; while the number of consumers of coffee/tea, fruit juice, milk, artisan/non-packaged snacks and sugar decreased. The food groups with the highest energy contribution were: rice (14%), red meat (12%) and bread (9%) in all the years evaluated. The groups with the greatest increase in the energy contribution from 2003 to 2015 were: toast / cookies, sweets / desserts, white and red meats, and industrialized juices. The consumption portion size of eggs has increased, while those of cold cuts, fruits, industrialized juices, rice and tubers/roots decreased.

Discussion: There was a diverse variation in the frequency of intake, the energy contribution and the food portion size over time with increase in some groups and decrease in others. These findings provide useful data to support future interventions and public policies focused on adolescent feeding.

Introduction: Childhood obesity is rising in all countries. Dietary habits are modifiable factors which develop early in life. During growth, several factors, such as peer- influence and food availability, determine the development of food preferences and eating behaviour. Parents play also a key role model by influencing their own food intake.

Objetives: The purpose of this study was to assess the influence of parental role modelling, as predictor of fruits and vegetables intake in European pre-schoolers.

Methods: The present study included a sample of 6633 preschool children (51.9% boys) from six European centres (Belgium, Bulgaria, Germany, Greece, Poland and Spain), 3.5 to 5.5 years of age, participating in the ToyBox-study. Data on parental role modelling related with their own fruits and vegetables intake (portions/day) and children's fruits and vegetables intake (portions/day) were collected via standardized proxy-administered questionnaires. Linear regression model was used to assess this association. The adjusted model included socioeconomic status and weight status.

Results: In the unadjusted model, boys whose parents consumed fruits, showed a mean intake of 0.09 (95% CI: 0.08–0.11; p ≤ 0.001) portions of fruits more than the boys whose parents did not consume fruits. Also, girls whose parents consumed fruits, had intake of 0.10 (95% CI: 0.08–0.12; p ≤ 0.001) portions of fruits more than the girls whose parents did not consume fruits.

Moreover, boys whose parents consumed vegetables, showed a mean intake of 0.09 (95% CI: 0.07–0.11; p ≤ 0.001) portions of vegetables more than the boys whose parents did not consume vegetables. Also, girls whose parents consumed fruits, had intake of 0.11 (95% CI: 0.09–0.13; p ≤ 0.001) portions of vegetables more than the girls whose parents did not consume vegetables.

Finally, parental role related with fruits consumption explained 19.3% of fruits intake in European pre-schoolers and the 17.8% of vegetables intake in boys and 21.9% of vegetable intake in girls taking into consideration the potential effect of socioeconomic status of the family and the weight status of the children.

Conclusions: Parental role model of fruit intake has moderate effect on the pre-schooler's dietary intake. However, home environment characteristics such as family rules or availability and accessibility of foods should be considered as potential factors related to food intake in pre-schoolers.

Lao PDR is one of the poorest countries in the world, ranked the 138th of 188 developing countries. Although household food insecurity has been prevalent in Northern Rao PDR, no valid measurement of household food insecurity exists. Therefore, the study was to develop a household food insecurity questionnaire and verify the validity of the questionnaire in the rural areas of Lao PDR.

Using a multistage-sampling cross-sectional study, the sample included 373 households with children under 5 years of age living in Xieng Khouang, Lao PDR. The questionnaire was composed of 18 items based on the US household Food Security Survey Module and partially modified to local circumstances. Internal consistency of questions measured with Cronbach's α was adequate, result of 0.746. External validity was evaluated through comparison analyses between food insecurity levels and household socioeconomic indicators.

Among 373 households, 42.7% were food-insecure and 4.3% were food-insecure with hunger. There were more food-insecure households in those with lower maternal education levels (P < 0.001), greater number of household members (P < 0.001), longer travel time to farmland (P = 0.003), and lower household asset scores (P < 0.001). Households with the residence made of natural material for walls (P < 0.001), roofs (P < 0.001) and floors (P < 0.001) as well as without electricity (P < 0.001), pipe to supply drinking water (P < 0.001), and income other than agriculture (P < 0.001) had higher food insecurity than their counterparts. In addition, inadequate maternal prenatal care and education, child health care, and vaccinations increased household food insecurity. Mothers and children in food-insecure households had lower intakes of various food groups including protein-source foods. This study would provide a valid instrument to assess food insecurity and be used in the future as an evaluation tool for the improvement of nutritional deficiencies as well as a tool for selection of target subjects in Northern Rao PDR.

Introduction: Dietary habits are established from a very young age. Parental role modeling is an important factor influencing the eating behavior of their children. Drinking behavior may have an impact in the development of childhood obesity. This study aimed to explore the correlations of core drinking beverages between parents and their children.

Materials and Methods: The present study included children of 3.5–5.5 years and their parents from the (Multifactorial evidence-based approach using behavioral models in understanding and promoting fun, healthy food, play and policy for the prevention of obesity in early childhood) ToyBox study. The study was a kindergarten-based family-involved intervention, in preschool children from six European countries: Belgium, Bulgaria, Germany, Greece, Poland, and Spain. For this study, we analyzed data from the baseline cross-sectional survey.

Data on consumption frequency of water, homemade or fresh fruit juice, prepacked fruit juice, light beverages and sugared sweetened beverages consumption from parents and their children was obtained via a validated food frequency questionnaire. Parents were given examples of serving sizes and asked about how to self-report their usual consumption per day or week. Beverage consumption of children was reported by their parents and information about frequency and portion sizes was collected. Body weight and height of children was measured and classified according to the International Obesity Task Force (IOTF). Bivariate correlations were performed to analyze beverage consumption (servings per day) in children and their parents.

Results: The studied sample included 5266 pairs of children (49.2% girls) and parents (91.7% women) that were included in the analysis.

Girls presented higher correlations in water (r2 = 0,317) and sugar sweetened beverages (r2 = 0,302), whereas boys, presented slightly higher correlations of light soft drinks (r2 = 0,273), pure fruit juices (r2 = 0,308) and prepacked fruit juices (r2 = 0,324), all of them at < 0.01 level of significance. Considering boys and girls together, a slightly higher significant correlation coefficients were found between children-parents’ dyads with overweight/obesity compared to normal weight children-parentś for sugar sweetened beverages (r2 = 0,303) and light soft drinks (r2 = 0,396).

Discussion: Beverage consumption of children and their parents were found to be moderately correlated. Overweight children seem to have better correlations with their parents in relation of sugar sweetened beverages and light soft drinks. Parents should encourage a healthy beverage consumption for their own health and most important, because there are key role models to their children.

Introduction: Caries is one of the most widespread chronic diseases in the world and in Italy, only 78.4% of the 4 years children are caries free. Caries is defined as an infectious multifactorial pathology and between the etiological factors that contribute to its developing we find excessive sugar consumption. Correct behaviours adopted since the pediatric age will allow the child to learn how to improve their lifestyle, thus protecting health. Parents must therefore be properly educated to transmit healthy habits to their children from the early years. The main goal of our project is the prevention of caries in the developmental age by means of educational interventions on parents of children in the kindergarten (0–3 years). The study assesses the oral hygiene and food habits of the child and caregiver at baseline and after 3 months from the interventions (follow-up).

Materials and Methods: We have used a questionnaire to collect the oral hygiene and food habits of parents and children. Next, dental hygienists and nutritionists organized training sessions for parents about correct oral hygiene and eating habits (in particular to reduce the sugar consumption). After 3 months from the training, the same questionnaires reconfirmed to evaluate the improvement of family habits.

Results: The number of participants was reduce from 99 to 68 at the follow-up. With regards to eating habits, after training, almost the whole of the sample began to practice breakfast, indicating that the actual importance of this meal was understood. The habit of morning and afternoon snack, essential for a growing child, has increased (from 84% at baseline to 94% at follow-up and from 92% to 97% respectively). The bad habit of the after dinner snack, often even after teeth brushing, has decreased consistently (32% to 22%).

The most significant advances in oral hygiene are those concerning tooth washing (86% to 97%), the average daily washing (1.27/die to 1.57/die), self-washing (33% to 30%), the use of toothpaste (85% to 90%) and fluoridated toothpaste (48% to 62%).

Discussion: Starting from the data obtained from our pilot study, we think that it is essential to intervene already in the first years of life, when the subject is still “plastic” and can be trained to perform correct eating habits and oral hygiene. Furthermore, reducing the consumption of foods rich in sugar does not have a positive effect only on the onset of caries but also on the health of the individual.

Background: Workplaces have been highlighted as a promising place to promote healthy food choices because of the recurrence of eating occasions (Wanjek, 2005). Beyond interventional research promoting healthier food choices in workplace restaurants, much remains to be understood regarding the specificities of eating choices of individuals during their worktime. Specifically, although working conditions seem likely to play a key role in workers’ eating choices (Raulio et al., 2007), the nature and extent of this association are unclear. Worktime organisation and workers’ control over their own schedule have been proposed to account for differences in the way workers interact with their workplace food environment (Massey & Saulais, in press; Raulio et al., 2012).

Objectives: The objective of this research is to investigate the relationships between two time-related working conditions, schedule flexibility and control over one's schedule, and workers’ lunch habits.

Methodology: An ad-hoc online questionnaire was developed partly after the French Working Conditions survey. 1,139 French wage-earning workers, recruited from an online survey panel, were asked about their time-related working conditions, their behavior during lunch breaks over a two-week period (including non-food related behaviors such as taking care of personal matters during break) and their subjective experience of these lunch breaks in relation with time (such as feeling rushed during lunch break).

Results: Workers with more flexibility in their schedule were more likely to report using lunch breaks as an adjusting variable in their workday, either by reducing it to compensate for their workload (p = .0001) or to attend to personal matters (p = .04). Perceived control over worktime organization also affected eating strategies during lunchtime.

Conclusion: This research is one of the first to investigate possible relationships between working conditions and workers’ lunch habits. Although results provide support to a link between time-related working conditions and lunch behaviors, socioeconomic status (SES), which have been shown to impact workers’ behaviors, could be a confounding factor (Massey & Saulais, in press), whose effect needs to be further investigated in controlled conditions.

Results: A total of 89 families (155 adults; 156 children) from the suburb of Copenhagen, Denmark, participated in the study (February-July 2018). A total of 291 (94%) participants completed the intervention. Results presented are preliminary.

Intention to treat analyses showed no significant effects of the salt reduction intervention on changes in systolic and diastolic blood pressure, plasma triglyceride. A small, but significant (-0.26 mmol/l; P = 0.02) decrease in total plasma cholesterol was shown in intervention group A. A similar, but non-significant, tendency was found in intervention group B. (more results will follow).

Subgroup analyses, including only participants in the intervention groups that decreased their salt intake by at least 20% from baseline to 4-month follow-up, showed a significant decrease in diastolic (-3.5 mmHg; P < 0.0001) and systolic (-6.3 mmHg; P < 0.0001) blood pressure, total plasma cholesterol (-0.25 mmol/l; P = 0.0009), LDL plasma cholesterol (logarithm transformed) (-6%; P = 0.03) and plasma triglyceride (logarithm transformed) (-17%; P = 0.04). No significant effects were found for HDL plasma cholesterol, aldosterone, renin, plasma glucose and HbA1c.

Conclusion: Reduced salt intake were associated with beneficial changes in cardiovascular risk factors. No adverse effects were observed.

Introduction: Most consumers remain unaware of iodine sources in the diet. With no prophylaxis, iodine insufficiency remains a largely unappreciated issue in the UK. Including seaweed to the food supply represents a solution and opportunity but this supply needs to be carefully curated and calibrated, as excess iodine may be harmful for thyroid health. This project aimed to test the efficacy of a proof-of-concept reformulated food using seaweed as an ingredient source of iodine, to supplement women who have a habitual low iodine intake.

Materials and Methods: Self-reported healthy women, pre-menopausal who avoid iodine-rich foods were randomised to: P1) reformulated food (pizza)with seaweed ingredient, or P2) a control food, similar to P1 but without supplemental iodine, or S1) control, empty capsules, or S2) PureSea Natural ascophyllum nodosum seaweed capsules, the ingredient used in P1. Capsules or food were to be consumed three times per week (providing 400μg iodine per intake). At least 10 spot urine samples were collected per person over at least 3 days preceding each study point. Urinary iodine was measured with a modified Sandell-Koltoff assay.

Results: Participants (n = 96, median age 29, IQR 23–42) had a habitual iodine intake of 64μg/d (IQR 39–119, no detectable difference between groups). Dropout rates at 3-month were 41% (P1 &P2 each), 21% for S1, 11% for S2.

Baseline urinary iodine concentration (UIC) was low/marginal, at 66μg/L (IQR 34-71), 64μg/L (IQR 40-96), 54μg/L (IQR 31-86) and 39μg/L (IQR 21-64) for P1, P2, S1 and S2 respectively (no difference between groups, p > 0.05).

Change in UIC differed between groups at week-2 (p < 0.001), increasing in P1 & S2: by 45μg/L (IQR 2-69), and 35μg/L (IQR 13-48), respectively, decreasing in S1: -14μg/L (IQR –24-(–1)), with no change in group P2. This remained true for groups S1 & S2 when urinary iodine excretion was corrected for creatinine.

After 3 months, differences in changes from baselines remained between groups (p < 0.01), with an increase in groups P1 and S2: 28μg/L (IQR 1-112), 43μg/L (IQR 23-93) but not groups P2 or S1. This remained true when UIC was corrected for creatinine.

Changes in weight between and within groups were not detected at either time points, with group median changes within 2 kg of baseline weight.

Discussion: Iodine-rich seaweed is effective in increasing the iodine status of women with a low habitual iodine intake, as a supplement, or as an ingredient in a cooked reformulated product. In term of feasibility, large attrition in the food groups P1 and P2 demands further attention, for interpretation of data and future translation of the findings.

Background: Front-of-package (FOP) nutrition labelling has become a core component of policy recommendations to address the growing burden of diet-related non-communicable disease globally. The CODEX Committee on Food Labelling is in the process of establishing standardized criteria for the definition of “high-in” for use with FOP labels highlighting excessive amounts of fats, sugars and sodium in foods. Recently, as part of Health Canada's Healthy Eating Strategy, regulations requiring the mandatory display of high-in FOP symbols have been published. The aim of this study was to investigate the extent to which these symbols would appear on foods and beverages in the Canadian prepackaged food supply, both overall and by food category.

Methods: Foods and beverages in the University of Toronto's Food Label Information Program database 2013 (n = 15,277) were assessed for the prevalence of products that would have to display a symbol based on criteria published in the draft Canadian regulations. The criteria include thresholds based on the % Daily Value (DV) for each nutrient, above which, products would be required to display a FOP symbol for that nutrient. Exemptions are provided for fruits and vegetables without added sodium, sugars, or saturated fats, non-flavoured whole or partly skimmed milk, eggs, sweetening agents (i.e. sugar, honey, syrups and molasses) and table salt.

Results: 61.7% (n = 10,251) of products would be required to display at least one symbol. Of these, 52.3% (n = 5,358) would have a sodium symbol, 41.9% (n = 4,295) a saturated fats symbol and 41.0% (n = 4,207) a sugars symbol. Overall, 37% of products would display a symbol for more than one nutrient. The highest concentration of symbols were found on processed meats (93.8%), soups (93.0%), desserts (87.2%), sugars and sweets (82.3%), dairy (76.9%) and bakery products (71.0%).

Discussion: This is the first study to evaluate the impact of proposed regulations for the mandatory display of FOP symbols on Canadian prepackaged foods. Findings identify a high concentration of symbols in categories contributing meaningfully to dietary sodium, sugars, and saturated fats intakes, but also in categories for which consumption is discouraged in national dietary guidelines (e.g. processed meats, desserts). The findings presented here will inform ongoing discussions on how best to optimize criteria underpinning the display of FOP “high-in” labels.

Introduction: Empirical evidence of the effects of product placement strategies on consumers’ dietary and purchasing behaviours is limited. A systematic review was conducted to collate the evidence, both observational and intervention, about how food and beverage product placement (availability and positioning) in food stores, influence dietary behaviours and sales.

Materials and Methods: Nine databases were systematically searched, using both MeSH and free text terms, for articles published between 2005 and February 2019. Titles and abstracts were screened by one reviewer. If eligible, two reviewers performed data extraction and assessed each article for risk of bias in relation to the research question based on predefined criteria according to guidelines from the Centre for Reviews and Dissemination. Results were synthesised using a vote counting technique which recorded the significance level and the direction of the effect in relation to the expected relationship with health improvement. This systematic review was registered with Prospero CRD: 42016048826.

Results: The search yielded 16,342 potential articles of which 38, 17 observational and 21 intervention articles, met the inclusion criteria. The heterogeneous nature of these studies meant meta-analyses were not possible.

Two observational studies were classified as having a high risk of bias, 6 moderate and 9 as low risk of bias. Two intervention studies were classified as having moderate risk of bias and the remaining 19 as high risk of bias.

For observation studies, six studies included sales outcomes, nine included diet outcomes and four included BMI outcomes. For intervention studies, 19 included sales outcomes, four included diet outcomes and one included BMI outcomes. 76 outcomes from observational studies and 89 outcomes from intervention studies were included in the vote counting synthesis. 76% of observational outcomes showed associations with placement strategies in the expected direction for health improvement with 41% being significant. 72% of intervention outcomes showed associations in the expected direction with 33% being significant.

Discussion: The evidence suggests food and beverage placement strategies in food stores have the potential to support healthier food-related behaviours. The difficulties in conducting high-quality intervention studies may be a contributing factor to the large number of non-significant results that have been published. This review provides evidence in support of the UK Government's updated Childhood Obesity Plan to restrict the prominent placement of unhealthy food in food stores.

Methods: In this cross-sectional descriptive study, dietitians were recruited through the weekly Association of Dietetics in South Africa newsletter and social media platforms. Dietitians (n = 138) completed an electronic survey using Survey Monkey. The survey consisted of five sections; consent, demographics, awareness of the sugar taxation, opinions and SSB purchasing/consumption of patients. Descriptive statistics was performed using Statistica version 13.2.

Results: Nearly all of the dietitians were female (95%, n = 131), with a mean age of 33 years (± 9.73). Two thirds were qualified with a four year professional Honors degree (67%, n = 92) and 25% (n = 34) had a Master's degree. A majority of dietitians were employed full time (80%, n = 111), working mainly in the area of clinical nutrition (26%, n = 33) and private practice (21%, n = 27). Most dietitians (98%, n = 127) were aware of the sugar tax, although 75% (n = 98) did not know the sugar content where tax was applicable and 78% (n = 101) did not know the tax amount levied. Dietitians opinion towards the HPL was positive (75%, n = 94), although 56% (n = 68) disagreed it would reduce obesity. A majority of dietitians (86%, n = 108) indicated other factors contribute to obesity. Most dietitians consult with patients (73%, n = 90). Patients were mainly from a lower socio-economic status (43%, n = 60). Dietitians disagreed it would reduce their patient's beverage consumption (61%, n = 55), with most agreeing the tax was too little to make a difference (71%, n = 89) and that it is mainly due to patient's liking the taste for not changing (46%, n = 36). Dietitians (34%, n = 31) use the SBL as a motivational tool, while 83% (n = 75) teach their patients to look for sugar on food labels.

Conclusion: From the dietitian's perspective, the sugar taxation has not influenced their patient's consumption behaviour. Dietitians have a positive attitude toward the HPL although they don't think it will reduce the prevalence of obesity. Other strategies should be employed to reduce sugar consumption in the SA population.